Identification of Specific Variables: Part 2 Faith Asper, MHS - - PowerPoint PPT Presentation

Identification of Specific Variables: Part 2

Faith Asper, MHS Director, ResDAC Assistance Desk

Objectives

• Review common types of research
• Review the worksheets that contain these

variables

• Review helpful resources

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Research Areas Using Cost Reports

• Facility Characteristics
• Financial Health of Facilities
• Calculating Costs

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Facility Characteristics

• Selected facility characteristics variables are used

in prospective payment.

• Article compared cost report data to AHA data and

concluded that cost report data was optimal for facility characteristics.

• “Identifying and Measuring Hospital

Characteristics Using the SEER-Medicare Data and Other Claims-Based Sources” Schrag D, et al. Medical Care

Suppl Vol 40, No 8, Suppl pp IV-96-IV-103, Aug 2002.

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Facility Characteristics

• Number of beds
• Number of days
• Number of discharges
• Ownership status
• Teaching Hospital
• Uncompensated or Charity care
• Payer Mix
• Geographic location

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Facility Variable Locations

Variable ble Location ion Total hospital beds Worksheet S-3, Part I Total inpatient days Worksheet S-3, Part I Total discharges Worksheet S-3, Part I Ownership status Worksheet S-2 & RPT file Teaching status Worksheet S-2 Uncompensated care Worksheet S-10 Payer Mix Worksheet S-3, Part I Location (zip code, urban/rural) Worksheet S-2

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Medicare Cost Reports

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Example of Hospital Form 2552-10, Worksheet S-3, Part I

Facility Characteristics: Other Resources

• Provider of Services File

˗ Source is the OSCAR database (Survey and Certification) ˗ Collected at different points in time depending on the facility type ˗ May be better source for facilities that can be free- standing and provider-based

» SNFs » HHAs » Hospices

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Facility Characteristics: Other Resources

• CMS “Compare” Databases

˗ Hospital Compare ˗ Nursing Home Compare ˗ Home Health Compare ˗ Dialysis Compare

• Current compare database can be downloaded

here

˗ https://www.medicare.gov/download/downloaddb.asp

• Archived copies can be found at

˗ http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/HospitalQualityInits/HospitalCompare.html

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Facility Characteristics: Other Resources

• American Hospital Associate Survey

˗ Includes all Hospitals ˗ Includes wide range of descriptive and financial characteristics ˗ Some survey information comes from the cost reports ˗ Survey is not audited ˗ Costly

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Financial Health of Facilities

• Total Margin
• Revenues
• Total Expenses
• Average Daily Census
• Bad Debt/Charity Care

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Financial Variable Locations

Variable ble Location ion Total Margin Worksheet G-3 Revenues Worksheet G-2 Expenses Worksheet G-2 Average Daily Census Worksheet S-3 Bad Debt Worksheet S-10

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Medicare Cost Reports

Example of Hospital Form 2552-10, Worksheet G-3

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Financial Variables

• Article that outlines formulas for calculating

financial indicators.

• Flex Monitoring Team Briefing Paper #7: “Financial

Indicators for Critical Access Hospitals” May 2005. (Table 3)

• “Sources of Financial Data on Medicare Providers”

MedPAC June 2004.

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Calculating Cost

• Calculating Costs

˗ Use Cost-to-Charge Ratios (CCR) to adjust facility charges to cost

» Total » Departmental » Medicare

˗ Use it in economic evaluations, such as cost- effectiveness analyses

• More to come in next segment

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Cost and Charge Variable Locations

Vari riable ble Location tion Total cost Worksheet C, Part 1 Total charges Worksheet C, Part 1 Total Medicare costs Worksheet D

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Medicare Cost Reports

Example of Hospital Form 2552-10, Worksheet C, Part 1

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Calculating Cost Other Resources

• Survey information

˗ Medicare Current Beneficiary Survey ˗ Medical Expenditure Panel Survey (MEPS) ˗ Healthcare Cost and Utilization Project (HCUP)

» Survey information may be able to better capture the cost to the beneficiary » Survey information may be subject to recall bias

• Provider accounting data

˗ Difficult to obtain ˗ Time consuming if dealing with national study

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• Cost reports are typically used to identify:
• Facility characteristics
• Financial health of a facility
• Calculate cost

Summary

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