Others titles
- Medicare HHRG Aggregate Table Payment State Data 2013
- Medicare Standardized Payment HHRG Aggregate Table 2013
- Medicare HHRG Aggregate Table Utilization and Payment Data 2013
- Medicare Home Health Resource Group Cost Data 2013
Keywords
- Medicare Payments
- HHA Submitted Charges
- Medicare Rate
- Medicare Home
- Medicare
- Home Health Agency
- Utilization and Payment Data
Medicare HHRG Aggregate Table By State 2013
The “HHRG by State Aggregate Table” contains information on utilization, Medicare payment, and submitted charges organized by HHRG by state.
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Description
The Home Health Agency PUF contains information on utilization, payment (Medicare payment and standardized payment), and submitted charges organized by Centers for Medicare and Medicaid Services (CMS) Certification Number (6-digit provider identification number), Home Health Resource Group (HHRG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Home Health Agency PUF covers calendar year 2013 and contains 100% final-action (i.e., all claim adjustments have been resolved) home health agency institutional claims for the Medicare fee-for-service (FFS) population.
The spending and utilization data in the Home Health Agency PUF are aggregated to the following:
a) the identification number for the agency, and
b) the Home Health Resource Group (HHRG).
Medicare makes payment under the home health prospective payment system on the basis of a national standardized 60-day episode payment rate that is adjusted for the applicable case-mix and wage index. The national standardized 60-day episode rate includes the six home health disciplines (skilled nursing, home health aide, physical therapy, speech-language pathology, occupational therapy, and medical social services). To adjust for case-mix, patients are assigned to one of 153 home health resource groups (HHRG). The clinical severity level, functional severity level, and service utilization are used to place the patient in a particular HHRG. Each HHRG has an associated case-mix weight which is used in calculating the payment for an episode. For episodes with four or fewer visits, Medicare pays national per-visit rates based on the discipline(s) providing the services. An episode consisting of four or fewer visits within a 60-day period receives what is referred to as a low utilization payment adjustment (LUPA). For certain cases that exceed a specific cost threshold, an outlier adjustment may also be available.
About this Dataset
Data Info
Date Created | 2015-12-09 |
---|---|
Last Modified | 2017-10-12 |
Version | 2017-10-12 |
Update Frequency |
Annual |
Temporal Coverage |
2013 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare and Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Medicare Payments, HHA Submitted Charges, Medicare Rate, Medicare Home, Medicare, Home Health Agency, Utilization and Payment Data |
Other Titles | Medicare HHRG Aggregate Table Payment State Data 2013, Medicare Standardized Payment HHRG Aggregate Table 2013, Medicare HHRG Aggregate Table Utilization and Payment Data 2013, Medicare Home Health Resource Group Cost Data 2013 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Home_Health_Resource_Group_Category | Home health resource group Code | string | - |
Episode_Type | Description of the HHRG category | string | - |
Therapies | Number of therapies received | string | - |
Clinical_Severity_Level | Severity of the illness. Clinical severity is a Measure of disability of 3 levels, 3 being most severe | integer | level : Ratio |
Functional_Severity_Level | Severity of physical function. Functional severity is a Measure of disability of 3 levels, 3 being most severe | integer | level : Ratio |
Service_Severity_Level | integer | level : Ratio | |
State | Name of State | string | - |
Total_Episodes | Total count of episodes provided by a specific home health agency or in a unique HHRG category in the calendar year | integer | level : Ratio |
Distinct_Users | Number of distinct Medicare beneficiaries receiving at least one home health episode in the calendar year. Beneficiaries may receive multiple home health episodes per year but are only counted once in this field. | integer | level : Ratio |
Average_HHA_Charge_Amount | Average of the charges that the home health agency submitted for non-LUPA episodes. | integer | level : Ratio |
Average_HHA_Medicare_Payment_Amount | Average amount that Medicare paid for non-LUPA episodes. Home health services do not have any cost-sharing requirements and the Medicare payment amount will equal the allowed amount. | integer | level : Ratio |
Average_HHA_Medicare_Standard_Payment_Amount | Average amount that Medicare paid for non-LUPA episodes adjusted for geographic differences in payment rates | integer | level : Ratio |
Data Preview
Home Health Resource Group Category | Episode Type | Therapies | Clinical Severity Level | Functional Severity Level | Service Severity Level | State | Total Episodes | Distinct Users | Average HHA Charge Amount | Average HHA Medicare Payment Amount | Average HHA Medicare Standard Payment Amount |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | AK | 79 | 75 | 2055 | 2096 | 1785 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | AL | 1320 | 1235 | 1448 | 1434 | 1764 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | AR | 1052 | 976 | 1726 | 1504 | 1776 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | AZ | 1239 | 1186 | 1633 | 1762 | 1740 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | CA | 8018 | 7661 | 1901 | 2185 | 1760 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | CO | 1204 | 1151 | 1559 | 1797 | 1759 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | CT | 1926 | 1857 | 1437 | 1985 | 1754 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | DC | 212 | 208 | 1823 | 1850 | 1763 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | DE | 412 | 403 | 1645 | 1770 | 1724 |
1AFK | Early Episode | 0-13 | 1 | 1 | 1 | FL | 9756 | 9190 | 1406 | 1616 | 1739 |