Unlocking Newly Released Medicare Provider and Payment Data: Home Health Agencies

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Unlocking Newly Released Medicare Provider and Payment Data: Home Health Agencies

Perscio is constantly getting the message out to organizations that the data you need for an effective strategy is probably already out there. As a further example, a new release of medical provider utilization data shows just how much information is more and more available for many industries, especially healthcare.

2013 Provider Utilization and Payment Data for Home Health Services

The Obama administration has been on a mission to put out open health information to make the United States health system more transparent, affordable, and accountable. At the center of this is releasing large troves of health information albeit with some lag involved in the date of which the data was collected. Just in time for the holidays, the Center for Medicare and Medicaid Services (CMS) gave us an early Christmas data gift in the form of the 2013 Provider Utilization and Payment data for Home Health services.

This release of data provides visibility into 4,290,069 episodes of care across all 50 states totaling over $12 billion dollars in 2013 CMS spending on Home Healthcare Services across the united states. As our population age rises and we enter an age bubble understanding these services is extremely important.

So What Does This Data Tell Us?

To first answer this question you need to be able to interact with it. We whipped up a quick and easy Tableau Public visualization (embedded below) to be able to pull out some insights from this data. Click and interact with it and the three different dashboards below!

Rising to the top of what we are seeing is an answer to the question – “Is there a lot of variance in the payments for Home Health services?”. To put it quite simple the answer is by far an astounding “yes”. With exception of 4 codes all had some level of variance amongst there reimbursement rates. The most significant variance was found in code 3CGK (Late Episode, 0-13 therapies, Clinical Severity Level 3, Functional Severity Level 2,Service Severity Level 1).

To put this variance in perspective (and using a holiday analogy), if Santa needed service classified as 3CGK on average in Florida the agency providing the service was payed anywhere between $12,659 per episode to $1,929 representing a variance in price of $10,730! Pretty significant reimbursement variation. What would be interesting to look at is amongst these agencies what level of quality do they provide and what is the right reimbursement level to get the biggest bang for our buck in terms of high quality care.

We wont go into exhaustive data of findings yet because we are still looking to understand what the data is telling us but wanted to provide you with the ability to do the same through the interactive visual. We hope you will let us know what insights you find!

Happy Holidays and give us a shout in 2016 if we can help your business leverage your data (or open data) to derive valuable insights!