Others titles

  • Disabled Beneficiaries Reimbursement for Skilled Nursing Facility by State and County of Residence
  • Medicare Fee-For-Service Data for County by Aged, Disabled, and ESRD Beneficiaries
  • Repricing Of FFS Claims Disabled Skilled Nursing Facility Reimbursement 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
  • Disabled Skilled Nursing Facility Reimbursement

Repricing FFS Claims Disabled Skilled Nursing Facility Data

The dataset includes data for Disabled beneficiaries Skilled Nursing Facility Reimbursement by state and county of residence. Medicare Fee-For-Service (FFS) data for each county broken down by aged, disabled, and end-stage renal disease (ESRD) beneficiaries.

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Description

The historical claims data for 2010 through 2014 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. The adjusted or repriced spreadsheets for Aged and Disabled reflect the annual impact of the repricing of 2010-2014 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). Medicare Fee-For-Service (FFS) data for each county broken down by aged, disabled, and end-stage renal disease (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.

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 Disabled beneficiaries repricing adjustments to the 2010-2014 skilled nursing facility reimbursement data to reflect the most current wage index (Data cells with less than 11 beneficiaries have been suppressed for privacy).

About this Dataset

Data Info

Date Created

2016-04-04

Last Modified

2020-04-05

Version

2020-04-05

Update Frequency

Annual

Temporal Coverage

2014-2018

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, Disabled Skilled Nursing Facility Reimbursement

Other Titles

Disabled Beneficiaries Reimbursement for Skilled Nursing Facility by State and County of Residence, Medicare Fee-For-Service Data for County by Aged, Disabled, and ESRD Beneficiaries, Repricing Of FFS Claims Disabled Skilled Nursing Facility Reimbursement by State and County of Residence

Data Fields

Name Description Type Constraints
FIPS_CodeIdentification codestring-
StateName of statestring-
CountyName of Countystring-
Year_2014Repricing adjustments to the 2014 skilled nursing facility reimbursement data to reflect the most current wage indexnumberlevel : Ratio
Year_2015Repricing adjustments to the 2015 skilled nursing facility reimbursement data to reflect the most current wage indexnumberlevel : Ratio
Year_2016Repricing adjustments to the 2016 skilled nursing facility reimbursement data to reflect the most current wage indexnumberlevel : Ratio
Year_2017Repricing adjustments to the 2017 skilled nursing facility reimbursement data to reflect the most current wage indexnumberlevel : Ratio
Year_2018Repricing adjustments to the 2018 skilled nursing facility reimbursement data to reflect the most current wage indexnumberlevel : Ratio

Data Preview

FIPS CodeStateCountyYear 2015Year 2016Year 2017Year 2018Year 2019
1000ALABAMAAUTAUGA-8752.2711868.0127997.9946905.9318185.72
1010ALABAMABALDWIN38626.83-57057.32-125552.37-245334.11-20984.93
1020ALABAMABARBOUR-31246.04-23710.34-18089.42-5761.63-335.3
1030ALABAMABIBB-14801.03-10533.86-2983.08-8756.53-331.53
1040ALABAMABLOUNT-14636.22-16339.06-2778.11-6261.026977.61
1050ALABAMABULLOCK-10650.75-7909.04-5204.96-3751.072058.01
1060ALABAMABUTLER-33614.56-34846.69-20989.41-6688.461432.94
1070ALABAMACALHOUN-225918.9725717.142089.62169404.8-132023.02
1080ALABAMACHAMBERS-79995.67-57962.07-31516.76-28934.82-11883.08
1090ALABAMACHEROKEE-26493.88-15910.06-13270.08-7902.621609.92