Others titles

  • Wage Index Tables Final Rule and Correction Notice
  • CMS Mix and Case Index

Keywords

  • Wage Index Tables
  • Wage Index
  • Case Mix Index
  • Lugar Hospitals
  • Social Security Act
  • Geographic Reclassification of Hospitals

Case Mix Index And Wage Index Table By CCN Final Rule

This dataset contains the non-transfer adjusted Case Mix Index (CMI) based on the Medicare Severity Diagnosis Related Groups (MS-DRGs) billed on the claim in the year the claim was incurred.

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Description

Section 1886(d)(3)(E) of the Social Security Act requires that, as part of the methodology for determining prospective payments to hospitals, the Secretary must adjust the standardized amounts “for area differences in hospital wage levels by a factor (established by the Secretary) reflecting the relative hospital wage level in the geographic area of the hospital compared to the national average hospital wage level.” This adjustment factor is the wage index. We currently define hospital geographic areas (labor market areas) based on the definitions of Core-Based Statistical Areas (CBSAs) established by the Office of Management and Budget and announced in December 2003. The wage index also reflects the geographic reclassification of hospitals to another labor market area in accordance with sections 1886(d)(8)(B) and 1886(d)(10) of the Act. Note that in the FY 2012 IPPS final rule, Centers for Medicare and Medicaid Services (CMS) finalized a policy that allows a Lugar hospital that is eligible for and accepts the outmigration adjustment to automatically waive its urban status for the 3-year period for which the outmigration adjustment is effective.

Note:

1.The CCNs with a “B” in the 4th position indicate a campus of an MCH located in a different CBSA from the main provider. The campus’s wages and hours are allocated to the CBSA of its physical location. The wage index reflects the CBSA of its location, or the MGCRB reclassified wage index, if applicable. The case-mix index and average hourly wages are not separated by campus; they reflect the provider as a whole.

2.A blank indicates FY 2018 MedPAR (which is used for the FY 2020 rates) was not available for the provider, and therefore, this provider was not included in the rate setting process.

3.This is the hospital’s FY 2020 wage index with all applicable adjustments.

4.A blank indicates wage data not available for the CCN for the fiscal year or all three fiscal years.

5.Hospitals cannot receive the out-migration adjustment if they are reclassified under section 1886(d)(10) of the Act or redesignated under section 1886(d)(8)(B) of the Act or redesignated under section 1886(d)(8)(E) of the Act.

6.For FY 2020 the wage index for hospitals with a wage index value below the 25th percentile wage index increased. Based on the data for the final rule, the 25th percentile wage index value across all hospitals is 0.8457. The proposed increase in the wage index for these hospitals would be equal to half the difference between the otherwise applicable final wage index value for a year for that hospital and the 25th percentile wage index value for that year across all hospitals.

Implemented a transition of a 5-percent cap on any decrease in a hospital’s wage index from the hospital’s final wage index in FY 2019.
Please see section III.N. of the preamble of the final rule for a complete discussion regarding these policies.

About this Dataset

Data Info

Date Created

2015

Last Modified

2020-12-30

Version

FY 2021

Update Frequency

Annual

Temporal Coverage

NA

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

NA

Source Citation

NA

Keywords

Wage Index Tables, Wage Index, Case Mix Index, Lugar Hospitals, Social Security Act, Geographic Reclassification of Hospitals

Other Titles

Wage Index Tables Final Rule and Correction Notice, CMS Mix and Case Index

Data Fields

Name Description Type Constraints
CMS_Certification_NumberCMS Certification Numberstring-
Indexes_For_Discharges_Occurring_In_Federal_Fiscal_Year_2019Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2019numberlevel : Nominal
Wage_Index_2020Wage Index CCN Correction Notice for FY 2020numberlevel : Nominal
Wage_Index_Prior_To_Quartile_And_Transition_2021Wage index prior to quartile and transition for fiscal year 2021numberlevel : Nominal
Wage_Index_With_Quartile_2021Wage index with quartile for fiscal year 2020.numberlevel : Nominal
Wage_Index_With_Quartile_And_Cap_2021Wage index with quartile and cap for fiscal year 2020numberlevel : Nominal
Average_Hourly_Wage_FY_2019Average Hourly Wage Index Correction Notice for FY 2019numberlevel : Nominal
Average_Hourly_Wage_FY_2020Average Hourly Wage Index CCN for FY 2020numberlevel : Nominal
Average_Hourly_Wage_FY_2021Average Hourly Wage Index for FY 2021numberlevel : Nominal
Average_Hourly_Wage_2019_2020_20213-Year Average Hourly Wage (2019, 2020, 2021)numberlevel : Nominal
Geographic_CBSAGeographic Core-Based Statistical Areasstring-
Reclassified_Redesignated_CBSAReclassified or Redesignated Core-Based Statistical Areasstring-
Lugar_NECMALugar New England County Metropolitan Area (NECMA)string-
Is_MGCRB_ReclassifiedMedicare Geographic Classification Review Board (MGCRB) reclassifiedboolean-
Is_MGCRB_Reclassified_To_HomeMGCRB reclassification to home areaboolean-
Is_Hospital_Reclassified_As_RuralHospital Reclassified as Rural Under Section 1886(d)(8)(E) of the Act (412.103)boolean-
Out_Migration_AdjustmentOut-Migration Adjustment related to Wage Indexnumberlevel : Nominal
County_NameCounty Namestring-
County_CodeCounty Codenumberlevel : Nominal
Is_Dual_Status_412_103_MGCRB_LUGARIs a hospital is located in a LUGAR county or qualified for reclassification (MGCRBboolean-

Data Preview

CMS Certification NumberIndexes For Discharges Occurring In Federal Fiscal Year 2019Wage Index 2020Wage Index Prior To Quartile And Transition 2021Wage Index With Quartile 2021Wage Index With Quartile And Cap 2021Average Hourly Wage FY 2019Average Hourly Wage FY 2020Average Hourly Wage FY 2021Average Hourly Wage 2019 2020 2021Geographic CBSAReclassified Redesignated CBSALugar NECMAIs MGCRB ReclassifiedIs MGCRB Reclassified To HomeIs Hospital Reclassified As RuralOut Migration AdjustmentCounty NameCounty CodeIs Dual Status 412 103 MGCRB LUGAR
100011.98750.94850.71550.77880.901130.478131.836231.430231.24512002011 TrueTrueHOUSTON1069True
100051.42760.81310.78930.81570.815729.368929.328.286628.9798113820 TrueMARSHALL1095
100061.75560.81310.73560.78880.788828.532229.135828.628628.76352252025 TrueTrue0.02LAUDERDALE1077True
100071.08230.75430.66580.75390.753924.107724.466825.226724.60951 COVINGTON1039
100080.9580.75430.66580.75390.753922.994327.026125.255925.11371 CRENSHAW1041
100111.86710.81270.81400000000000010.8280.82837.711734.655839.541337.172213820 JEFFERSON1073
100121.49880.75430.66580.75390.753926.439527.015629.640727.67931 DE KALB1049
100161.86810.81270.81400000000000010.8280.82833.660932.243434.269633.377713820 SHELBY1117
100181.30350.81270.81400000000000010.8280.82831.588732.334434.871233.037713820 JEFFERSON1073
100191.33230.75430.66580.75390.753927.919827.491128.494927.967522520 COLBERT1033