FY 2018 IPPS Impact File										
"DATA SOURCES FOR THIS FY 2018 RULE IMPACT FILE ARE THE FOLLOWING: MARCH 2017 UPDATE OF FY 2016 MEDPAR,  MARCH 2017 UPDATE OF PROVIDER SPECIFIC FILE, FY2014/FY2015 COST REPORT DATA"										
NOTE: Wage Index Data has a 100% Occ Mix adjustment based on CY 2013 survey data										
Provider Number	6 digit Medicare provider number; the first 2 digits are the state code.									
Name	"Name of Medicare provider from OSCAR.(""blank"" = unknown)"									
Geographic Labor Market Area	The Geographic CBSA location based on OMB's Core Based Statistical Area (CBSA) designations.  The CBSA assignment is based on where the provider is physically located based on SSA state and county code information.  Rural areas are designated by 2-digit SSA state codes.									
Pre-Reclass Labor Market Area  	Pre-reclassification CBSA									
Post-Reclass Labor Market Area	Post-reclassification CBSA for FY 2018									
Payment Labor Market Area 	Payment CBSA (urban or rural) for purposes of determining capital payments &  operating payments (other than wage index)									
SSA COUNTY CODE	SSA state county code. First two digits represent the state code and the last 4 digits represent the county code. SSA system is used to Identify the county in which provider is geographically located and this field be used in conjunction with the MSA/CBSA crosswalk file.									
REGION	1=NEW ENGLAND; 2=MIDDLE ATLANTIC; 3=SOUTH ATLANTIC; 4=EAST NORTH CENTRAL; 5=EAST SOUTH CENTRAL; 6=WEST NORTH CENTRAL; 7=WEST SOUTH CENTRAL; 8-=MOUNTAIN; 9=PACIFIC; 40=PUERTO RICO									
URGEO	"Large urban, Other Urban or Rural designation of the providers geographic CBSA"									
URSPA	Urban or Rural designation based on payment CBSA									
RECLASS	Reclass Status FY 2018:  N -provider did not reclassify; W -provider reclassified for wage index; L provider reclassified under 1886(d)(8)(B) of the SSA; S-provider redesignated as rural under Sec. 401 of BIPA. 									
FY 2018 Wage Index	"FY 2018 wage index after applying the MGCRB reclassifications, rural floor, adjustments for the Frontier wage index provision and the P.L. 108-173 Sec 505 adjustments where applicable for FY 2018. Wage Index reflects the application of national rural floor budget neutrality required under the Affordable Care Act."									
LUGAR	Provider is located in a Lugar County as defined in 1886(d)(8)(B) of the Act									
Section 401 hospital	A 'YES' denotes urban providers redesignated as rural under CFR 412.103 - Sec 401 of BIPA AND does not have 									
Section 401 Hospital with a LUGAR or MGCRB Wage Index Reclass	A 'YES' denotes a hospital that is redesignated as rural under CFR 412.103  (Sec 401 of BIPA) AND also is Reclassified to another CBSA through the MGCRB for wage index purposes or is located in a Lugar County as defined in 1886(d)(8)(B) of the Act (and did not waive its LUGAR status).									
Section 505 eligible	A 'YES' denotes providers eligible  to receive a wage index adjustment under  Sec. 505  of  P.L. 108-173 for  FY 2018									
Section 505 adjustment	Wage adjustment for providers who are eligible to receive a wage index adjustment under Sec. 505 of P.L. 108-173 for FY 2018									
Cost of Living Adjustment	Cost of Living Adjustment factor based on data from the U.S. Office of Personnel Management  for IPPS providers located in Alaska or Hawaii for IPPS operating payments									
Resident to Bed Ratio	Resident to Bed Ratio. Used to determine IME factor for operating IPPS payments									
RDAY	Resident to Average Daily Census (ADC) ratio. Used to calculate the IME adjustment for Capital IPPS									
BEDS	The number of total beds obtained from cost report data.**									
Average Daily Census	Calculated as the ratio of Total Acute Inpatient Days to Total Days in the Cost Reporting Period obtained from cost report data.**									
TCHOP	IME adjustment factor for Operating IPPS									
TCHCP	IME adjustment factor for Capital IPPS									
DSHPCT	Disproportionate Share Hospital Patient Percentage (DPP) as determined from March 2017 update of the Provider Specific File (PSF) & SSA data									
DSHOPP	Estimated FY 2018 Operating Disproportionate Share Hospital (DSH) adjustment. Reflects a 75% reduction to the DSH adjustment required under Section 3333 of the Affordable Care Act									
UCP_ADJ	"FY 2018 Uncompensated Care Payment Factor is the proportion of the additional payment amount for uncompensated care costs that a DSH hospital will receive under the implementation of Section 3133 of the Affordable Care Act. The Uncompensated Care Payment Factor is the hospital's uncompensated care costs relative to all DSH hospital's uncompensated care costs. DSH hospitals are identified as those hospitals that are projected to receive DSH for FY 2018. Note, these amounts do not reflect any changes that may result from the 30-day period after the publication of the final rule for hospitals to review and submit comments on the accuracy of the list of mergers we identified in the final rule."									
UCP Per Claim Amount	"FY 2018 Uncompensated Care Per Claim Amount based on a hospital's assigned Uncompensated Care Payment amount divided by the 3 year claims average based on MedPAR files from FY14-FY16. Per Claim Amount is used in determination of outliers and used in to determine if the SCH is paid on a hospital specific rate or federal rate on a per claim basis. Note, these amounts do not reflect any changes that may result from the 30-day period after the publication of the final rule for hospitals to review and submit comments on the accuracy of the list of mergers we identified in the final rule."									
DSH_LY	Estimated FY 2017 Operating Disproportionate Share Hospital (DSH) adjustment. Reflects a 75% reduction to the DSH adjustment required under Section 3333 of the Affordable Care Act									
UCP_ADJ_LY	FY 2017 Uncompensated Care Payment Factor is the proportion of the additional payment amount for uncompensated care costs that a DSH hospital will receive under the implementation of Section 3133 of the Affordable Care Act. The Uncompensated Care Payment Factor is the hospital's uncompensated care costs relative to all DSH hospital's uncompensated care costs. DSH hospitals are identified as those hospitals that were projected to receive DSH for FY 2017. 									
DSHCPG	FY 2018 Capital Disproportionate Share (DSH) adjustment									
Operating CCR	Ratio of Medicare operating costs to Medicare covered charges from the March 2017 update of the Provider Specific File (PSF). CCRs do not have the inflation factor applied. 									
Capital CCR	Ratio of Medicare capital costs to Medicare covered charges from the March 2017 update of the Provider Specific File (PSF). CCRs do not have the inflation factor applied. 									
Provider Type 	Type of provider - key:  0=IPPS; 7=RURAL REFERRAL CENTER (RRC); 16=Sole Community Hospital (SCH); 17=SCH/RRC; 21=ESSENTIAL ACCESS CMTY HSP (EACH); 22=EACH/RRC									
HSP Rate	Hospital Specific Payment (HSP) Rate updated to FY 2018 for SCH providers.  HSP Rate is based on the March 2017 update of the Provider Specific File (PSF).									
BILLS	"Total number of Medicare cases for the provider from the FY 2016 MedPAR, March 2017 update"									
CASETA34	Transfer Adjusted Cases under Grouper V34 and FY 2017 Post-Acute Transfer Policy									
CMIV34	Case Mix Index under Grouper V34 (generally applicable for SCH providers paid under their Hospital Specific Payment rate). 									
TACMIV34	Transfer adjusted Case Mix Index under Grouper V34									
IME_CASETA34	Transfer adjusted cases under Grouper V34 for Medicare Advantage cases submitted by teaching hospitals that receive a fee-for-service IME payment. The IME payment associated with these cases are included in the budget neutrality calculations and in payment modelling.									
IME_TACMIV34	Transfer adjusted Case Mix under Grouper V34 for Medicare Advantage cases submitted by teaching hospitals that received a Fee-for-Service IME payment. These CMIs are included to calculate the IME payments for budget neutrality. 									
CASETA35	Transfer Adjusted Cases under Grouper V35  and FY2018 Post-Acute Transfer Policy									
CMIV35	Case Mix Index under Grouper V35 (generally applicable for SCH providers paid under their Hospital Specific Payment rate). 									
TACMIV35	Transfer adjusted Case Mix Index under Grouper V35									
IME_CASETA35	Transfer adjusted cases under Grouper V35 for Medicare Advantage cases submitted by teaching hospitals that receive a fee-for-service IME payment. The IME payment associated with these cases are included in the budget neutrality calculations and in payment modelling.									
IME_TACMIV35	Transfer adjusted Case Mix under Grouper V35 for Medicare Advantage cases submitted by teaching hospitals that received a Fee-for-Service IME payment. These CMIs are included to calculate the IME payments for budget neutrality. 									
GAF	Post Reclassification Geographic adjustment factor (GAF) for Capital IPPS for FY 2018									
Capital Cost of Living Adjustment	"Capital COLA factor for hospitals located in Alaska and Hawaii, which is based on the applicable operating IPPS COLA factor."									
OUT18F	Estimated operating outlier payments as a percentage of the provider's Federal operating IPPS payments									
COUT18F	Estimated capital outlier payments as a percentage of the provider's Federal capital IPPS payments									
MCR_PCT	Medicare days as a percent of total inpatient days (not available for all providers that receive HSP rate) 									
Low Volume Hospital Adjustment	Low volume hospital adjustment as defined under Section 1886(d)(12) of the Act.  									
Proxy Value Based Purchasing Adjustment Factor	Proxy payment adjustment for value based purchasing program (Section 3001 of Affordable Care Act) based on performance scores from an older performance period.									
Readmission Adjustment Factor	Payment adjustment for Hospital Readmissions Reduction Program (Section 3025 of Affordable Care Act). Maryland and Puerto Rico hospitals are exempt from the payment adjustment. 									
Proxy Quality Reduction 	"Value of '1' indicates a hospital that was found not to have submitted quality data in the form and manner based on the March 2017 update of the Provider Specific File (PSF), and therefore was modeled as receiving a reduction to the percentage increase in the market basket index for FY 2018 under §412.64(d)(2). (Note, variable this will not reflect any subsequent adjustments, if any, to this indicator made in the PSF.)"									
Proxy EHR Reduction	"Value of '1' indicates a hospital that was found not to be a meaningful electronic health record (EHR) user for the applicable EHR reporting period and did not receive an exception based on the March 2017 update of the Provider Specific File (PSF), and therefore was modeled as receiving a reduction to the percentage increase in the market basket index for FY 2018 under §§ 412.64(d)(3)-(4). (Note, variable this will not reflect any subsequent adjustments, if any, to this indicator made in the PSF.)"									
										
"**The most recent available cost report data were used (FYs 2014 - 2015). A ""zero"" value may indicate unavailable or incomplete data. "										
