The Centers for Medicare and Medicaid Services on Wednesday released data on 15,055 skilled nursing facilities, over 2.5 million stays, and almost $27 billion in Medicare payments for 2013.
The released information in the Skilled Nursing Facility Utilization and Payment Public Use File is part of ongoing efforts to increase transparency for federal health programs. CMS said. It contains data on utilization, payments, and submitted charges organized by provider, state, and resource utilization group.
In addition to information on payments and charges, the data contains two categories of Resource Utilization Groups for patients who receive a significant amount of therapy: Ultra-High (RU) and Very High (RV) Rehabilitation services.
[Also: Opponents of CMS Medicare Part B proposal call plan 'perverse' and 'dangerous']
Medicare skilled nursing facility per diem payment amounts for rehabilitation are primarily based on therapy minutes. Consistent with prior CMS findings, the data shows that the amount of therapy provided is often very close to the minimum minutes needed to qualify for payment.
"CMS strives to ensure that patient need, rather than payment system incentives, are driving the provision of therapy services," said Dr. Shantanu Agrawal, deputy administrator for Program Integrity and director of the Center for Program Integrity. "These concerns have prompted us to refer this issue to the Recovery Auditor Contractors for further investigation, and our hope is that data transparency will facilitate real changes."
[Also: CMS tests new model to lower cost of prescription drugs]
The public data set was created from Part A institutional claims covering calendar year 2013. It provides information on services provided without individually identifying Medicare beneficiaries.
Twitter: @SusanJMorse