Repricing FFS Claims Aged Disabled Hospice PartA And PartB

$179 / year

The dataset includes the data for aged and disabled, Medicare Part A and Part B, beneficiaries reimbursement for the hospice by state and county of residence. The data included cover the years 2014 to 2016.

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) Accountable Care Organizations (ACO), 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

Aged Beneficiaries Reimbursement, Disabled Beneficiaries Reimbursement, Hospice Reimbursement, Medicare Fee for Service Data, Medicare Cost, Medicare Fee-for-Service Reimbursement, Medicare Advantage Fee-For-Service, ACO Part A and Part B Reimbursement, Medicare Spending Per Beneficiary, Cost Management

Other Titles

Aged Disabled Beneficiaries Reimbursement For Hospice, Aged Disabled Beneficiaries Medicare Fee-For-Service Data By County, Repricing Of FFS Claims Aged Disabled Hospice 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_Enrollment_HospiceThe number of Medicare part A enrollees who benefit from hospice care servicesintegerlevel : Ratio
Part_A_Reimbursement_HospiceRepricing adjustments to the Part A reimbursement data for fee-for-service hospice costsintegerlevel : Ratio
Part_A_Per_Capita_HospiceRepricing adjustments to the Part A reimbursement data for fee-for-service hospice costs, per Medicare part A enrollee who benefits of hospice care servicesnumberlevel : Ratio
Part_A_Reimbursement_Hospice_Without_IME_DSH_DGMERepricing adjustments to the Part A reimbursement data for fee-for-service hospice costs, without direct graduate medical education (DGME) and indirect medical education (IME) expenditures and disproportionate share hospital (DSH) expendituresintegerlevel : Ratio
Part_A_Per_Capita_Hospice_Without_IME_DSH_DGMERepricing adjustments to the Part A reimbursement data for fee-for-service hospice costs without DGME, IME and DSH costs, per Medicare part A enrollee who benefits of hospice care servicesnumberlevel : Ratio
Part_B_Enrollment_HospiceThe number of Medicare part B enrollees who benefit from hospice care servicesintegerlevel : Ratio
YearBeneficiaries_TypeFIPS_CodeState_AbbreviationStateCountyPart_A_Enrollment_HospicePart_A_Reimbursement_HospicePart_A_Per_Capita_HospicePart_A_Reimbursement_Hospice_Without_IME_DSH_DGMEPart_A_Per_Capita_Hospice_Without_IME_DSH_DGMEPart_B_Enrollment_Hospice
2014Aged45741TXTexasKing2020
2014Disabled45741TXTexasKing
2014Disabled13120IDIdahoCamas
2014Disabled13160IDIdahoClark
2014Aged2180AKAlaskaNome635493
2014Disabled12040HIHawaiiKauai
2014Disabled45150TXTexasBorden
2014Disabled45732TXTexasKenedy
2014Disabled45762TXTexasLoving
2014Aged2140AKAlaskaKobuk444344