Repricing FFS Claims Aged Disabled Cost Contracts For PartA And PartB

$179 / year

The dataset includes aged and disabled beneficiaries’ reimbursement data for cost contracts for part A and part B by state and county for years 2014-2016. It also contains Medicare Fee-For-Service (FFS) data for each county by aged and disabled beneficiaries including total Medicare FFS reimbursement data for Parts A and B, reimbursement for direct graduate education (DGME) and indirect medical education (IME) expenditures and disproportionate share hospital (DSH) expenditures for Part A.

Complexity

The historical claims data is used to rebase the Medicare Advantage (MA) Fee-For-Service (FFS) capitation rate book for the years that follow. 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. The 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

2014-2016

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

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

Other Titles

Aged Beneficiaries Reimbursement Cost Contracts Part A and Part B by State and County of Residence, Repricing Of FFS Claims Aged Cost Contracts For PartA PartB by State and County of Residence, Medicare fee-for-service data for aged, disabled, and ESRD beneficiaries by County

NameDescriptionTypeConstraints
YearThe year of the corresponding datadate-
Beneficiaries_TypeSpecifies if the beneficiaries data are for Aged or Disabled or combined data for Aged and Disabled; starting with 2015 available data the values for aged and disabled beneficiaries were combinedstringenum : Array
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-
Part_A_Total_ReimbursementMedicare fee-for-service Part A total reimbursement cost contractsintegerlevel : Ratio
Part_A_Total_Reimbursement_Without_IME_DSH_DGMEMedicare fee-for-service Part A total reimbursement without direct graduate medical education (DGME) and indirect medical education (IME) expenditures and disproportionate share hospital (DSH) expendituresintegerlevel : Ratio
Part_A_Reimbursement_For_IMEMedicare fee-for-service Part A reimbursement for indirect medical education (IME) expenditures; data available starting with 2015 dataintegerlevel : Ratio
Part_A_Reimbursement_For_DSHMedicare fee-for-service Part A reimbursement for disproportionate share hospital (DSH) expenditures; data available starting with 2015 dataintegerlevel : Ratio
Part_A_Reimbursement_For_DGMEMedicare fee-for-service Part A reimbursement for direct graduate medical education (DGME) expenditures; data available starting with 2015 dataintegerlevel : Ratio
Part_B_Total_ReimbursementMedicare fee-for-service Part B total reimbursement cost contractsintegerlevel : Ratio
YearBeneficiaries_TypeFIPS_CodeState_AbbreviationStateCountyPart_A_Total_ReimbursementPart_A_Total_Reimbursement_Without_IME_DSH_DGMEPart_A_Reimbursement_For_IMEPart_A_Reimbursement_For_DSHPart_A_Reimbursement_For_DGMEPart_B_Total_Reimbursement
2014AgedGUGuamGuam
2014Aged16460IAIowaIda
2014DisabledGUGuamGuam
2014Aged16140IAIowaCass
2014Aged16200IAIowaClay
2014Aged16470IAIowaIowa
2014Aged16720IAIowaPage
2014Aged45113TXTexasBee
2014Aged46120UTUtahKane
2014Aged46160UTUtahRich