WASHINGTON, D.C. (January 29, 2021)—The Centers for Medicare & Medicaid Services (CMS) has added the 2018 calendar year to publicly-available online files of the Post-Acute Care and Hospice Provider Utilization and Payment Public Use Files.
The Post-Acute Care and Hospice Provider Utilization and Payment Public Use Files (PAC PUF) present 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). The PAC PUF 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 information at the payment system level for home health agencies, SNFs and IRFs. The PAC PUF is derived from information in CMS’s Chronic Conditions Data Warehouse (CCW) data files, and is based on 100% final-action (i.e., all claim adjustments have been resolved) Part A institutional claims. The PAC PUF is segmented by year. The PAC PUF data is extremely valuable and interesting information on a state and a provider-by-provider basis and contains identifying information, so it allows providers to see competitor-specific data.
Although the PAC PUF provides a wealth of payment and utilization information about post-acute services, the dataset also has a number of limitations. The information presented in this file does not indicate the quality of care provided by individual providers. The file only contains cost and utilization information. Additionally, the data are not risk adjusted and thus do not account for differences in the underlying severity of disease of patient populations treated by providers. For additional limitations, please review the methodology document available on the website.
The PAC PUF contains four tables: 1) aggregated information by provider, 2) aggregated information by provider and home health resource group (HHRG), 3) aggregated information by provider and resource utilization group (RUG), and 4) aggregated information by provider and case-mix group (CMG). All four tables also contain summary information by state as well as national totals.
Data are available in an online interactive dataset (allows users to sort and filter data directly without downloading) and Microsoft Excel.
—Via NAHC
