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Medicare Analysis for Hospitals

Nearly every month, new Medicare payment policy changes forcing healthcare providers constantly react. Evaluation these policy changes and accurately predicting Medicare reimbursement levels becomes paramount. Our Medicare Analysis for Hospitals helps providers focus on changes that impact them the most.
 

Hospital Profile Report

The Hospital Profile Report provides a comprehensive description of the acute care hospitals, critical access hospitals (CAHs) in your state using key statistics and indicators from the Medicare cost report and other data files from the Centers for Medicare and Medicaid Services (CMS).
   

IPPS Analysis Reports

This analysis is intended to show providers how Medicare inpatient FFS payments will change from the current year to the next year based on the policies and rules set forth by CMS. The analysis compares the year-to-year of change in operating, capital, and uncompensated care IPPS payments and includes breakout sections that provide detailed insight into specific policies that influence IPPS payment changes. This analysis also includes adjustments for geographic variation.
 
Analysis is performed twice each year, once for proposed rule changes and once for final rule changes.

Current Proposed Rule Impact Analysis – FFY 2019

 

Current Final Rule Impact Analysis – FFY 2019

 
 
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Financial Analysis Reports

 
Medicare Margins Analysis

This analysis shows the trends in Medicare margins over the most recent time period of ten years . The margins are shown graphically for hospitals and for various comparison groups. Margins are shown for the following areas/units: inpatient, outpatient, Graduate Medical Education, psychiatric unit, rehabilitation unit, skilled nursing unit, and swing beds.
 
Margin Analysis Q4 2017 Data Release:
 
 

Hospital Financial Indicators Analysis

This analysis provides all-payer comparative financial ratios/metrics for hospitals compared to various State and national benchmark groups for thirteen 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 the thirteen financial indicators.
 
Margin Analysis Q3 2017 Data Release:

OPPS Analysis Reports

Like the IPPS analysis, this analysis is intended to show providers how Medicare outpatient fee-for-service (FFS) payments will change from year to year based on the policies set forth by CMS. This report compares changes in; Marketbasket, Wage Index, APC Factors, Outlier BN and others.

Analysis is performed twice each year, once for proposed rule changes and once for final rule changes.
 

Current Proposed Rule Impact Analysis – 2019

 

Current Final Rule Impact Analysis – 2018


  
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Quality Analysis Reports

 
Quality Program Measure Trends Analysis

The Quality Program Measure Trends Analysis  is designed to provide hospitals with a comparative review over time of the quality data collected by the Centers for Medicare and Medicaid Services (CMS) and published on the Hospital Compare Web site at https://www.medicare.gov/hospitalcompare/.
 
The specific measures analyzed represent the measures included in a Medicare Quality Programs: Value Based Purchasing (VBP), Readmissions Reduction Program (RRP), and Hospital Acquired Conditions (HAC) reduction program as well as the Comprehensive Care for Joint Replacement (CJR) program. The analysis also includes HCAHPS and overall star ratings. Measures are divided into categories: Star Ratings, Safety of Care, Patient Experience of Care (VBP/CJR), Outcomes, Readmissions, and Efficiency. The analysis includes measures that CMS has adopted for use in at least one of the four programs for the current program year and forward.  Certain measures do not apply to all program years.
 
Quality Program Trends – 2018 Q1
 
 

Value Based Purchasing (VBP) Impact Analysis

The VBP Impact Analysis is intended to provide hospitals with a preview of the potential impact of the next fiscal year inpatient hospital VBP Program based on publicly available data and program rules established by the Centers for Medicare and Medicaid Services (CMS).
 
The reports included in this analysis estimate VBP scores, impacts, and trends and provide full detail on how the points and scores for each VBP measure and domain are calculated.
 
Updates are provided quarterly, shortly after updates to the Core Measures and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data from the Centers for Medicare and Medicaid Services.
 
VBP Impact Analysis – FFY 2019 Program
 
 

Readmission Reduction Program Analysis

This Analysis provides detailed performance information on the readmissions measures that are currently evaluated or will be evaluated under the Hospital Readmissions Reduction Program. The analysis is intended to provide hospitals with an in-depth review of actual performance under previous years of the Program. The analysis also projects potential exposure under upcoming program years.
 
Readmission Reduction Impact Analysis – FFY 2019 Program
 
 

Hospital Acquired Conditions (HAC) Reduction Program Analysis

This analysis is intended to provide hospitals with a preview of the potential impact of the Medicare inpatient HAC Reduction Program. The analysis includes estimates and detail on how HAC measure and domain scores are calculated and how payment penalties are determined and applied under the Program. A report that compares the current program year performance to the estimated impact of subsequent year is also included.
 
HAC Reduction Program Impact Analysis – FFY 2019 Program
  • Due to data limitations, this analysis does not use the data for the same performance periods that CMS will use to calculate its final FFY 2019 HAC Program scores.  That data will not be available on until the start of FFY 2019.
  • Current Oregon Report
  • Analysis Description

Wage Index Analysis Reports

The Medicare Wage Index is an important factor in determining a hospital’s final Medicare payment rate.  It accounts for geographic discrepancies in employee pay that can make salaries at hospitals in one metropolitan area higher or lower than another.
 
Apprise prepares an annual analysis of each hospital’s Wage Index calculation from the Centers for Medicare and Medicaid Services (CMS).  It provides a detailed comparison of the elements that make up the hospital’s wage index calculation for the most recent two years of available data.  This allows a hospital to spot large variations between years that make indicate further analysis may be needed.
 

Wage Data Report

This analysis is intended to provide hospitals with a comparative review of the Wage data that will be used to develop the following year’s Medicare hospital wage index. There are three analyses that are released throughout the year. Two contain preliminary data, which contain data prior to any hospital-submitted revisions. The other analysis contains final data after hospital-submitted revisions. Because this data is subject to revision, this analysis is not intended to be used to calculate hospital wage indexes, but to give hospitals a way to review the wage data as published by CMS.
 
Wage Data Final Release FFY 2018
Wage Data Revised Release FFY 2019
 
 

Occupational Mix Data Report

This analysis is intended to provide hospitals with a comparative review of the occupational mix data that will be used to develop the following year’s Medicare hospital wage index. There are three analyses that are released throughout the year. Two contain preliminary data, which contain data prior to any hospital-submitted revisions. The other analysis contains final data after hospital-submitted revisions. Because this data is subject to revision, this analysis is not intended to be used to calculate an occupational mix adjusted wage index, but to give hospitals a way to review the occupational mix data as published by CMS.
 
Occ Mix Data Final Release FFY 2018
Occ Mix Data Revised Release FFY 2019
 
The Occupational Mix Data Comparison analyzes the final occupational mix data released by CMS. It is important that hospitals review this data promptly because hospitals have only a limited timetable for submitting requests to their Fiscal Intermediary or Medicare Administrative Contractor to make corrections to the wage data.
 
 

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