"DATA SOURCES FOR THIS FY 2013 PROPOSED RULE IMPACT FILE: DECEMBER 2011 UPDATE OF FY 2011 MEDPAR, DECEMBER 2011 UPDATE OF PROVIDER SPECIFIC FILE, FY2009/FY2008 COST REPORT DATA"								
								
								
WAGE INDEX DATA has a 100% Occ Mix adjustment based on FY 2008/2009 survey data								
								
Provider Number	6 digit Medicare provider number; the first 2 digits are the state code.							
Name	"Name of Medicare provider from OSCAR.(""blank"" = unknown)"							
Geographic Labor Market Area	The Geographic CBSA location based on OMB's Core Based Statistical Area (CBSA) designations.  The CBSA assignment is based on where the provider is physically located based on SSA state and county code information.  Rural areas are designated by 2-digit SSA state codes.							
Pre Reclass Labor Market Area  	Pre-reclassification CBSA							
Payment Labor Market Area (for purposes of Capital and DSH)	Payment CBSA ( urban vs rural) for purposes of determining capital & DSH payments							
SSA COUNTY CODE	SSA state county code. First two digits represent the state code and the last 4 digits represent the county code. SSA system is used to Identify the county in which provider is geographically located and this field be used in conjunction with the msa/cbsa crosswalk file.							
REGION	1=NEW ENGLAND; 2=MIDDLE ATLANTIC; 3=SOUTH ATLANTIC; 4=EAST NORTH CENTRAL; 5=EAST SOUTH CENTRAL; 6=WEST NORTH CENTRAL; 7=WEST SOUTH CENTRAL; 8-=MOUNTAIN; 9=PACIFIC; 40=PUERTO RICO							
URGEO	"Large urban, Other Urban or Rural designation of the providers geographic CBSA"							
URSPA	Urban or Rural designation based on payment CBSA							
RECLASS	Proposed Reclass Status FY 2013:  N -provider did not reclassify; W -provider reclassified for wage index ; L provider reclassified under 1886(d)(8)(B) of the SSA; S-provider redesignated as rural under Sec. 401 of BIPA. 							
POST RECLASS Labor Market Area	 Proposed Post Reclassification CBSA for FY 2013							
FY 2013 Wage Index	"FY 2013 proposed wage index after applying the MGCRB reclassifications, rual floor, adjustements for the Frontier wage index provision and the P.L. 108-173 Sec 505 adjustments where applicable for FY 2013. Wage Index reflects the application of national rural floor budget neutrality required under the Affordable Care Act ."							
FY 2013 Puerto Rico Specific  wage index	"FY 2013 Proposed Puerto Rico Specific wage index after applying the MGCRB reclassifications, rural floor and the P.L. 108-173 Sec 505 adjustments where applicable for FY 2013. Wage Index reflects the application of national rural floor budget neutrality required under the Affordable Care Act."							
LUGAR	Provider is located in a Lugar County as defined in 1886(d)(8)(B) of the Act							
Section 401 hospital	A 'SEC401' denotes urban providers redesignated as rural under CFR 412.103 - Sec 401 of BIPA							
Section 505 eligible	A 'YES' denotes providers eligible  to receive a wage index adjustment under  Sec. 505  of  P.L. 108-173 for  FY 2013							
Section 505 wage adjustment	Wage adjustment for providers who are eligible to receive a wage index adjustment under  Sec. 505  of P.L. 108-173 for FY 2013. 							
Cost of Living Adjustment	Cost of Living Adjustment factor obtained from the U.S. Office of Personnel Management  for IPPS providers located in Alaska or Hawaii for IPPS operating payments							
Resident to Bed Ratio	Resident to Bed Ratio. Used to determine IME factor for operating PPS payments							
RDAY	Resident to Average Daily Census (ADC) ratio. Used to calculate the IME adjustment for Capital PPS							
BEDS	The number of total beds obtained from cost report data.**							
Average Daily Census	Calculated as the ratio of Total Acute Inpatient Days to Total Days in the Cost Reporting Period obtained from cost report data.**							
TCHOP	IME adjustment factor for Operating PPS							
TCHCP	IME adjustment factor for Captial PPS							
DSHPCT	Disproportionate Share Hospital Patient percent as determined from cost report data & SSA data							
DSHOPG	Operating Disproportionate Share Hospital (DSH) adjustment							
DSHCPG	Capital Disproportionate Share (DSH) adjustment							
Operating CCR	Ratio of Medicare operating costs to Medicare covered charges from the December 2011 update of the Provider Specific File (PSF)							
Capital CCR	Ratio of Medicare capital costs to Medicare covered charges from the December 2011 update of the Provider Specific File (PSF)							
Provider Type	Type of provider - key:  0=IPPS; 7=RURAL REFERRAL CENTER (RRC); 8=INDIAN; 16=Sole Community Hospital (SCH); 17=SCH/RRC; 21=ESSENTIAL ACCESS CMTY HSP (EACH); 22=EACH/RRC; Reflects expiration of Medicare Dependent Hospital payment status where providers no longer have the provider type of 14 (former MDH) or 15 (former MDH/RRC).							
FY13 HSP Rate	82/87/96/06 Hospital Specific Payment (HSP) Rate updated to FY2013 for SCH providers with the proposed documentation and coding adjustment and increase to the rate due to the Cape Cod v. Sebelius decision.  							
BILLS	"Total number of Medicare cases for the provider from the FY2011 MEDPAR, December 2011 Update"							
TACMIV29	Transfer adjusted Case Mix Index under Grouper V29							
CASETA29	Transfer Adjusted Cases under Grouper V29 and FY 2012 Post Acute Transfer Policy							
CMIV29	Case Mix Index under Grouper V29 for SCH/ former MDH providers paid under their Hospital Specific Payment rate							
IME_TACMIV29	Transfer adjusted Case Mix under Grouper V29 for Medicare Advantage cases submitted by teaching hospitals that received a Fee-for-Service IME payment. These CMIs are included to calculate the IME payments for  budget neutrality. 							
IME_CASETA29	Transfer adjusted  cases under Grouper V29 for Medicare Advantage cases submitted by teaching hospitals that receive a fee-for-service IME payment. The IME payment associated with these cases are included in the budget neutrality calculations and in payment modelling.							
TACMIV30	Transfer adjusted Case Mix Index under Proposed Grouper V30							
CASETA30	Transfer Adjusted Cases under Proposed Grouper V30  and Proposed FY2013 Post Acute Transfer Policy							
CMIV30	Case Mix Index under Proposed Grouper V30 for SCH providers paid under their Hospital Specific Payment rate							
IME_TACMIV30	Transfer adjusted Case Mix under Proposed Grouper V30 for Medicare Advantage cases submitted by teaching hospitals that received a Fee-for-Service IME payment. These CMIs are included to calculate the IME payments for  budget neutrality. 							
IME_CASETA30	Transfer adjusted  cases under Proposed Grouper V30 for Medicare Advantage cases submitted by teaching hospitals that receive a fee-for-service IME payment. The IME payment associated with these cases are included in the budget neutrality calculations and in payment modelling.							
FY 2013 GAF	Proposed Post Reclass Geographic adjustment factor (GAF) for Capital FY 2013							
FY 2013 Puerto Rico Specific GAF	Proposed Post Reclass GAF for Capital for Puerto Rico Providers FY 2013							
Cost of Living Adjustment-Capital	"Capital COLA factor for hospitals located in Alaska and Hawaii, which is based on the applicable operating IPPS COLA factor ."							
OUT13F	Estimated operating outlier payments as a percentage of the provider's Federal operating PPS payments							
COUT13F	 Estimated capital outlier payments as a percentage of the provider's Federal capital PPS payments							
MCR_PCT	Medicare days as a percent of total inpatient days (not available for all providers that receive HSP rate) 							
Proposed Proxy Value Based Purchasing Adjustment Factor	"Proposed payment adjustment for proposed value based purchasing program (Section 3001 of Affordable Care Act) based on performance scores from an older performance period. Puerto Rico hospitals are exempt from the payment adjustment, as proposed. The Secretary has the authority to exempt Maryland hospitals from the Program, annually. The  data is estimated, based on a hypothetical, historical period of performance and that it is used as a proxy adjustment for the FY 2013 Hospital VBP Payment adjustment factor, which we will not know until the actual FY 2013 performance period ends and the values are computed.  For FY 2013, this will not occur until after the FY 2013 IPPS rule is finalized."							
Proposed Proxy Readmission Adjustment Factor	"Proposed payment adjustment for Hospital Readmissions Reduction Program (Section 3025 of Affordable Care Act).  Puerto Rico hospitals are exempt from the payment adjustment, as proposed. The Secretary has the authority to exempt Maryland hospitals from the Program, annually. Readmission Adjustment Factors are based on excess readmission ratios under a methodology finalized in the FY 2012 IPPS Final Rule,  from an older performance period (July 1, 2007 to June 30, 2010). and will be updated based on excess readmission ratios from the finalized performance period of July 1, 2008 to June 30, 2011 in the final rule. The excess readmission ratios used to calculate these proposed adjustments will not be the same ratios used to determine the final payment adjustment and are used in the proposed rule for the purpose of modeling our proposed methodology to calculate the readmission adjustment factor."							
								
"**The most recent available cost report data were used (FYs 2008 - 2009). A ""zero"" value may indicate unavailable or incomplete data. "								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
								
