CMS releases new hospital, physician payment data: 5 findings

CMS released data Monday that shows hospitals' Medicare charges and payments and what Medicare paid physicians and suppliers in 2013.

The data includes information on the amounts 3,000 hospitals billed Medicare for services in connection with the 100 most common Medicare inpatient stays and 30 selected outpatient procedures. The data includes information from hospitals located in all 50 states and Washington, D.C.

The top 100 inpatient stays represented in the hospital inpatient data are associated with approximately $62 billion in Medicare payments to hospitals and outpatient facilities and more than seven million hospital discharges in 2013.

Additionally, the data includes Medicare Part B physician, practitioner and other supplier utilization and payment information, such as information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals, according to CMS. The data also shows payment and submitted charges, or bills, for those services and procedures by provider. The data has information for over 950,000 distinct healthcare providers who collectively received $90 billion in Medicare payments.

Here are five findings from the CMS data.

1. Major joint replacement continues to be the most frequently occurring discharge nationally with 446,148 total discharges and total allowed amount cost of $6.6 billion in 2013.  

2. Based on an analysis of hospital discharge rate per capita, the highest discharge rates for major joint replacement were found in the Midwest and Rocky Mountain areas. The lowest discharge rates per 1,000 were seen in parts of the northeast, New Mexico, and parts of California and Nevada.

3. CMS said hospital discharges have increased over time and at a modest rate.For example, major joint replacement grew from $50,116 to $52,249, or a rate of 4.3 percent, from 2011 to 2012, and grew from $52,249 to $54,239, a rate of 3.8 percent, from 2012 to 2013.   

4. Medicare paid at least 3,900 individual healthcare providers at least $1 million in 2013, according to a Bloomberg analysis of the CMS data.

5. In 2013, physicians on average received about $74,000 in Medicare reimbursement, although five received more than $10 million, according to the Bloomberg analysis.

 

 

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