FY 2016 IPPS Proposed Rule: Hospital Readmissions Reduction Program- Supplemental Data,
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Variable,Description
Provider,Medicare Provider Number or CCN
Proposed                          FY 2016 Proxy Readmissions Adjustment Factor,"Proxy Readmissions Adjustment Factor is based on excess readmission ratios with a performance period of July 1, 2010 to June 30, 2013, and calculated based on policies presented in the FY 2016 IPPS Proposed Rule.  Methodology to calculate the proxy readmission adjustment factor is presented in the FY 2016 IPPS Proposed Rule and is based on the following 5 readmissions measures: Acute Myocardial Infarction Heart Failure, Pneumonia, Chronic Obstructive Pulmonary Disease and Total Hip/Total Knee Arthroplasty. Data source to calculate readmission adjustment factor is MedPAR.  For the FY 2016, the proxy readmission payment adjustment factor that is higher of a ratio or 0.9700. Only IPPS hospitals are included the Hospital Readmissions Reduction Program (Puerto Rico and Maryland hospitals excluded from the Program)."
Number of Pneumonia Cases,"Number of Pneumonia admissions based on applicable period of July 1, 2011 to June 30, 2014. Admissions for the condition are identified based on methodology finalized in the FY 2012 IPPS Final Rule (76 FR 51666). Data source to identify admissions is the Standard Analytic File (SAF). "
Excess Readmission Ratio for Pneumonia,Excess Readmission Ratio based on methodology finalized in the FY 2012 IPPS Final Rule (76 FR 51666). Hospitals with fewer than 25 cases do not have an excess readmission ratio for that condition. Hospitals in Puerto Rico are not included.
Number of Heart Failure Cases,"Number of Heart Failure admissions based on an applicable period of July 1, 2011 to June 30, 2014.  Admissions for the condition are identified based on methodology finalized in the FY 2012 IPPS Final Rule (76 FR 51666). Data source to identify admissions is the Standard Analytic File (SAF)."
Excess Readmission Ratio for Heart Failure,Excess Readmission Ratio for Heart Failure based on methodology finalized in the FY 2012 IPPS Final Rule (76 FR 51666).  Hospitals with fewer than 25 cases do not have an excess readmission ratio for that condition. Hospitals in Puerto Rico are not included.
Number of Acute Myocardial Infarction Cases,"Number of acute myocardial infarction (AMI) admissions based on an applicable period of July 1, 2011 to June 30, 2014.  Admissions for the condition are identified based on methodology finalized in the FY 2012 IPPS Final Rule (76 FR 51666). Data source to identify admissions is the Standard Analytic File (SAF)."
Acute Myocardial Infarction Excess Readmission Ratio,Excess Readmission Ratio for Acute Myocardial Infarction based on methodology finalized in the FY 2012 IPPS Final Rule (76 FR 51666). Hospitals with fewer than 25 cases do not have an excess readmission ratio for that condition.  Hospitals in Puerto Rico are not included.
Number of Total Hip/Total Knee Arthroplasty  Cases,"Number of Total Hip/Total Knee Arthroplasty  (TKA/THA) admissions based on an applicable period of July 1, 2011 to June 30, 2014. Admissions for the condition are identified based on methodology finalized in the FY 2014 IPPS Final Rule and FY 2015 IPPS Final Rule. Data source to identify admissions is the Standard Analytic File (SAF)."
Total Hip/Total Knee Arthroplasty  Excess Readmission Ratio,Excess Readmission Ratio for Total Hip/Total Knee Arthroplasty based on methodology finalized in the FY 2014 IPPS Final Rule and FY 2015 IPPS Final Rule. Hospitals with fewer than 25 cases do not have an excess readmission ratio for that condition.  Hospitals in Puerto Rico are not included.
Number of COPD Cases,"Number of Chronic Obstructive Pulmonary Disease  admissions based on an applicable period of July 1, 2011 to June 30, 2014.  Admissions for the condition are identified based on methodology finalized in the FY 2014 IPPS Final Rule and the FY 2015 IPPS Final Rule. Data source to identify admissions is the Standard Analytic File (SAF)."
COPD  Excess Readmission Ratio,Excess Readmission Ratio for Chronic Obstructive Pulmonary Disease based on methodology finalized in the FY 2014 IPPS Final Rule and FY 2015 IPPS Final Rule. Hospitals with fewer than 25 cases do not have an excess readmission ratio for that condition.  Hospitals in Puerto Rico are not included.
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