Hospice Providers Utilization and Payment data 2014
Medicare Hospice Utilization and Payment data 2014
Medicare Hospice Charges and Amounts 2014
Keywords
Hospice providers
Payment data
Hospice charges
Hospice Providers Utilization and Payment Data 2014
The Hospice providers utilization and payment data 2014 provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF contains information on utilization, payment (Medicare payment and standard payment), submitted charges, primary diagnoses, sites of service, and hospice beneficiary demographics organized by CMS Certification Number (6-digit provider identification number), and state.
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The dataset is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Hospice PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) hospice claims for the Medicare population including beneficiaries enrolled in a Medicare Advantage plan. Although the Hospice PUF has a wealth of payment and utilization information about hospice services, the data set also has a number of limitations. The information presented in this file does not indicate the quality of care provided by individual hospice providers. The file only contains cost and utilization information. Additionally, the data are not risk adjusted and thus do not account for differences in patient populations.
About this Dataset
Data Info
Date Created
2016-12-20
Last Modified
2016-12-20
Version
2016.12
Update Frequency
Annual
Temporal Coverage
2014
Spatial Coverage
United States
Source
John Snow Labs; Centers For Medicare and Medicaid Services;
Source License URL
Source License Requirements
N/A
Source Citation
N/A
Keywords
Hospice providers, Payment data, Hospice charges
Other Titles
Hospice Providers Utilization and Payment data 2014, Medicare Hospice Utilization and Payment data 2014, Medicare Hospice Charges and Amounts 2014
Data Fields
Name
Description
Type
Constraints
Provider_Id
Provider identification, 6-digit identification number for the hospice provider on the claim
integer
level : Nominal
Name
Name of Hospice provider as reported in the provider of service (POS) file.
string
maxLength : 50
Street_Address
The hospice provider address, as reported in the POS file.
string
maxLength : 50
City
City where the hospice provider is located, as reported in the POS file.
string
maxLength : 20
State
State where the hospice is located, as reported in the POS file. The fifty U.S. states, the District of Columbia and Puerto Rico are reported by the state postal abbreviation.
string
maxLength : 2
Zip_Code
Zipcode of the provider area
integer
level : Nominal
Hospital_Referral_Region
Region of Hospice HRR of the hospice provider based on provider ZIP code.
string
maxLength : 31
Hospice_Beneficiaries
Number of distinct Medicare beneficiaries receiving at least one day of hospice care in the calendar year.
number
level : Ratio
Total_Days
Total count of hospice care days provided in the calendar year. Includes first and last day of care.
number
level : Ratio
Total_Medicare_Payment_Amount
Total amount that Medicare paid for hospice care. Hospice services do not have any cost-sharing requirements and the Medicare payment amount will equal the allowed amount.
number
level : Ratio
Total_Medicare_Standard_Payment_Amount
Total amount that Medicare paid for hospice care adjusted for geographic differences in payment rates.
number
level : Ratio
Total_Charge_Amount
Total charges that hospice providers submitted for hospice care.
number
level : Ratio
Percent_Routine_Home_Care_Days
Percent of total number of hospice days that were routine home care (RHC) days. RHC days identified using Revenue Code 0651.
number
level : Ratio
Physician_Services
Total number of hospice care physician services provided. Physician services identified using Revenue Code 0657.
number
level : Ratio
Home_Health_Visit_Hours_Per_Day
Average number of hours per day of home health hospice care provided. Home health visits identified using Revenue Codes 0570, 0571, 0572 and 0579.
number
level : Ratio
Skilled_Nursing_Visit_Hours_Per_Day
Average number of hours per day of skilled nursing hospice care provided. Skilled nursing visits identified using Revenue Codes 0550, 0551, 0552 and 0559.
number
level : Ratio
Social_Service_Visit_Hours_Per_Day
Average number of hours per day of social services hospice care provided. Social service visits identified using Revenue Codes 0560, 0561, 0562 and 0569.
number
level : Ratio
Total_Live_Discharges
Number of distinct Medicare beneficiaries with live discharges from hospice care. A hospice beneficiary was considered to have a live discharge if hospice beneficary did not die in hospice care and was not receiving hospice care in CY2015. Includes live discharges for any reason including revocation.
Number of distinct Medicare beneficiaries with 7 or fewer hospice care days in CY2014. Excludes hospice beneficaries whose hospice care continued from a previous calendar year or into the next calendar year.
Average number of hours per day of home health hospice care provided during the seven days prior to death. Home health visits identified using Revenue Codes 0570, 0571, 0572 and 0579.
Average number of hours per day of skilled nursing hospice care provided during the seven days prior to death. Skilled nursing visits identified using Revenue Codes 0550, 0551, 0552 and 0559.
Average number of hours per day of social services hospice care provided during the seven days prior to death. Social service visits identified using Revenue Codes 0560, 0561, 0562 and 0569.
number
level : Ratio
Average_Age
Average age of Medicare beneficiaries using hospice care in CY2014.
number
level : Ratio
Male_Hospice_Beneficiaries
Number of distinct male Medicare beneficiaries receiving at least one day of hospice care in the calendar year.
number
level : Ratio
Female_Hospice_Beneficiaries
Number of distinct female Medicare beneficiaries receiving at least one day of hospice care in the calendar year.
number
level : Ratio
White_Hospice_Beneficiaries
Number of distinct white Medicare beneficiaries receiving at least one day of hospice care in the calendar year.
number
level : Ratio
Black_Hospice_Beneficiaries
Number of distinct black Medicare beneficiaries receiving at least one day of hospice care in the calendar year
number
level : Ratio
Asian_Hospice_Beneficiaries
Number of distinct Asian Medicare beneficiaries receiving at least one day of hospice care in the calendar year.
number
level : Ratio
Hispanic_Hospice_Beneficiaries
Number of distinct Hispanic Medicare beneficiaries receiving at least one day of hospice care in the calendar year.
number
level : Ratio
Other_Unknown_Race_Hospice_Beneficiaries
Number of distinct Medicare beneficiaries of other/unknown race receiving at least one day of hospice care in the calendar year.
number
level : Ratio
Medicare_Advantage_Hospice_Beneficiaries
Number of distinct Medicare beneficiaries enrolled in Medicare Advantage for at least one month and receiving at least one day of hospice care in the calendar year
number
level : Ratio
Medicaid_Eligible_Hospice_Beneficiaries
Number of distinct Medicare beneficiaries eligible for Medicaid for at least one month and receiving at least one day of hospice care in the calendar year
Number of distinct Medicare beneficiaries receiving hospice care for a primary diagnosis of cancer. Clinical Classifications Software single level diagnosis categories 11-17 were used to define cancer diagnoses. If a hospice beneficiary had more than one primary diagnosis the most frequent diagnosis in terms of hospice care days was used.
Number of distinct Medicare beneficiaries receiving hospice care for a primary diagnosis of dementia. Clinical Classifications Software single level diagnosis category 653 were used to define dementia diagnoses. If a hospice beneficiary had more than one primary diagnosis the most frequent diagnosis in terms of hospice care days was used.
Number of distinct Medicare beneficiaries receiving hospice care for a primary diagnosis of circulatory/heart disease. Clinical Classifications Software single level diagnosis categories 96-108 and 114-121 were used to define circulatory/heart diagnoses. If a hospice beneficiary had more than one primary diagnosis the most frequent diagnosis in terms of hospice care days was used.
Number of distinct Medicare beneficiaries receiving hospice care for a primary diagnosis of stroke. Clinical Classifications Software single level diagnosis categories 109-113 were used to define stroke diagnoses. If a hospice beneficiary had more than one primary diagnosis the most frequent diagnosis in terms of hospice care days was used.
Number of distinct Medicare beneficiaries receiving hospice care for a primary diagnosis of respiratory disease. Clinical Classifications Software single level diagnosis categories 127-134 were used to define respiratory diagnoses. If a hospice beneficiary had more than one primary diagnosis the most frequent diagnosis in terms of hospice care days was used.
Number of distinct Medicare beneficiaries receiving hospice care for a primary diagnosis other than cancer, dementia, circulatory/heart, stroke, or respiratory. If a hospice beneficiary had more than one primary diagnosis the most frequent diagnosis in terms of hospice care days was used.
number
level : Ratio
Site_Of_Service_Home_Hospice_Beneficiaries
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days at home. Site of service was determined using HCPCS codes Q5001-Q5010, Q5001 indicates care provided in hospice beneficiary's private residence (home).
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days in an assisted living facility. Site of service was determined using HCPCS codes Q5001-Q5010, Q5002 indicates care provided in an assisted living facility.
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days in a long term care or non-skilled nursing facility. Site of service was determined using HCPCS codes Q5001-Q5010, Q5003 indicates care provided in a long term care or non-skilled nursing facility.
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days in a skilled nursing facility. Site of service was determined using HCPCS codes Q5001-Q5010, Q5004 indicates care provided in a skilled nursing facility.
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days in an inpatient hospital. Site of service was determined using HCPCS codes Q5001-Q5010, Q5005 indicates care provided in an inpatient hospital.
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days in an inpatient hospice facility. Site of service was determined using HCPCS codes Q5001-Q5010, Q5006 indicates care provided in an inpatient hospice facility.
Number of distinct Medicare beneficiaries receiving the majority of their hospice care days in a long term care hospital, psychiatric facility, home care in a hospice facility or unknown facility. Site of service was determined using HCPCS codes Q5001-Q5010, Q5007-Q5010 indicate care provided in other facilities.
number
level : Ratio
Data Preview
Provider Id
Name
Street Address
City
State
Zip Code
Hospital Referral Region
Hospice Beneficiaries
Total Days
Total Medicare Payment Amount
Total Medicare Standard Payment Amount
Total Charge Amount
Percent Routine Home Care Days
Physician Services
Home Health Visit Hours Per Day
Skilled Nursing Visit Hours Per Day
Social Service Visit Hours Per Day
Total Live Discharges
Hospice Beneficiaries With 7 Or Fewer Hospice Care Days
Hospice Beneficiaries With More Than 60 Hospice Care Days
Hospice Beneficiaries With More Than 180 Hospice Care Days
Home Health Visit Hours Per Day During Week Prior To Death
Skilled Nursing Visit Hours Per Day During Week Prior To Death
Social Service Visit Hours Per Day During Week Prior To Death
Average Age
Male Hospice Beneficiaries
Female Hospice Beneficiaries
White Hospice Beneficiaries
Black Hospice Beneficiaries
Asian Hospice Beneficiaries
Hispanic Hospice Beneficiaries
Other Unknown Race Hospice Beneficiaries
Medicare Advantage Hospice Beneficiaries
Medicaid Eligible Hospice Beneficiaries
Hospice Beneficiaries With A Primary Diagnosis Of Cancer
Hospice Beneficiaries With A Primary Diagnosis Of Dementia
Hospice Beneficiaries With A Primary Diagnosis Of Stroke
Hospice Beneficiaries With Primary Diagnosis Circulatory Heart Disease
Hospice Beneficiaries With A Primary Diagnosis Of Respiratory Disease
Hospice Beneficiaries With Other Primary Diagnoses
Site Of Service Home Hospice Beneficiaries
Site Of Service Assisted Living Facility Hospice Beneficiaries
Site Long Term Care Non Skilled Nursing Facility Hospice Beneficiaries
Site Of Service Skilled Nursing Facility Hospice Beneficiaries
Site Of Service Inpatient Hospital Hospice Beneficiaries
Site Of Service Inpatient Hospice Hospice Beneficiaries
Site Of Service Other Facility Hospice Beneficiaries
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