|
Home Health Prospective Payment System
(HHPPS)
|
| Study Number |
A07_97 |
| Background of Dataset |
| Purpose of the Data Set |
The files included under this section were used
in the development of the Home Health Prospective Payment System
(HH PPS) for which the Notice of Proposed Rule Making (NPRM) was
published in the Federal Register on October 28, 1999. The audited
cost report file contains audited cost reports for sample agencies
with cost reporting periods ending in fiscal year 1997. |
| Criteria(s) for Inclusion/Exclusion |
Representative sample of providers used
to calculate HHPPS. |
| Age Range Included |
N/A |
| Method(s) of Data Gathering |
The provider level utilization file, derived from
National Claims History (NCH) data and combined with wage index
value data, contains visit totals for the 6 disciplines (skilled
nursing, physical therapy, occupational therapy, speech language
therapy, medical social, and home health aide) as well as the
total number of episodes (for both episodes with less than or
equal to 4 visits and for episodes with greater than 4 visits)
aggregated to the provider level. The 199-code HCPC file contains
the 199 procedure codes identified as non-routine medical supply
codes that could be unbundled and billed under Part B. And finally,
the grouper pseudocode file contains the logic for the classification
of patients into one of the Home Health Resource Groups (HHRGs)
used in determining the episode payment. When utilized in a manner
similar to that described in the NPRM, these files can help interested
parties in their understanding and analysis of this proposed system.
|
| Sampling Frame/Design |
N/A |
| Limitation(s) of Study |
None |
|
Year(s) Available
|
1997 |
| Number of Observations |
567; 10,506 |
| Unit of Observation |
Home Health Agency |
| Publisher |
Health Care Financing Administration |
| Contact Information/Web Address |
http://www.hcfa.gov/stats/pufiles.htm |
| Condition of Use |
Publicly Available |
| Contents of Database |
|
Key Linking Variables
|
N/A |
| Demographics Information |
N/A |
| Access/Utilization Information |
|
| Unit of Utilization |
HH Provider |
| Source of Information |
|
|
•Self reported
|
Cost reports |
|
•Parent
|
|
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•Medical provider
|
|
|
•Billing/encounters
|
Yes |
|
•Other source
|
|
| Health Insurance Information |
|
|
•Insurance status
|
|
|
•Insurance type
|
|
|
•Other information
|
|
| Health Care Utilization |
|
| >Type |
|
| 1) Outpatient |
|
|
•Date of visits
|
|
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•Number of visits
|
|
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•Referrals information
|
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•Specialty visits
|
|
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•Other outpatient utilization
|
|
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2) Inpatient
|
|
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•Admission/discharge dates
|
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•Number of admissions
|
|
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•Length of stay
|
|
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•Admission status (transfer, ER admissions...etc)
|
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•Discharge status
|
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•Other information
|
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3) Emergency room
|
|
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•Date of visits
|
|
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•Number of visits
|
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•Other information
|
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4) Pharmacy
|
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•Date of prescription
|
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•Drug information
|
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•Other information
|
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5) Other utilization
|
|
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•Home care services
|
Yes |
|
•Long term care
|
|
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•Other services
|
|
| >Medical Codes |
|
|
•CPT codes
|
|
|
•ICD-9 codes
|
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•DRG codes
|
|
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•Other codes
|
Health Care Procedure Code (HCPC) |
| Health Care Facility Information |
N/A |
| Physician Information |
N/A |
| Cost/Expenditure Information |
|
|
•Unit of cost
|
|
|
•Charges/costs/payments
|
|
|
•Total
|
|
|
•Allied and additional services
|
Yes |
|
•Pharmacy
|
|
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•Out-of-pocket payments
|
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•Other information
|
Wage Indices |
| Other Information |
|
