Figure 3-1 is titled "Distribution of Freestanding versus Hospital-Based SNFs, IRFs, and Freestanding and HWH LTCHs in 2007." It is a map the total number of SNF, IRF, and LTCH providers by state. There are five levels of shading based on total number of providers per state. The levels of shading correspond to the following breakdowns: 1.) 73-310 facilities per state; 2.) 311-754 facilities per state; 3.) 755-1,364 facilities per state; 4.) 1,365-3,079 facilities per state; and 5.) 3,080-4,568 facilities per state. States with the fewest total providers include Nevada, Idaho, Montana, Utah, Wyoming, North Dakota, South Dakota, New Mexico, Alabama, Hawaii, West Virginia, Maine, New Hampshire, and Vermont. States with the highest number of total providers include California, Texas, Florida, Illinois, Ohio, and Pennsylvania. In addition to looking at the total number of providers per state, this map also displays the location of each type of freestanding or hospital-based provider across the United States. The source for this analysis was the 2007 POS data.
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Figure 3-2 is titled "PAC Transitions for Live Acute Hospital Discharges, Number and Percent of Admissions, 2006." This figure shows the post-acute care transitions for live acute hospital discharges in the 2006 post-acute episode file (Medicare claims 5% sample). This transition table shows the number and percent of beneficiaries discharged to each site of post-acute care. In 2006, there were 310,628 live hospital discharges. Of these live hospital discharges, 109,236 (35.2 percent) of beneficiaries went on to use post-acute care. Of the beneficiaries going on to post-acute care, 40,865 (37.4 percent) were discharged to HHA; 11,240 (10.3 percent) were discharged to IRF; 2,235 (2.0 percent) were discharged to LTCH; 9,968 (9.1 percent) were discharged to hospital outpatient therapy; and 44,929 (41.1 percent) were discharged to SNF. This figure continues to track the number and percent of beneficiaries discharged to subsequent sites of post-acute care. The post-acute episodes presented here are truncated at the fourth post-acute claim following hospital discharge.
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Figure 3-3 is titled "PAC Transitions for Live Acute Hospital Discharges, Mean Utilization and Medicare Payments, 2006." This figure shows the mean utilization and Medicare payments per setting for beneficiaries discharged to each post-acute care setting within their episode. The sample for this analysis was 109,236 beneficiaries using post-acute care in the 2006 (Medicare claims 5% sample). This transition table shows the mean utilization and payment per setting of care for beneficiaries discharged to each site of care. Utilization is measured in mean days for acute, IRF, SNF, and LTCH; mean visits for HHA, and mean units of service for hospital outpatient therapy. The mean length of stay and Medicare payments for index acute admissions was 6.8 days and $10,297. For beneficiaries discharged to HHA, mean HHA visits were 17.8 and mean Medicare payments for HHA were $2,760. For beneficiaries discharged to IRF, mean length of stay was 12.4 days and mean Medicare payment for the IRF stay was $14,660. For beneficiaries discharged to LTCH, mean length of stay was 28.8 days and mean Medicare payment for the LTCH stay was $35,917. For beneficiaries discharged to hospital outpatient therapy, mean use was 27.9 units of service and mean Medicare payment for hospital outpatient therapy was $847. For beneficiaries discharged to SNF, mean length of stay was 28.5 days and mean Medicare payment for the SNF stay was $8,759. This figure also shows the mean use and mean Medicare payment per site of care for beneficiaries discharged to subsequent sites of post-acute care during their episode. The post-acute episodes presented here are truncated at the fourth post-acute claim following hospital discharge.
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Figure 3-4 is titled "PAC Transitions for Live Acute Hospital Discharges from DRG 089 Simple Pneumonia and Pleurisy Age > 17 with CC, Number and Percentage of Admissions, 2006." This figure shows the post-acute care transitions for live acute hospital discharges in the 2006 post-acute episode file for beneficiaries in DRG 089 Simple Pneumonia & Pleurisy Age > 17 (Medicare claims 5% sample). This transition table shows the number and percent of beneficiaries discharged to each site of care. In 2006, there were 13,911 live hospital discharges in DRG 089. Of these live hospital discharges, 4,675 (33.6 percent) of beneficiaries went on to use post-acute care. Of the beneficiaries going on to post-acute care, 1,749 (37.4 percent) were discharged to HHA; 84 (1.8 percent) were discharged to IRF; 57 (1.2 percent) were discharged to LTCH; 573 (12.3 percent) were discharged to hospital outpatient therapy; and 2,212 (47.3 percent) were discharged to SNF. This figure continues to track the number and percent of beneficiaries discharged to subsequent sites of post-acute care. The post-acute episodes presented here are truncated at the fourth post-acute claim following hospital discharge.
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Figure 3-5 is titled "PAC Transitions for Live Acute Hospital Discharges from DRG 089 Simple Pneumonia and Pleurisy Age > 17 with CC, Mean Utilization and Medicare Payment, 2006." This figure shows the mean utilization and Medicare payments per setting for post-acute care transitions for beneficiaries in DRG 089 Simple Pneumonia & Pleurisy Age > 17. The sample for this analysis was 4,675 beneficiaries in DRG 089 using post-acute care in the 2006 (Medicare claims 5% sample). This transition table shows the mean utilization and payment per setting of care for beneficiaries discharged to each site of care. Utilization is measured in mean days for acute, IRF, SNF, and LTCH; mean visits for HHA, and mean units of service for hospital outpatient therapy. The mean length of stay and Medicare payment for index acute admissions was 6.2 days and $5,161. For beneficiaries discharged to HHA, mean HHA visits were 18.7 and mean Medicare payment for HHA was $2,722. For beneficiaries discharged to IRF, mean length of stay was 12.1 days and mean Medicare payment for the IRF stay was $14,285. For beneficiaries discharged to LTCH, mean length of stay was 21.5 days and mean Medicare payment for the LTCH stay was $28,091. For beneficiaries discharged to hospital outpatient therapy, mean use was 22.8 units of service and mean Medicare payment for hospital outpatient therapy was $669. For beneficiaries discharged to SNF, mean length of stay was 28.1 days and mean Medicare payment for the SNF stay was $8,150. This figure also shows the mean use and mean Medicare payment per site of care for beneficiaries discharged to subsequent sites of post-acute care during their episode. The post-acute episodes presented here are truncated at the fourth post-acute claim following hospital discharge.
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Figure 3-6 is titled "PAC Transitions for Live Acute Hospital Discharges from DRG 544 Major Joint Replacement or Reattachment of Lower Extremity, Number and Percentage of Admissions, 2006." This figure shows the post-acute care transitions for live acute hospital discharges in the 2006 post-acute episode file for beneficiaries in DRG 544 Major Joint Replacement or Reattachment of Lower Extremity (Medicare claims 5% sample). This transition table shows the number and percent of beneficiaries discharged to each site of care. In 2006, there were 17,475 live hospital discharges in DRG 544. Of these live hospital discharges, 15,261 (87.3 percent) of beneficiaries went on to use post-acute care. Of the beneficiaries going on to post-acute care, 5,442 (35.7 percent) were discharged to HHA; 2,963 (19.4 percent) were discharged to IRF; 50 (0.3 percent) were discharged to LTCH; 1,122 (7.4 percent) were discharged to hospital outpatient therapy; and 5,684 (37.2 percent) were discharged to SNF. This figure continues to track the number and percent of beneficiaries discharged to subsequent sites of post-acute care. The post-acute episodes presented here are truncated at the fourth post-acute claim following hospital discharge.
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Figure 3-7 is titled "PAC Transitions for Live Acute Hospital Discharges from DRG 544 Major Joint Replacement or Reattachment of Lower Extremity, Mean Utilization and Medicare Payment, 2006." This figure shows the mean utilization and Medicare payments per setting for post-acute care transitions for beneficiaries in DRG 544 Major Joint Replacement or Reattachment of Lower Extremity. The sample for this analysis was 15,261 beneficiaries in DRG 544 using post-acute care in the 2006 (Medicare claims 5% sample). This transition table shows the mean utilization and payment per setting of care for beneficiaries discharged to each site of care. Utilization is measured in mean days for acute, IRF, SNF, and LTCH; mean visits for HHA, and mean units of service for hospital outpatient therapy. The mean length of stay and Medicare payment for index acute admissions was 4.2 days and $10,532. For beneficiaries discharged to HHA, mean HHA visits were 14.4 and mean Medicare payment for HHA were $3,120. For beneficiaries discharged to IRF, mean length of stay was 10.1 days and mean Medicare payment for the IRF stay was $11,542. For beneficiaries discharged to LTCH, mean length of stay was 22.1 days and mean Medicare payment for the LTCH stay was $23,122. For beneficiaries discharged to hospital outpatient therapy, mean use was 41.5 units of service and mean Medicare payment for hospital outpatient therapy was $882. For beneficiaries discharged to SNF, mean length of stay was 19.6 days and mean Medicare payment for the SNF stay was $6,985. This figure also shows the mean use and mean Medicare payment per site of care for beneficiaries discharged to subsequent sites of post-acute care during their episode. The post-acute episodes presented here are truncated at the fourth post-acute claim following hospital discharge.
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Figure 3-8 is titled "Medicare Payments by Service Type, All Post-Acute Users, 2006." This is a pie chart depicting the proportion of Medicare payments attributable to different service types. The mean episode payment for all post-acute users (N=109,236) is $30,028. The pie chart shows that 34.1 percent of Medicare payments are for Index Admissions; 17.9 percent of Medicare payments are for SNF; 6.4 percent of Medicare payments are for IRF; 7.9 percent of Medicare payments are for HHA; 1.0 percent of Medicare payments are for therapy; 3.7 percent of Medicare payments are for LTCH; 15.9 percent of Medicare payments are for acute readmissions; 11.9 percent of Medicare payments are for Part B services; 1.0 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
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Figure 3-9 is titled "Medicare Payments by Service Type, All Post-Acute Users, by APR-DRG." This is a figure with four pie charts depicting the proportion of Medicare payments attributable to different service types for beneficiaries in APR-DRG Severity Index Level 1, APR-DRG Severity Index Level 2, APR-DRG Severity Index Level 3, and APR-DRG Severity Index Level 4. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
The mean episode payment for post-acute users in APR-DRG Severity Index Level 1 (N=16,906) is $21,349. The pie chart for APR-DRG Severity Index Level 1 shows that 37.6 percent of Medicare payments are for Index Admissions; 16.4 percent of Medicare payments are for SNF; 8.0 percent of Medicare payments are for IRF; 10.7 percent of Medicare payments are for HHA; 1.5 percent of Medicare payments are for therapy; 1.1 percent of Medicare payments are for LTCH; 12.3 percent of Medicare payments are for acute readmissions; 11.5 percent of Medicare payments are for Part B services; 0.9 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. Note that the percent of payments for hospice are 0 due to rounding.
The mean episode payment for post-acute users in APR-DRG Severity Index Level 2 (N=49,614) is $26,053. The pie chart for APR-DRG Severity Index Level 2 shows that 32.2 percent of Medicare payments are for Index Admissions; 20.0 percent of Medicare payments are for SNF; 7.4 percent of Medicare payments are for IRF; 9.2 percent of Medicare payments are for HHA; 1.1 percent of Medicare payments are for therapy; 1.8 percent of Medicare payments are for LTCH; 15.6 percent of Medicare payments are for acute readmissions; 11.7 percent of Medicare payments are for Part B services; 1.0 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in APR-DRG Severity Index Level 3 (N=31,192) is $34,156. The pie chart for APR-DRG Severity Index Level 3 shows that 32.7 percent of Medicare payments are for Index Admissions; 18.1 percent of Medicare payments are for SNF; 5.7 percent of Medicare payments are for IRF; 7.0 percent of Medicare payments are for HHA; 0.8 percent of Medicare payments are for therapy; 4.1 percent of Medicare payments are for LTCH; 18.1 percent of Medicare payments are for acute readmissions; 12.4 percent of Medicare payments are for Part B services; 1.0 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in APR-DRG Severity Index Level 4 (N=6,845) is $63,087. The pie chart for APR-DRG Severity Index Level 4 shows that 43.2 percent of Medicare payments are for Index Admissions; 11.1 percent of Medicare payments are for SNF; 4.3 percent of Medicare payments are for IRF; 3.7 percent of Medicare payments are for HHA; 0.5 percent of Medicare payments are for therapy; 10.6 percent of Medicare payments are for LTCH; 13.8 percent of Medicare payments are for acute readmissions; 12.0 percent of Medicare payments are for Part B services; 0.8 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
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Figure 3-10 is titled "Medicare Payments by Service Type, All Post-Acute Users, by MS-DRG." This is a figure with three pie charts depicting the proportion of Medicare payments attributable to different service types for beneficiaries in MS-DRG Level No CCs, MS-DRG Level W/CCs, and MS-DRG Severity W/MCCs. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
The mean episode payment for post-acute users in MS-DRG Level No CCs (N=61,196) is $26,609. The pie chart for MS-DRG Level No CCs shows that 36.0 percent of Medicare payments are for Index Admissions; 17.7 percent of Medicare payments are for SNF; 6.6 percent of Medicare payments are for IRF; 8.8 percent of Medicare payments are for HHA; 1.1 percent of Medicare payments are for therapy; 3.7 percent of Medicare payments are for LTCH; 14.1 percent of Medicare payments are for acute readmissions; 11.2 percent of Medicare payments are for Part B services; 0.9 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in MS-DRG Level W/CCs (N=26,736) is $30,238. The pie chart for MS-DRG Level W/CCs shows that 30.9 percent of Medicare payments are for Index Admissions; 19.6 percent of Medicare payments are for SNF; 7.1 percent of Medicare payments are for IRF; 8.1 percent of Medicare payments are for HHA; 0.9 percent of Medicare payments are for therapy; 2.7 percent of Medicare payments are for LTCH; 17.4 percent of Medicare payments are for acute readmissions; 12.1 percent of Medicare payments are for Part B services; 1.1 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in MS-DRG Level W/MCCs (N=21,304) is $39,587. The pie chart for MS-DRG Level W/MCCs shows that 34.3 percent of Medicare payments are for Index Admissions; 16.6 percent of Medicare payments are for SNF; 5.4 percent of Medicare payments are for IRF; 5.9 percent of Medicare payments are for HHA; 0.8 percent of Medicare payments are for therapy; 4.8 percent of Medicare payments are for LTCH; 17.8 percent of Medicare payments are for acute readmissions; 13.3 percent of Medicare payments are for Part B services; 1.0 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
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Figure 3-11 is titled "Medicare Payments by Service Type, DRG 089 Simple Pneumonia & Pleurisy Age > 17 with CC." This is a pie chart depicting the proportion of Medicare payments attributable to different service types for beneficiaries in DRG 089. The mean episode payment for all post-acute users in DRG 089 (N=4,675) is $20,476. The pie chart shows that 25.2 percent of Medicare payments are for Index Admissions; 26.3 percent of Medicare payments are for SNF; 2.4 percent of Medicare payments are for IRF; 9.1 percent of Medicare payments are for HHA; 1.0 percent of Medicare payments are for therapy; 2.8 percent of Medicare payments are for LTCH; 20.1 percent of Medicare payments are for acute readmissions; 11.9 percent of Medicare payments are for Part B services; 1.2 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
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Figure 3-12 is titled "Medicare Payments by Service Type, DRG 089 Simple Pneumonia & Pleurisy Age > 17 w CC, by APR-DRG." This is a figure with four pie charts depicting the proportion of Medicare payments attributable to different service types for beneficiaries in DRG 089 in APR-DRG Severity Index Level 1, APR-DRG Severity Index Level 2, APR-DRG Severity Index Level 3, and APR-DRG Severity Index Level 4. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
The mean episode payment for post-acute users in DRG 089 in APR-DRG Severity Index Level 1 (N=153) is $15,383. The pie chart for APR-DRG Severity Index Level 1 shows that 32.4 percent of Medicare payments are for Index Admissions; 25.8 percent of Medicare payments are for SNF; 1.1 percent of Medicare payments are for IRF; 11.1 percent of Medicare payments are for HHA; 0.9 percent of Medicare payments are for therapy; 0.4 percent of Medicare payments are for LTCH; 16.7 percent of Medicare payments are for acute readmissions; 10.7 percent of Medicare payments are for Part B services; 0.6 percent of Medicare payments are for DME; and 0.2 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in DRG 089 in APR-DRG Severity Index Level 2 (N=2,392) is $18,657. The pie chart for APR-DRG Severity Index Level 2 shows that 26.7 percent of Medicare payments are for Index Admissions; 27.1 percent of Medicare payments are for SNF; 2.1 percent of Medicare payments are for IRF; 9.9 percent of Medicare payments are for HHA; 1.0 percent of Medicare payments are for therapy; 1.7 percent of Medicare payments are for LTCH; 19.0 percent of Medicare payments are for acute readmissions; 11.2 percent of Medicare payments are for Part B services; 1.3 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in DRG 089 in APR-DRG Severity Index Level 3 (N=1,950) is $34,156. The pie chart for APR-DRG Severity Index Level 3 shows that 23.4 percent of Medicare payments are for Index Admissions; 25.8 percent of Medicare payments are for SNF; 2.7 percent of Medicare payments are for IRF; 8.6 percent of Medicare payments are for HHA; 0.8 percent of Medicare payments are for therapy; 3.4 percent of Medicare payments are for LTCH; 21.5 percent of Medicare payments are for acute readmissions; 12.5 percent of Medicare payments are for Part B services; 1.1 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in DRG 089 in APR-DRG Severity Index Level 4 (N=180) is $27,365. The pie chart for APR-DRG Severity Index Level 4 shows that 24.7 percent of Medicare payments are for Index Admissions; 23.7 percent of Medicare payments are for SNF; 2.8 percent of Medicare payments are for IRF; 5.3 percent of Medicare payments are for HHA; 0.7 percent of Medicare payments are for therapy; 8.1 percent of Medicare payments are for LTCH; 19.9 percent of Medicare payments are for acute readmissions; 13.6 percent of Medicare payments are for Part B services; 0.9 percent of Medicare payments are for DME; and 0.2 percent of Medicare payments are for Hospice.
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Figure 3-13 is titled "Medicare Payments by Service Type, DRG 089 Simple Pneumonia & Pleurisy Age > 17 w CC, by MS-DRG." This is a figure with three pie charts depicting the proportion of Medicare payments attributable to different service types for beneficiaries in DRG 089 in MS-DRG Level No CCs, MS-DRG Level W/CCs, and MS-DRG Severity W/MCCs. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
The mean episode payment for post-acute users in DRG 089 in MS-DRG Level No CCs (N=1,222) is $17,525. The pie chart for MS-DRG Level No CCs shows that 28.2 percent of Medicare payments are for Index Admissions; 28.3 percent of Medicare payments are for SNF; 1.2 percent of Medicare payments are for IRF; 10.0 percent of Medicare payments are for HHA; 1.1 percent of Medicare payments are for therapy; 1.7 percent of Medicare payments are for LTCH; 18.2 percent of Medicare payments are for acute readmissions; 10.1 percent of Medicare payments are for Part B services; 1.1 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in DRG 089 in MS-DRG Level W/CCs (N=2,625) is $20,517. The pie chart for MS-DRG Level W/CCs shows that 25.1 percent of Medicare payments are for Index Admissions; 25.5 percent of Medicare payments are for SNF; 2.7 percent of Medicare payments are for IRF; 9.4 percent of Medicare payments are for HHA; 0.8 percent of Medicare payments are for therapy; 2.6 percent of Medicare payments are for LTCH; 20.7 percent of Medicare payments are for acute readmissions; 11.9 percent of Medicare payments are for Part B services; 1.3 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
The mean episode payment for post-acute users in DRG 089 in MS-DRG Level W/MCCs (N=828) is $24,701. The pie chart for MS-DRG Level W/MCCs shows that 22.4 percent of Medicare payments are for Index Admissions; 26.3 percent of Medicare payments are for SNF; 2.7 percent of Medicare payments are for IRF; 7.3 percent of Medicare payments are for HHA; 1.1 percent of Medicare payments are for therapy; 4.4 percent of Medicare payments are for LTCH; 20.7 percent of Medicare payments are for acute readmissions; 13.9 percent of Medicare payments are for Part B services; 1.1 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
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Figure 3-14 is titled "Medicare Payments by Service Type, DRG 544 Major Joint Replacement or Reattachment of Lower Extremity." This is a pie chart depicting the proportion of Medicare payments attributable to different service types for beneficiaries in DRG 544. The mean episode payment for all post-acute users in DRG 544 (N=15,261) is $23,985. The pie chart shows that 43.9 percent of Medicare payments are for Index Admissions; 13.8 percent of Medicare payments are for SNF; 10.3 percent of Medicare payments are for IRF; 10.4 percent of Medicare payments are for HHA; 1.6 percent of Medicare payments are for therapy; 0.7 percent of Medicare payments are for LTCH; 7.7 percent of Medicare payments are for acute readmissions; 10.9 percent of Medicare payments are for Part B services; 0.6 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample. Note that the percent of payments for hospice are 0 due to rounding.
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Figure 3-15 is titled "Medicare Payments by Service Type, DRG 544 Major Joint Replacement or Reattachment of Lower Extremity, by APR-DRG." This is a figure with four pie charts depicting the proportion of Medicare payments attributable to different service types for beneficiaries in DRG 544 in APR-DRG Severity Index Level 1, APR-DRG Severity Index Level 2, APR-DRG Severity Index Level 3, and APR-DRG Severity Index Level 4. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
The mean episode payment for post-acute users in DRG 544 in APR-DRG Severity Index Level 1 (N=4,686) is $20,513. The pie chart for APR-DRG Severity Index Level 1 shows that 50.6 percent of Medicare payments are for Index Admissions; 10.1 percent of Medicare payments are for SNF; 8.7 percent of Medicare payments are for IRF; 11.4 percent of Medicare payments are for HHA; 2.2 percent of Medicare payments are for therapy; 0.3 percent of Medicare payments are for LTCH; 5.3 percent of Medicare payments are for acute readmissions; 10.7 percent of Medicare payments are for Part B services; 0.7 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. Note that the percent of payments for hospice are 0 due to rounding.
The mean episode payment for post-acute users in DRG 544 in APR-DRG Severity Index Level 2 (N=7,272) is $24,446. The pie chart for APR-DRG Severity Index Level 2 shows that 42.8 percent of Medicare payments are for Index Admissions; 14.5 percent of Medicare payments are for SNF; 10.8 percent of Medicare payments are for IRF; 10.3 percent of Medicare payments are for HHA; 1.5 percent of Medicare payments are for therapy; 0.6 percent of Medicare payments are for LTCH; 8.2 percent of Medicare payments are for acute readmissions; 10.8 percent of Medicare payments are for Part B services; 0.6 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. Note that the percent of payments for hospice are 0 due to rounding.
The mean episode payment for post-acute users in DRG 544 in APR-DRG Severity Index Level 3 (N=3,161) is $27,223. The pie chart for APR-DRG Severity Index Level 3 shows that 39.6 percent of Medicare payments are for Index Admissions; 16.2 percent of Medicare payments are for SNF; 11.2 percent of Medicare payments are for IRF; 9.7 percent of Medicare payments are for HHA; 1.0 percent of Medicare payments are for therapy; 1.4 percent of Medicare payments are for LTCH; 9.3 percent of Medicare payments are for acute readmissions; 11.1 percent of Medicare payments are for Part B services; 0.6 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. Note that the percent of payments for hospice are 0 due to rounding.
The mean episode payment for post-acute users in DRG 544 in APR-DRG Severity Index Level 4 (N=118) is $43,823. The pie chart for APR-DRG Severity Index Level 4 shows that 32.1 percent of Medicare payments are for Index Admissions; 21.3 percent of Medicare payments are for SNF; 12.7 percent of Medicare payments are for IRF; 6.0 percent of Medicare payments are for HHA; 0.4 percent of Medicare payments are for therapy; 3.6 percent of Medicare payments are for LTCH; 10.7 percent of Medicare payments are for acute readmissions; 12.6 percent of Medicare payments are for Part B services; 0.5 percent of Medicare payments are for DME; and 0.1 percent of Medicare payments are for Hospice.
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Figure 3-16 is titled "Composition of PAC Episode Payments, DRG 544 Major Joint Replacement or Reattachment of Lower Extremity, by MS-DRG." This is a figure with two pie charts depicting the proportion of Medicare payments attributable to different service types for beneficiaries in DRG 544 in MS-DRG Level No MCCs and MS-DRG Severity W/MCCs. The data source for this analysis is RTI analysis of 2006 Medicare claims 5% sample.
The mean episode payment for post-acute users in DRG 544 in MS-DRG Level No MCCs (N=14,446) is $23,441. The pie chart for MS-DRG Level No MCCs shows that 44.8 percent of Medicare payments are for Index Admissions; 13.4 percent of Medicare payments are for SNF; 10.2 percent of Medicare payments are for IRF; 10.6 percent of Medicare payments are for HHA; 1.6 percent of Medicare payments are for therapy; 0.6 percent of Medicare payments are for LTCH; 7.3 percent of Medicare payments are for acute readmissions; 10.7 percent of Medicare payments are for Part B services; 0.6 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. Note that the percent of payments for hospice are 0 due to rounding.
The mean episode payment for post-acute users in DRG 544 in MS-DRG Level W/MCCs (N=815) is $35,409. The pie chart for MS-DRG Level W/CCs shows that 33.2 percent of Medicare payments are for Index Admissions; 18.6 percent of Medicare payments are for SNF; 12.0 percent of Medicare payments are for IRF; 7.5 percent of Medicare payments are for HHA; 1.1 percent of Medicare payments are for therapy; 2.8 percent of Medicare payments are for LTCH; 11.9 percent of Medicare payments are for acute readmissions; 12.2 percent of Medicare payments are for Part B services; 0.6 percent of Medicare payments are for DME; and 0 percent of Medicare payments are for Hospice. Note that the percent of payments for hospice are 0 due to rounding.