Introduction to Medicare Cost Reports 4/4/2013 Faith Asper, MHS - - PowerPoint PPT Presentation

Introduction to Medicare Cost Reports

Faith Asper, MHS Director, ResDAC Assistance Desk

4/4/2013

About ResDAC

• Centers for Medicare and Medicaid (CMS)

contractor

• Offer free assistance to researchers interested in

using Medicare and Medicaid data for research

• Staffed by a team of public health and health

services research specialists

• Provide a range of services related to CMS data

˗ Assistance Desk ˗ Workshops and Outreach

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Upcoming Webinars

• 04/09 - DE-SynPUFs
• 04/10 –Limited Data Sets
• 04/25 –Research Identifiable Data
• 05/02 – Utilization Data

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Overview of Webinar

• What are the Medicare cost reports?
• Which types of facilities submit cost reports?
• What types of research can be conducted with the

cost reports?

• Where can researchers find resources to work with

the Medicare cost reports?

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Medicare Cost Reports

• A series of forms that collect descriptive, financial,

and statistical data to determine if Medicare over

• r underpaid the provider
• Providers submit cost reports annually
• Cost reports are available for institutional

providers

˗ Not required for physicians or other non-institutional providers

• Only national data available for all types of

providers (non-profit, for-profit, government)

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Medicare Cost Reports

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

Medicare Cost Reports

• The worksheets collect the following types of

information:

˗ Facility characteristics (ownership status, type of facility) ˗ Statistical ˗ Financial ˗ Cost ˗ Charge ˗ Wage Index information

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Medicare Cost Reports

• Hospitals
• Skilled Nursing Facilities
• Home Health Care Agencies
• Hospices
• Renal Dialysis
• Independent Rural Health Clinic and Freestanding

Federally Qualified Health Center

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Types of Facilities Submitting Cost Reports

Medicare Cost Reports

• Facilities that submit cost reports but they are not

currently available as a downloadable file.

˗ Organ Procurement Organization and Tissue Typing Laboratory

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Types of Facilities Submitting Cost Reports

Medicare Cost Reports

• Cost reports are NOT required and therefore, NOT

available for the following providers.

˗ Federal Hospitals

» Veterans Hospitals » Indian Health Services Hospitals

˗ Some children’s hospitals ˗ Emergency Hospital

• Represents about 10% of all hospitals

˗ Source: CMS Data Compendium, 2011 Edition, Table VI.1.

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Types of Facilities Not Included

Medicare Cost Reports

• Examine facility characteristics
• Calculate cost
• Determine financial health of a facility

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Types of Research

Medicare Cost Reports

• Examine facility characteristics

˗ Facility size (beds) ˗ Teaching facility ˗ Ownership (for-profit, non-profit, government) ˗ Total Beds ˗ Total Patient Days ˗ Total Discharges

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Types of Research

Medicare Cost Reports

• Calculate cost

˗ Cost information will vary by the facility submitting the information

» Hospitals submit cost and charge information » SNFs submit cost per day » HHA submit cost per visit » Hospice submit cost per day » Renal Dialysis submit cost per treatment

˗ Total costs for all patients ˗ Medicare costs

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Types of Research

Medicare Cost Reports

• Determine financial health of a facility

˗ Revenues ˗ Expenses ˗ Net income (or loss) ˗ Payer Mix (Medicare, Medicaid, All Other) ˗ Bad debt

» Charity Care/Uncompensated care collected for Hospitals

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Types of Research

Medicare Cost Reports

• Cost Reports can be downloaded from the CMS

Cost Report by Fiscal Year website

• Resource documents are found on the respective

provider cost report page

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Where do I find the data and resources?

Medicare Cost Reports

• Cost Reports can be downloaded from the CMS

Cost Reports by Fiscal Year website

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Where do I find the data and resources?

Medicare Cost Reports

• The data are in the Healthcare Cost Reporting

Information Systems database (HCRIS)

• CMS will update the data on a quarterly basis
• The entire database is overwritten each quarter

with the latest information

• The number of years available will vary depending
• n the facility
• Usually takes about 18 months to have a

complete FY, so FY 2012 data may not be 100% complete.

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Where do I find the data and resources?

Medicare Cost Reports

• The data are provided in a relational database

format.

• Three files contain all the variables submitted on

the cost reports

˗ RPT – contains information about the cost report submitted ˗ ALPHA – contains all character variables ˗ NMRC – contains all numeric variables

• Need to know where the variable resides within

the forms to identify it in the data.

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Where do I find the data and resources?

Medicare Cost Reports

• Resource documents found on the respective

provider cost report page

• Documents describe the data file structure,

variable definitions and types, code values, and special instructions.

• Training video to get you started

˗ Introduction to Cost Reports

» http://www.resdac.org/training/media/tutorials

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Where do I find resources?

Resources for Help

• ResDAC Website

˗ Knowledgebase articles

» Creation of the fiscal year cost report files » Data on Uncompensated Care in the Hospital Cost Reports » Understanding the variable Usage in the cost reports » Assigning Link Specifications for the Hospital Cost Report Data in MS Access

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Contacting ResDAC

• ResDAC Assistance Desk

˗ Email: resdac@umn.edu ˗ Phone: 1-888-973-7322 ˗ Web: http://www.resdac.org

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