Repricing FFS Claims Disabled Uncompensated Care Reimbursement Data

$179 / year

The dataset includes data for Disabled beneficiaries repricing adjustments to the 2010-2014 uncompensated care 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.

Complexity

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. Dataset includes Disabled beneficiaries repricing adjustments to the 2010-2014 uncompensated care reimbursement data to reflect the most current rules (Disproportionate Share Repriced To Uncompensated Care Until September 2013) (Data cells with less than 11 beneficiaries have been suppressed for privacy).

Date Created

2016-04-04

Last Modified

2016-04-04

Version

2016-04-04

Update Frequency

Annual

Temporal Coverage

2010-2014

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

Cost Management, Medicare Cost, Medicare Fee For Service, FFS Insurance Medicare, FFS, FFS Cost, Medicare Spending Per Beneficiaries, Fee For Service Reimbursement, Repricing of FFS Claims, Disabled Uncompensated Care Reimbursement Data

Other Titles

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

NameDescriptionTypeConstraints
FIPS_CodeIdentification codestring-
StateName of statestring-
CountyName of Countystring-
Year_2010Repricing adjustments to the 2010 uncompensated care reimbursement data to reflect the most current rulesnumberlevel : Ratio
Year_2011Repricing adjustments to the 2011 uncompensated care reimbursement data to reflect the most current rulesnumberlevel : Ratio
Year_2012Repricing adjustments to the 2012 uncompensated care reimbursement data to reflect the most current rulesnumberlevel : Ratio
Year_2013_Jan_SepRepricing adjustments to the Jan to Sep 2013 uncompensated care reimbursement data to reflect the most current rulesnumberlevel : Ratio
Year_2013_Oct_DecRepricing adjustments to the Oct to Dec 2013 uncompensated care reimbursement data to reflect the most current rulesnumberlevel : Ratio
Year_2014Repricing adjustments to the 2014 uncompensated care reimbursement data to reflect the most current rulesnumberlevel : Ratio
FIPS_CodeStateCountyYear_2010Year_2011Year_2012Year_2013_Jan_SepYear_2013_Oct_DecYear_2014
45741TEXASKING
13120IDAHOCAMAS
13160IDAHOCLARK
12040HAWAIIKAUAI
45150TEXASBORDEN
45732TEXASKENEDY
45762TEXASLOVING
28570NEBRASKALOUP
45621TEXASHARTLEY
45877TEXASROBERTS