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 2
Research Areas Using Cost Reports Facility Characteristics Financial Health of Facilities Calculating Costs 3
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. 4
Facility Characteristics Number of beds Number of days Number of discharges Ownership status Teaching Hospital Uncompensated or Charity care Payer Mix Geographic location 5
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, Worksheet S-2 urban/rural) 6
Medicare Cost Reports Example of Hospital Form 2552-10, Worksheet S-3, Part I 7
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 8
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 9
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 10
Financial Health of Facilities Total Margin Revenues Total Expenses Average Daily Census Bad Debt/Charity Care 11
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 12
Medicare Cost Reports Example of Hospital Form 2552-10, Worksheet G-3 13
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. 14
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 15
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 16
Medicare Cost Reports Example of Hospital Form 2552-10, Worksheet C, Part 1 17
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 18
Summary Cost reports are typically used to identify: Facility characteristics Financial health of a facility Calculate cost 19
Recommend
More recommend
