Decision Support Reports: Brief Descriptions of DataGen’s KeySTATS National Analyses

The Medicare Cost Report Model provides hospital associations/systems with commonly sought after data elements from the Centers for Medicare and Medicaid’s (CMS) Healthcare Cost Report Information System (HCRIS) database. The model highlights hospital utilization, inpatient, outpatient, overall hospital statistics, and uncompensated care data.

The Financial Indicators Analysis provides all-payer comparative financial ratios/metrics for hospitals compared to various benchmark groups for twelve financial ratios. The financial ratios shown are calculated using standard accepted formulas, as defined by various ratings agencies. The model includes a dictionary with calculation instructions and data for each of these indicators.

The Medicare Margins Analysis shows the trends in Medicare margins over the most recent ten-year period. The margins are shown graphically for hospitals and for various comparison groups. Medicare margins are shown for the following areas/units: inpatient, outpatient, Graduate Medical Education (GME), psychiatric unit (IPF), rehabilitation unit (IRF), skilled nursing unit (SNF), and swing beds

The Hospital Profile Report provides a comprehensive description of the acute care hospitals, critical access hospitals (CAHs), children’s hospitals and cancer hospitals in your state/multi-state system using key statistics and indicators from the Medicare cost report and other data files from CMS. The Hospital Profile Report is intended for use both internally as well as with Members of Congress and their staff as a way to easily describe hospital opportunities and challenges.

The Medicare Spending per Beneficiary (MSPB) Report provides a price-standardized, non-risk-adjusted measure designed by CMS to evaluate a hospital’s efficiency – as measured by program spending. This report compares the average Medicare spending per beneficiary for the hospital to State and US benchmarks, using the following three time periods: 1 to 3 days prior to the index hospital admission; during the index hospital admission; and 1 through 30 days after discharge from the index hospital admission.

The Wage and Occupational Mix Analyses are intended to provide hospitals with a comparative review of the wage and occupational mix data that will be used to develop the federal fiscal year Medicare hospital wage index. The data analyzed is preliminary, revised and “final” using wage data public use files (PUFs) that CMS issues to develop the hospital wage index. The analyses give hospitals a way to review the most recent wage and occupational mix data as published by CMS. The Medicare Hospital Wage Index Reclassification Analysis is intended to allow hospitals to test their potential ability to achieve a federal fiscal year (FFY) 2020 Medicare hospital wage index reclassification.

The S-10 Uncompensated Care Distribution Analysis is intended to provide hospitals with comparative data to ascertain if reporting improvement is needed on Worksheet S-10, as well as to show how inpatient revenue may be impacted as the Centers for Medicare and MedicaidServices (CMS) transitions to using Worksheet S-10 as the basis for distribution of funds from the Medicare Disproportionate Share Hospital (DSH) Uncompensated Care (UCC) Pool.

The Critical Access DataBook is intended to provide CAHs with a comprehensive and comparative review of Medicare inpatient utilization, Medicare outpatient utilization, Financial indicator performance and Quality performance.

QUALITY SUITE:

The Value-Based Purchasing (VBP) Impact Analysis is intended to provide hospitals with a preview of the potential impact of the federal fiscal year Medicare inpatient hospital VBP Program based on publicly available data and program rules established by CMS. The reports included in this analysis estimate VBP scores, impacts, and scoring trends and provide full detail on how the points and scores for each VBP measure and domain are calculated.

The Readmissions Reduction Program (RRP) Analysis provides detailed performance information on the readmissions measures that are currently evaluated under the Medicare Hospital Readmissions Reduction Program and to provide hospitals with an in-depth review of actual performance under the previous two Federal Fiscal Years programs and the projected potential exposure under the next Federal Fiscal Year Program.

The Hospital-Acquired Condition (HAC) Reduction Program Analysis is intended to provide hospitals with a preview of the potential impact of the Medicare inpatient HAC Reduction Program, based on publicly available data and the program rules established by CMS. The reports included in this analysis evaluate hospital performance under the program using the most recent data updates of Hospital Compare. The analysis includes estimates and details on how HAC measures and domain scores are calculated and how payment penalties are determined and applied under the program.

The Quality Program Measure Trends Analysis is designed to provide hospitals with a comparative review over time of the quality data collected by CMS and published on the Hospital Compare Web site. The specific measures analyzed represent the measures included in the VBP, RRP, and HAC reduction programs as well as the Comprehensive Care for Joint Replacement (CJR) program. The analysis also includes HCAHPS and overall star ratings.

REGULATORY SUITE:

Proposed and Final rules analyses are intended to show providers how Medicare fee-for-service (FFS) payments will change from one year to the next based on the policies set forth in the proposed and final rules. These analyses are done for the following payment settings: Inpatient, Outpatient, Skilled Nursing Facility, Inpatient Rehabilitation Facility, Long Term Acute Care Hospital, Inpatient Psychiatric Facility and Home Health.

LEGISLATIVE SUITE:

The Enacted Cuts Analysis is intended for advocacy purposes only and indicates to what extent that hospital providers have been impacted by existing Medicare provider payment cuts enacted by Congress to achieve Medicare payment policy and/or long-term deficit reduction goals. The impacts shown in this analysis include the major cuts enacted since 2010.

The Medicare Proposals Under Consideration Analysis is intended for advocacy purposes only, and indicates how existing Medicare provider payments would be affected by additional changes that Congress may consider to achieve Medicare payment policy and/or long-term deficit reduction goals. The impacts shown in this analysis include several of the major revisions proposed in recent years. There is no judgment made on the likelihood of these proposals being adopted (e.g. restoration of Medicare DSH cuts).

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