Medicare Hospital Spending by Claim

$179 / year

This dataset includes a list of all hospitals that have been registered with Medicare and their Medicare Spending per Beneficiary (MSPB). The list includes Hospital Name, Period of hospital admission and Claim Type. It also includes Averages as well as Percentages of Spending per Episode for Hospital, State and Nation.

Complexity

This dataset is also known as Medicare Spending per Beneficiary (MSPB) Spending Breakdowns by Claim Type file. This dataset shows average spending levels during hospitals’ Medicare Spending per Beneficiary (MSPB) episodes.

An MSPB episode includes all Medicare Part A and Part B claims paid during the period from 3 days prior to a hospital admission through 30 days after discharge. These average Medicare payment amounts have been price-standardized to remove the effect of geographic payment differences and add-on payments for indirect medical education (IME) and disproportionate share hospitals (DSH). CMS uses the information on this webpage to calculate a hospital’s MSPB Measure value, which is reported on Hospital Compare.

Specifically, the MSPB Measure methodology risk-adjusts the values on this webpage to account for beneficiary age and severity of illness. This webpage provides the pre-risk-adjusted values to help the public understand the MSPB Measure and its composition.

The dataset under discussion divides each hospital’s average episode spending levels into three time periods:
1) 1 to 3 days Prior to Index Hospital Admission,
2) During Index Hospital Admission, and
3) 1 through 30 days After Discharge from Index Hospital Admission.

Within these three time periods, the average episode spending levels are further broken down into the seven claim types (e.g. inpatient, outpatient). The start and end date of this data set is January 01, 2015 to December 31st, 2015.

Date Created

2012-07-07

Last Modified

2020-01-28

Version

2020-01-28

Update Frequency

Annual

Temporal Coverage

2018

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare & Medicaid Services (CMS);

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Hospital Compare, Medicare Hospital Spending, Spending Claim Types, Meicare Payment

Other Titles

Hospital Compare Medicare Hospital Spending, Different Claim Types for Medicare Hospital Spending, Medicare Spending per Beneficiary (MSPB)

NameDescriptionTypeConstraints
Hospital_NameName of the hospital (also referred to as the provider)stringrequired : 1
Provider_IDCMS certification number (CCN). Identification number of the hospital within the CMS dataset. The CCN for providers and suppliers is a 6 digit number. The first 2 digits identify the State in which the provider is located. The last 4 digits identify the type of facility.integerlevel : Nominal required : 1
State_AbbreviationTwo letter abbreviation of different states of U.S. This includes information on hospitals in:stringrequired : 1
Hospital_Admission_PeriodIt represents the relevant time period during the Medicare Spending per Beneficiary (MSPB) episode. It contains one of the three episode time periods discussed above: (i) 1 to 3 days Prior to Index Hospital Admission, (ii) During Index Hospital Admission, andstringrequired : 1
Claim_TypeEpisode spending is broken down by seven claim settings. These include: (i) home health agency, (ii) hospice, (iii) inpatient, (iv) outpatient, (v) skilled nursing facility, (vi) durable medical equipment, and (vii) carrier. In addition, the “Total” claim type contains the total average price-standardized non-risk-adjusted spending for each hospitalization episode.stringrequired : 1
Avg_Spending_Per_Episode_Per_HospitalAverage spending across each of the time period/claim type combinations for each hospital. The sum of the average spending per episode across these time period/claim type combinations is presented in an additional "Complete Episode/Total" category for each hospital entry.integerlevel : Ratio
Avg_Spending_Per_Episode_Per_StateAverage spending across each of the time period/claim type combinations for the state in which the hospital is located. The sum of the average spending per episode across these time period/claim type combinations is presented in an additional "Complete Episode/Total" category for each state.integerlevel : Ratio
Avg_Spending_Per_Episode_Per_NationAverage spending across each of the time period/claim type combinations for the nation. The sum of the average spending per episode across these time period/claim type combinations is presented in an additional "Complete Episode/Total" category for each nation.integerlevel : Ratio
Percent_of_Spending_Per_HospitalThe portion of the total average episode spending amount that each of a hospital’s time period/claim type average episode spending amounts contributes to the total.numberlevel : Ratio
Percent_of_Spending_Per_StateThe portion of the total average episode spending amount that each of a state’s time period/claim type average episode spending amounts contributes to the total.numberlevel : Ratio
Percent_of_Spending_Per_NationThe portion of the total average episode spending amount that each of a nation’s time period/claim type average episode spending amounts contributes to the total.numberlevel : Ratio
Hospital NameProvider IDState AbbreviationHospital Admission PeriodClaim TypeAvg Spending Per Episode Per HospitalAvg Spending Per Episode Per StateAvg Spending Per Episode Per NationPercent of Spending Per HospitalPercent of Spending Per StatePercent of Spending Per Nation
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionHome Health Agency2116130.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionHospice2110.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionInpatient6770.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionOutpatient2191081520.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionSkilled Nursing Facility1220.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionDurable Medical Equipment9880.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001AL1 to 3 days Prior to Index Hospital AdmissionCarrier5385375850.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001ALDuring Index Hospital AdmissionHome Health Agency0000.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001ALDuring Index Hospital AdmissionHospice0000.00.00.0
SOUTHEAST ALABAMA MEDICAL CENTER10001ALDuring Index Hospital AdmissionInpatient106699801101390.50.50.5