Repricing FFS Claims Aged Disabled Durable Medical Equipment Non-CBA

$79 / year

The dataset includes the data for aged and disabled, Medicare Part B, beneficiaries reimbursement for Durable Medical Equipment Non-Competitive Bidding Area (Non-CBA) by state and county of residence. The data included cover the years 2010-2016.

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

2010-2016

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

Aged Beneficiaries Reimbursement, Disabled Beneficiaries Reimbursement, Durable Medical Equipment, Medicare Fee for Service Data, Part A and Part B Cost Contracts, Medicare Fee-for-Service Reimbursement, Medicare Advantage Fee-For-Service, ACO Part A and Part B Reimbursement, Medicare Spending per Beneficiary, Aged Durable Medical Equipment, Disabled Durable Medical Equipment

Other Titles

Aged Disabled Beneficiaries Reimbursement for Durable Medical Equipment Non-CBA, Aged Disabled Beneficiaries Medicare Fee-For-Service Data By County, Repricing Of FFS Claims Aged Disabled Durable Medical Equipment Non-CBA By County

NameDescriptionTypeConstraints
Beneficiaries_TypeSpecifies if the beneficiaries data are for Aged or Disabled or combined data for Aged and Disabledstring-
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-
Part_B_Reimbursement_Non_CBA_2010Repricing adjustments to the Part B 2010 reimbursement data for fee-for-service Durable Medical Equipment Non-CBA; only separate data for aged and for disablednumberlevel : Ratio
Part_B_Reimbursement_Non_CBA_2011Repricing adjustments to the Part B 2011 reimbursement data for fee-for-service Durable Medical Equipment Non-CBAintegerlevel : Ratio
Part_B_Reimbursement_Non_CBA_2012Repricing adjustments to the Part B 2012 reimbursement data for fee-for-service Durable Medical Equipment Non-CBAintegerlevel : Ratio
Part_B_Reimbursement_Non_CBA_2013Repricing adjustments to the Part B 2013 reimbursement data for fee-for-service Durable Medical Equipment Non-CBAintegerlevel : Ratio
Part_B_Reimbursement_Non_CBA_2014Repricing adjustments to the Part B 2014 reimbursement data for fee-for-service Durable Medical Equipment Non-CBAintegerlevel : Ratio
Part_B_Reimbursement_Non_CBA_2015Repricing adjustments to the Part B 2015 reimbursement data for fee-for-service Durable Medical Equipment Non-CBA; only combined data for aged and for disabled (starting 2015)integerlevel : Ratio
Part_B_Reimbursement_Non_CBA_2016Repricing adjustments to the Part B 2016 reimbursement data for fee-for-service Durable Medical Equipment Non-CBA; only combined data for aged and for disabled (starting 2015)integerlevel : Ratio
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