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Medicare Is Simple
Thursday, October 6, 2016
CMS releases new data to increase transparency on Medicare hospice payments
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.