Thursday, April 8, 2010

Overview CMS Dashboard

The CMS Dashboard BETA  is a beta release and offers statistical views of the Inpatient Prospective Payment System (IPPS) data as it relates to claims payment and volume as collected by CMS. The data contained in this beta version is current as of March, 2010, for inpatient discharges from January, 2006, to December, 2009.  Future releases may contain additional CMS Program data.

The Road to Data Democracy

Information Displayed in the CMS Dashboard BETA 

Section 1886(d) of the Social Security Act (the Act) sets forth a system of payment for the operating costs of acute care hospital inpatient stays under Medicare Part A (Hospital Insurance) based on prospectively set rates.  The CMS Dashboard BETA  includes a limited set of diagnosis-related groups (DRGs) and Hospitals paid under the Inpatient Prospective Payment System (IPPS).  Under the IPPS, each case is categorized into a DRG.  Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG.  These include all U.S. Hospitals that accept the IPPS (Maryland and some territories are not included because they do not accept payment based on the IPPS System).

In addition to the DRG  payments, the amounts displayed also include payments that Congress has determined support important public policy goals, including, the provision of medical education, additional funding to hospitals that take a disproportionate share of low-income patients, additional payments to rural hospitals, additional funding to hospitals with high cost outlier payments for cases that incur extraordinarily high costs of treatment, and adjustments for the underlying costs in different geographic regions.  In addition, the data on the number of patients and the total dollars may vary from year to year based on the number of beneficiaries who choose to participate in the Medicare Advantage side of the program.  These data only include fee-for-service beneficiaries.

Data Quality and Timeliness

The data used in the CMS Dashboard BETA is summarized by fiscal year and grouped by claim payment, volume, DRG, and by individual hospital. This summarized data is not risk-adjusted.  The claims processing cycle is an iterative process that impacts the time for a claim to become finalized. Note that there are time lags between the time services are provided and when claims are processed.   Please see the upper-right corner of the dashboard for information pertaining when the data was updated, and on the inpatient discharge reporting timeframe.  The CMS Dashboard BETA will be updated on a monthly basis starting in 2010.  The data for 2006 and 2010 does not represent a full year, thus should not be compared as such to 2007, 2008, and 2009.