This dataset shows the 2013 Shared Savings Program (SSP) Accountable Care Organization (ACO) data Public Use File (PUF), which has been updated to include for each ACO the mean final prospective Centers for Medicare and Medicaid Service’s (CMS) Hierarchical Condition Category (HCC) risk score for the four Medicare enrollment types (End-Stage Renal Disease (ESRD), disabled, aged/dual, aged/non-dual) for each of the benchmark year and calendar year 2013 risk scores for performance year 1.
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This dataset shows the 2013 Shared Savings Program (SSP) Accountable Care Organization (ACO) data Public Use File (PUF), which has been updated to include for each ACO the mean final prospective CMS-HCC risk score for the four Medicare enrollment types (End-Stage Renal Disease (ESRD), disabled, aged/dual, aged/non-dual) for each of the benchmark year and calendar year 2013 risk scores for performance year 1.
This dataset addresses the increasing number of requests for SSP ACO data, the Centers for Medicare and Medicaid Services (CMS) has created a standard analytical file that CMS can use to efficiently satisfy these requests. It is the intent of CMS to publish the ACO-level public-use file (PUF) that contains ACO-specific metrics as well as summarized beneficiary and provider information for each performance year of the SSP program.
The risk scores used in this dataset are based on the applicable risk adjustment model for the applicable year and renormalized so that the mean national Fee-For-Services (FFS) risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
The dataset mentioned plays a crucial role in supporting applications of Generative AI in healthcare by enhancing terminology accuracy and facilitating better communication among medical professionals and patients.
About this Dataset
Data Info
Date Created
2016-11-15
Last Modified
2017-09-21
Version
2017-09-21
Update Frequency
Annual
Temporal Coverage
2013
Spatial Coverage
United States
Source
John Snow Labs; Centers for Medicare and Medicaid Services (CMS) and Medicare Shared Savings Program (MSSP);
What is an ACO?, ACO Public Use File 2013, ACO Shared Savings Program PUF 2013, Accountable Care Organization SSP PUF 2013
Data Fields
Name
Description
Type
Constraints
ACO_Number
Encrypted ACO Identifier.
string
-
ACO_Name
Legal business name associated with the ACO.
string
-
Start_Date
ACO agreement start date.
date
-
Advance_Pay_Status
ACO Elected Advanced Payment
integer
level : Ratio
Is_Quality_Score
During PY1 Final, quality reporting is pay for reporting for all ACOs. 100% for complete and accurate reporting, otherwise 0%. For 2012 starters, quality score must be 100% in both 2012 and 2013 in order to be eligible for earned performance payment.
boolean
-
Quality_Sharing_Rate
Set at 50% for Track 1 ACOs and 60% for Track 2 ACOs in PY1 Final.
number
level : Ratio
Final_Sharing_Rate
Quality performance sharing rate multiplied by quality score. The percentage of savings an ACO shares if the ACO is eligible for shared savings.
number
level : Ratio
Minimum_Loss_Rate
number
level : Ratio
Minimum_Savings_Rate
number
level : Ratio
Total_Benchmark_Expenditures
Per capita benchmark expenditures multiplied by total person-years, PY1 Final.
number
level : Ratio
Total_Performance_Year_Expenditures
Per capita expenditures multiplied by total person-years, PY1 Final.
number
level : Ratio
Total_Savings_Losses
Total benchmark expenditures minus total performance year expenditures. Does not account for the application of the ACO’s final sharing rate based on quality performance or reduction for sequestration.
number
level : Ratio
Total_Earned_Shared_Savings
The ACO’s share of savings for ACOs whose savings equaled or exceeded their minimum savings rates, and who were eligible for a performance payment because they met the program’s quality performance standard. This amount accounts for the application of the ACO’s final sharing rate based on quality performance, as well as the reduction in performance payment due to sequestration. This amount does not account for repayment of advance payments.
number
level : Ratio
Total_Owed_Shared_Losses
The ACO’s share of losses for Track 2 ACOs whose losses equaled or exceeded their minimum loss rate (flat 2%). This amount accounts for the application of the ACO’s final loss sharing rate (which is equal to 1 minus the final sharing rate and does not exceed 60%) based on quality performance. Only for Track 2 ACOs.
number
level : Ratio
Total_Number_of_Assigned_Beneficiaries
Number of assigned beneficiaries for the PY1 Final performance period. For 2012 starters, the number of unique assigned beneficiaries assigned in either the interim period (6 or 9-months of CY2012) or in CY2013.
integer
level : Ratio
Total_Assigned_Beneficiary_Person_Years
Number of assigned beneficiaries for CY2013 adjusted downwards for beneficiaries with less than a full 12 months of eligibility ; Number of person months divided by 12.
number
level : Ratio
Total_Number_of_ESRD_Person_Years
Number of assigned beneficiaries with ESRD enrollment type for CY2013 adjusted for the total number of months that each beneficiary was classified as ESRD; Number of ESRD person months divided by 12.
number
level : Ratio
Total_Number_of_Disabled_Person_Years
Number of assigned beneficiaries with Disabled enrollment type for CY2013 adjusted for the total number of months that each beneficiary was classified as Disabled; Number of Disabled person months divided by 12.
number
level : Ratio
Total_Number_of_AGED_Dual_Person_Years
Number of assigned beneficiaries with Aged/Dual enrollment type for CY2013 adjusted for the total number of months that each beneficiary was classified as Aged/Dual; Number of Aged/Dual person months divided by 12.
number
level : Ratio
Total_Number_of_AGED_Non_Dual_Person_Years
Number of assigned beneficiaries with Aged/Non-dual enrollment type for CY2013 adjusted for the total number of months that each beneficiary was classified as Aged/Non-dual; Number of Aged/Non-dual person months divided by 12.
number
level : Ratio
Total_Assigned_Beneficiaries_Age_0_To_64
Total number of assigned beneficiaries, age 0-64 in CY2013; age calculated as of 1/1/2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Age_65_To_74
Total number of assigned beneficiaries, age 65-74 in CY2013; age calculated as of 1/1/2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Age_75_To_84
Total number of assigned beneficiaries, age 75-84 in CY2013; age calculated as of 1/1/2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Age_85_Plus
Total number of assigned beneficiaries, age 85+ in CY2013; age calculated as of 1/1/2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Female
Total number of assigned beneficiaries, female (Gender=2) in CY2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Male
Total number of assigned beneficiaries, male (Gender=1) in CY2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Non_Hispanic_White
Total number of assigned beneficiaries, Non-Hispanic White (Race=1) in CY2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Black
Total number of assigned beneficiaries, Black (Race=2) in CY2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Asian
Total number of assigned beneficiaries, Asian (Race=4) in CY2013.
integer
level : Ratio
Total_Assigned_Beneficiaries_Hispanic
Total number of assigned beneficiaries, Hispanic (Race=5) in CY2013.
Per capita expenditures on acute care inpatient services in a short term acute care setting for assigned beneficiaries in CY2013.
number
level : Ratio
Long_Term_Care_Hospital_Expenditures
Per capita expenditures on inpatient services in a long term care setting for assigned beneficiaries in CY2013.
number
level : Ratio
Inpatient_Rehabilitation_Facility_Expenditures
Per capita expenditures on inpatient services in a rehabilitation facility setting for assigned beneficiaries in CY2013.
number
level : Ratio
Inpatient_Psychiatric_Hospital_Expenditures
Per capita expenditures on inpatient services in a psychiatric hospital setting for assigned beneficiaries in CY2013.
number
level : Ratio
Hospice_Expenditures
Per capita expenditures on hospice services for assigned beneficiaries in CY2013.
number
level : Ratio
Skilled_Nursing_Facility_Expenditures
Per capita expenditures for services in a skilled nursing facility setting for assigned beneficiaries in CY2013.
number
level : Ratio
Other_Inpatient_Expenditures
Per capita expenditures for other inpatient services for assigned beneficiaries in CY2013.
number
level : Ratio
Physician_Supplier_Expenditures
Per capita expenditures for physician/supplier services for assigned beneficiaries in CY2013.
number
level : Ratio
Ambulance_Expenditures
Per capita expenditures for ambulance services for assigned beneficiaries in CY2013.
number
level : Ratio
Home_Health_Expenditures
Per capita expenditures for home health services for assigned beneficiaries in CY2013.
number
level : Ratio
Durable_Medical_Equipment_Expenditures
Per capita expenditures on durable medical equipment for assigned beneficiaries in CY2013.
number
level : Ratio
Inpatient_Hospital_Discharges
Total number of inpatient hospital discharges per 1,000 person years in CY2013.
number
level : Ratio
Short_Term_Acute_Care_Hospital_Discharges
Total number of short term acute care hospital discharges per 1,000 person years in CY2013.
number
level : Ratio
LTCH_Discharges
Total number of long term care hospital (LTCH) discharges per 1,000 person years in CY2013.
number
level : Ratio
IRF_Discharges
Total number of inpatient rehabilitation facility (IRF) discharges per 1,000 person years in CY2013.
number
level : Ratio
IPF_Discharges
Total number of inpatient psychiatric facility (IPF) discharges per 1,000 person years in CY2013.
number
level : Ratio
CHF_Discharges
Total number of discharges for congestive heart failure (CHF) per 1,000 person years in CY2013.
number
level : Ratio
COPD_Asthma_Discharges
Total number of discharges for chronic obstructive pulmonary disease (COPD) or asthma per 1,000 person years in CY2013.
number
level : Ratio
Bacterial_Pneumonia_Discharges
Total number of discharges for bacterial pneumonia per 1,000 person years in CY2013.
number
level : Ratio
Short_Term_Acute_Care_Readmissions
Total number of short term acute care readmissions (all-cause 30 day) per 1,000 discharges in CY2013.
number
level : Ratio
Post_Discharge_Provider_Visits
Total number of provider visits within 30 days of discharge from a short term acute care hospital per 1,000 discharges in CY2013.
number
level : Ratio
Skilled_Nursing_Facility_Discharges
Total number of discharges from a skilled nursing facility per 1,000 person years in CY2013.
number
level : Ratio
Outpatient_ED_Visits
Total number of visits to an outpatient emergency department (ED) per 1,000 person years in CY2013.
number
level : Ratio
Inpatient_ED_Visits
Total number of visits to an emergency department (ED) that result in an inpatient stay per 1,000 person years in CY2013.
number
level : Ratio
CT_Events
Total number of computed tomography (CT) events per 1,000 person years in CY2013.
number
level : Ratio
MRI_Events
Total number of magnetic resonance imaging (MRI) events per 1,000 person years in CY2013.
number
level : Ratio
Primary_Care_Services
Total number of primary care services per 1,000 person years in CY2013.
number
level : Ratio
Primary_Care_Services_With_A_PCP
Total number of primary care services provided by a primary care physician (PCP) per 1,000 person years in CY2013.
number
level : Ratio
Primary_Care_Services_With_A_Specialist
Total number of primary care services provided by a specialist per 1,000 person years in CY2013.
number
level : Ratio
Primary_Care_Services_With_A_NP_PA_CNS
Total number of primary care services provided by a nurse practitioner (NP), physician's assistant (PA), or clinical nurse specialist (CNS) per 1,000 person years in CY2013.
number
level : Ratio
Primary_Care_Services_With_A_FQHC_RHC
Total number of primary care services provided at a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) per 1,000 person years in CY2013.
number
level : Ratio
Number_of_CAH_IIs
Total number of Method II Critical Access Hospitals participating in the ACO in the performance period. Based on the ACO's certified participant list used in financial reconciliation.
integer
level : Ratio
Number_of_FQHCs
Total number of Federally Qualified Health Centers participating in the ACO in the performance period. Based on the ACO's certified participant list used in financial reconciliation.
integer
level : Ratio
Number_of_RHCs
Total number of Rural Health Clinics participating in the ACO in the performance period. Based on the ACO's certified participant list used in financial reconciliation.
integer
level : Ratio
Number_of_ETA_Hospitals
Total number of Electing Teaching Amendment Hospitals participating in the ACO in the performance period. Based on the ACO's certified participant list used in financial reconciliation.
integer
level : Ratio
Number_of_Other_Facility_Types
Total number of other facilities participating in the ACO in the performance period. Based on the ACO's certified participant list used in financial reconciliation.
integer
level : Ratio
Number_of_Participating_PCPs
Total number of primary care physicians (PCPs) that reassigned billing rights to an ACO participant in the performance period. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).
integer
level : Ratio
Number_of_Participating_Specialists
Total number of physician specialists that reassigned billing rights to an ACO participant in the performance period. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).
integer
level : Ratio
Number_of_Participating_Nurse_Practitioners
Total number of nurse practitioners that reassigned billing rights to an ACO participant in the performance period. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).
integer
level : Ratio
Number_of_Participating_Physician_Assistants
Total number of physician assistants that reassigned billing rights to an ACO participant in the performance period. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).
Total number of clinical nurse specialists that reassigned billing rights to an ACO participant in the performance period. Based on the ACO's certified participant list used in financial reconciliation and information in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).
integer
level : Ratio
Average_ESRD_HCC_Rsk_Score_In_Benchmark_Year_1
Mean final prospective CMS-HCC risk score for ESRD enrollment type in benchmark year 1, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for DISABLED enrollment type in benchmark year 1, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/DUAL enrollment type in benchmark year 1, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in benchmark year 1, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
number
level : Ratio
Average_ESRD_HCC_Risk_Score_In_Benchmark_Year_2
Mean final prospective CMS-HCC risk score for ESRD enrollment type in benchmark year 2, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for DISABLED enrollment type in benchmark year 2, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/DUAL enrollment type in benchmark year 2, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in benchmark year 2, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0.Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
number
level : Ratio
Average_ESRD_HCC_Risk_Score_In_Benchmark_Year_3
Mean final prospective CMS-HCC risk score for ESRD enrollment type in benchmark year 3, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for DISABLED enrollment type in benchmark year 3, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/DUAL enrollment type in benchmark year 3, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in benchmark year 3, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
number
level : Ratio
Average_ESRD_HCC_Risk_Score_In_Performance_Year
Mean final prospective CMS-HCC risk score for ESRD enrollment type in calendar year 2013, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for DISABLED enrollment type in calendar year 2013, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/DUAL enrollment type in calendar year 2013, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Mean final prospective CMS-HCC risk score for AGED/NON-DUAL enrollment type in calendar year 2013, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score equals 1.0. Risk scores for each enrollment type are renormalized to their own populations and thus are not on the same scale and not comparable.
Demos
