Others titles
- End-Stage Renal Disease Beneficiaries For Part A And Part B By State and County of Residence
- Medicare Fee-For-Service Data for County by Aged, Disabled, and ESRD Beneficiaries
- Repricing Of FFS Claims End-Stage Renal Disease (ESRD) Beneficiaries by State and County of Residence
Keywords
- Medicare Fee For Service
- FFS Insurance Medicare
- FFS
- FFS Cost
- Medicare Spending Per Beneficiaries
- Fee For Service Reimbursement
- Repricing of FFS Claims
- Dialysis
- ESRD
Repricing FFS Claims Dialysis PartA PartB
The dataset includes data for End-Stage Renal Disease (ESRD) beneficiaries or Dialysis for Part A Part B by state and county of residence. Medicare fee-for-service (FFS) data for each county broken down by aged, disabled, and ESRD beneficiaries.
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Description
The historical claims data for 2015 through 2021 is used to rebase the Medicare Advantage (MA) Fee-For-Service (FFS) capitation rate book for 2017. 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. Medicare fee-for-service (FFS) data for each county broken down by aged, disabled, and ESRD beneficiaries including data on total Medicare fee-for-service reimbursement and enrollment for Parts A and B, the corresponding per capita reimbursement, for Part A, reimbursement for direct (DME) and indirect medical education (IME) expenditures and disproportionate share expenditures (DSH), and the per capita expenditures with the medical education and disproportionate share expenditures removed. The adjusted or repriced spreadsheets for Aged and Disabled reflect the annual impact of the repricing of 2015-2021 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 wage index / 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 file. An additional adjustment to 2012, 2013, and 2014 claims to account for shared savings payments and shared losses are made to Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACO) and Pioneer ACOs. The dataset includes End-Stage Renal Disease (ESRD) beneficiaries or Dialysis – 2015 Enrollment, Reimbursement, Per Capita Cost (Monthly) For Part A And Part B By State. Beneficiaries Enrolled In Both Parts A And B.
About this Dataset
Data Info
Date Created | 2016-04-04 |
---|---|
Last Modified | 2022-03-27 |
Version | 2022-03-27 |
Update Frequency |
Annual |
Temporal Coverage |
2016-2022 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicaid and Medicare Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Medicare Fee For Service, FFS Insurance Medicare, FFS, FFS Cost, Medicare Spending Per Beneficiaries, Fee For Service Reimbursement, Repricing of FFS Claims, Dialysis, ESRD |
Other Titles | End-Stage Renal Disease Beneficiaries For Part A And Part B By State and County of Residence, Medicare Fee-For-Service Data for County by Aged, Disabled, and ESRD Beneficiaries, Repricing Of FFS Claims End-Stage Renal Disease (ESRD) Beneficiaries by State and County of Residence |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
FIPS_Code | Identification code | string | - |
State | Name of state | string | - |
PartA_Enrollment_Months | Medicare Fee-For-Service Part A enrollment | number | level : Ratio |
PartA_Total_Reimbursement_In_Thousands | Medicare Fee-For-Service Part A total reimbursement | number | level : Ratio |
PartA_Total_Per_Capita | Medicare Fee-For-Service Part A total per-capita expenditure | number | level : Ratio |
PartA_IME_In_Thousands | Medicare Fee-For-Service Part A indirect medical education (IME) expenditures | number | level : Ratio |
PartB_Enrollment_In_Months | Medicare Fee-For-Service Part B enrollment | number | level : Ratio |
PartB_Total_Reimbursement_In_Thousands | Medicare Fee-For-Service Part B total reimbursement | number | level : Ratio |
PartB_Total_Per_Capita | Medicare Fee-For-Service Part B total per-capita expenditure | number | level : Ratio |
Risk_Score_For_Non_Pace_Plan | Medicare Fee-For-Service risk score for non pace plan | number | level : Ratio |
Risk_Score_For_Pace_Plan | Medicare Fee-For-Service risk score for pace plan | number | level : Ratio |
Data Preview
FIPS Code | State | PartA Enrollment Months | PartA Total Reimbursement In Thousands | PartA Total Per Capita | PartA IME In Thousands | PartB Enrollment In Months | PartB Total Reimbursement In Thousands | PartB Total Per Capita | Risk Score For Non Pace Plan | Risk Score For Pace Plan |
1 | Alabama | 68895 | 160046 | 2323.04 | 4279 | 68895 | 267999 | 3889.96 | 0.9545 | 0.9554 |
2 | Alaska | 5797 | 11257 | 1941.93 | 189 | 5797 | 28372 | 4894.34 | 0.9532 | 0.9431 |
3 | Arizona | 59656 | 161850 | 2713.05 | 4937 | 59656 | 244321 | 4095.51 | 0.9804 | 0.9823 |
4 | Arkansas | 39910 | 93506 | 2342.92 | 2294 | 39910 | 151743 | 3802.13 | 0.9522 | 0.9537 |
5 | California | 362352 | 1251625 | 3454.17 | 43231 | 362352 | 1765600 | 4872.61 | 1.0235 | 1.017 |
6 | Colorado | 31009 | 66736 | 2152.14 | 2474 | 31009 | 127563 | 4113.73 | 0.9678 | 0.9677 |
7 | Connecticut | 29322 | 101707 | 3468.64 | 9519 | 29322 | 141212 | 4815.9 | 1.0267 | 1.0488 |
8 | Delaware | 14277 | 37581 | 2632.26 | 1437 | 14277 | 60866 | 4263.25 | 0.9772 | 0.9782 |
9 | District of Columbia | 12858 | 44376 | 3451.23 | 4862 | 12858 | 55020 | 4279.02 | 1.0495 | 1.0457 |
10 | Florida | 209060 | 658952 | 3151.97 | 18974 | 209060 | 895076 | 4281.43 | 1.027 | 1.037 |