Repricing FFS Claims ACO Combined Data Aged Disabled PartA And PartB

$79 / year

The dataset includes the Accountable Care Organizations (ACOs) combined data for aged and disabled beneficiaries reimbursement for part A and part B by state and county of residence for the years 2012-2016.

Complexity

The historical claims data is used to rebase the Medicare Advantage (MA) Fee-For-Service capitation rate book for the years that follows. The historical claims data is rebased to reflect the most current wage and cost indices, repriced the claims to account for the changes made by the Affordable Care Act (ACA) to payments to disproportionate share hospitals, and also repriced durable medical equipment claims to account for the change in prices associated with the competitive bid program. The adjusted or repriced datasets for aged and disabled reflect the annual impact of the repricing of FFS claims. The institutional claims – acute inpatient hospital, skilled nursing facility, hospital outpatient, home health agency, and physician – reflect the repricing of the original claims with the current geographic practice cost index (GPCI). Adjustments have also been made to reflect the transition of disproportionate share hospital (DSH) payments to uncompensated care payments (UCP). The effects of competitive bidding for durable medical equipment (DME) are reflected in the corresponding adjustment dataset. An additional adjustment to the 2012-2016 claims to account for shared savings payments and shared losses is made to Medicare Shared Savings Program (MSSP) ACOs, including ACOs from Pioneer program for 2012 and without the ACOs of Pioneer program for 2013-2016. Dataset contains information on ACOs combined data for aged and disabled beneficiaries reimbursement for part A and part B by state and county of residence.

Data cells with less than 11 beneficiaries have been suppressed for privacy.

Date Created

2016-04-04

Last Modified

2018-02-01

Version

2018-02-01

Update Frequency

Annual

Temporal Coverage

2012-2016

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare and Medicaid Services

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

ACO Combined Data, ACO Aged and Disabled Beneficiary Reimbursement, ACO Part A and Part B Reimbursement, Medicare Fee for Service, Medicare Spending per Beneficiary, Medicare Advantage Fee-For-Service, Repricing FFS Claims, Disabled Beneficiaries Reimbursement, Aged Beneficiaries Reimbursement

Other Titles

Repricing of FFS Claims ACO Combined Data Parts A and B by State and County of Residence, ACO Combined Data for Aged and Disabled Beneficiaries Reimbursement for Part A and Part B, Fee For Service Reimbursement Aged and Disabled beneficiaries PartA PartB

NameDescriptionTypeConstraints
County_FIPS_CodeThe 5 digits county Federal Information Processing Standard (FIPS) codestring-
State_AbbreviationThe abbreviated name of the statestring-
StateThe full name of the statestring-
CountyName of countystring-
Reimbursement_2012Adjustments to reimbursement combined data for aged and disabled Parts A and B for shared saving payments and shared losses made to ACOs, including those from Pioneer programintegerlevel : Ratio
Reimbursement_2013Adjustments to reimbursement combined data for aged and disabled Parts A and B for shared saving payments and shared losses made to ACOsintegerlevel : Ratio
Reimbursement_2014Adjustments to reimbursement combined data for aged and disabled Parts A and B for shared saving payments and shared losses made to ACOsintegerlevel : Ratio
Reimbursement_2015Adjustments to reimbursement combined data for aged and disabled Parts A and B for shared saving payments and shared losses made to ACOsintegerlevel : Ratio
Reimbursement_2016Adjustments to reimbursement combined data for aged and disabled Parts A and B for shared saving payments and shared losses made to ACOsintegerlevel : Ratio
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