CMS Releases 2019 Post-Acute Care and Hospice Utilization and Payment Data

Today, CMS posted the annual update of the Post-Acute Care and Hospice Provider Public Use File (herein known as “PAC PUF”) with data for 2019.  The PAC PUF now has data available for years 2013-2019.  The PAC PUF presents summarized information on services provided to Medicare beneficiaries by home health agencies, hospices, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs).  It contains information on demographic and clinical characteristics of beneficiaries served, professional and paraprofessional service utilization, submitted charges, and payments at the provider, state, and national levels.  Additionally, the PAC PUF includes payment information at the payment system level for home health agencies, SNFs, and IRFs. For 2019, we have modified the data for SNFs presented in the PAC PUF.  Specifically, SNF data are reported in a separate file and only cover the period between January 1, 2019 and September 30, 2019. We adjusted the PAC PUF for SNFs because the SNF Prospective Payment System (PPS) changed from RUG IV to the Patient Driven Payment Model (PDPM) on October 1, 2019.  To minimize confusion, we have only reported data for RUG IV in the 2019 PAC PUF.  We will incorporate data for the PDPM payment system in our next annual release of the PAC PUF.  In addition, beginning with the 2019 PAC PUF, we applied an updated crosswalk from the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (AHRQ) to classify primary diagnoses using the Clinical Classifications Software Refined (CCSR) for ICD-10-CM version 2021.2.  Previous releases of the PAC PUF used the Clinical Classifications Software (CCS) for ICD-10-CM/PCS (Beta version).  More information can be found in the supplemental Methodology document. The 2019 PAC PUF summarizes information on nearly 15 million claims and over $69 billion in Medicare payments for 2019.  It contains information on 9,001 home health agencies, 4,584 hospices, 14,532 SNFs, 1,106 IRFs, and 358 LTCHs.  CMS protects beneficiaries’ personal information in all public data releases. LINK TO 2013-2019 PAC PUFs: https://data.cms.gov/provider-summary-by-type-of-service/medicare-post-acute-care-hospice/medicare-post-acute-care-hospice-by-provider-and-service

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.