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In this paper, we describe technical approaches for calculating costs associated with Medicare post-acute care provider claims, including long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), home health agencies (HHAs), and skilled nursing facilities (SNFs), using Medicare cost report data (Healthcare Cost Report Information System, or HCRIS) and claims data. Analyses of resource utilization often focus on costs of providing medical care, rather than payments for medical care. Calculated costs more accurately reflect the claim-level costs to providers of providing care than the payments made to providers, which often include policy adjustments (such as disproportionate share payments for inpatient hospitals) that are not directly related to the costs of providing care.
This paper describes technical approaches for calculating costs associated with Medicare post-acute care provider claims including long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), home health agencies (HHAs), and skilled nursing facilities (SNFs) using Medicare cost report data (Healthcare Cost Report Information System or HCRIS) and claims data. Costs of providing medical care, rather than payments for medical care, are often the focus of analyses of resource utilization. Calculated costs more accurately reflect the claim level costs to providers of providing care than the payments made to providers, which often include policy adjustments (such as disproportional share payments for inpatient hospitals) that are not directly related to the costs of providing care.
Medicare Program - Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, etc. - Correction (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare Program - Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, etc. - Correction (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This document corrects technical and typographical errors in the final rule that appeared in the August 22, 2016 Federal Register titled "Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals." This book contains: - The complete text of the Medicare Program - Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals, etc. - Correction (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
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This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.