CMS releases new data to increase transparency on Medicare hospice payments

CMS News

FOR IMMEDIATE RELEASE
October 6, 2016

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries
 

CMS releases new data to increase transparency on Medicare hospice payments and the Third Release of the Market Saturation and Utilization Data Tool

Data serves as comprehensive resource for information on payments and utilization

 

As part of our efforts to improve care delivery, payments to providers, and the sharing and utilization of information, the Centers for Medicare & Medicaid Services (CMS) today released a privacy-protected public data set, the Hospice Utilization and Payment Public Use File (Hospice PUF), which provides information on services provided to Medicare beneficiaries by hospice providers. CMS also released an update to the Market Saturation and Utilization Data Tool, formerly called the Moratoria Provider Services and Utilization Data Tool. For the first time, this tool will include information on hospice services.

“The Hospice data and Market Saturation and Utilization Data Tool made available today support our goals of increasing access to Medicare data and improving the flow of information,” said CMS Chief Data Officer Niall Brennan.  “CMS believes that greater data transparency leads to a more effectively functioning health care system, which leads to better care and smarter spending.”

The Hospice PUF contains information on utilization, payments, submitted charges, diagnoses, and hospice beneficiary demographics organized by provider and state. The Hospice PUF covers calendar year 2014 and includes information on 4,025 hospice providers, over 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. With this data, it is now possible to analyze geographic variation in the delivery of hospice care, as well as variation across individual hospice providers.  The Hospice PUF also includes a number of metrics on hospice beneficiary demographics and diagnoses to facilitate analyses of differences in the patient population across providers.

The third release of the Market Saturation and Utilization Data Tool includes interactive maps and supporting data sets that show national-, state-, and county-level provider services and utilization data for three reference periods and the following health service areas: Home Health, Ambulance (Emergency, Non-Emergency, Emergency & Non-Emergency), Independent Diagnostic Testing Facilities (Part A and Part B), Skilled Nursing Facilities, and Hospice.

The Market Saturation and Utilization Data Tool can be used by CMS to monitor market saturation as a means to prevent fraud, waste, and abuse.  The data can also be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. Provider services and utilization data by geographic regions are easily compared using an interactive map. There are a number of research uses for these data, but one objective of making these data public is to assist health care providers in making informed decisions about their service locations and the beneficiary populations they serve.

The release of the Hospice PUF and the Market Saturation and Utilization Data Tool continues CMS’ commitment to greater data transparency.  The Hospice PUF also adds to the suite of provider-level transparency data sets that CMS has released over the past several years, including hospital-, physician-, and prescriber-level utilization and payment data files.

To view a fact sheet on the Hospice PUF, visit:

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-06.html

To access the Hospice PUF, visit: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Hospice.html

To view the Market Saturation and Utilization Data Tool visit: https://data.cms.gov/market-saturation