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

Introduction to Medicare Cost Reports 4/4/2013 Faith Asper, MHS Director, ResDAC Assistance Desk

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 3

Upcoming Webinars  04/09 - DE-SynPUFs  04/10 –Limited Data Sets  04/25 –Research Identifiable Data  05/02 – Utilization Data 4

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? 5

Medicare Cost Reports  A series of forms that collect descriptive, financial, and statistical data to determine if Medicare over or 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) 6

Medicare Cost Reports Example of Hospital Form 2552-10, Worksheet S-3, Part I 7

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 8

Medicare Cost Reports Types of Facilities Submitting Cost Reports  Hospitals  Skilled Nursing Facilities  Home Health Care Agencies  Hospices  Renal Dialysis  Independent Rural Health Clinic and Freestanding Federally Qualified Health Center 9

Medicare Cost Reports Types of Facilities Submitting Cost Reports  Facilities that submit cost reports but they are not currently available as a downloadable file. ˗ Organ Procurement Organization and Tissue Typing Laboratory 10

Medicare Cost Reports Types of Facilities Not Included  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. 11

Medicare Cost Reports Types of Research  Examine facility characteristics  Calculate cost  Determine financial health of a facility 12

Medicare Cost Reports Types of Research  Examine facility characteristics ˗ Facility size (beds) ˗ Teaching facility ˗ Ownership (for-profit, non-profit, government) ˗ Total Beds ˗ Total Patient Days ˗ Total Discharges 13

Medicare Cost Reports Types of Research  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 14

Medicare Cost Reports Types of Research  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 15

Medicare Cost Reports Where do I find the data and resources?  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 16

Medicare Cost Reports Where do I find the data and resources?  Cost Reports can be downloaded from the CMS Cost Reports by Fiscal Year website 17

Medicare Cost Reports Where do I find the data and resources?  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 on the facility  Usually takes about 18 months to have a complete FY, so FY 2012 data may not be 100% complete. 18

Medicare Cost Reports Where do I find the data and resources?  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. 19

Medicare Cost Reports Where do I find resources?  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 20

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 21

Contacting ResDAC  ResDAC Assistance Desk ˗ Email: resdac@umn.edu ˗ Phone: 1-888-973-7322 ˗ Web: http://www.resdac.org 22