FY 2019 IPPS Proposed Rule: Hospital Readmissions Reduction Program                                                    Supplemental Data 	
Variable Name	Variable Description 
Hospital CCN	Medicare Provider Number or CMS Certification Number (CCN). The file only includes open IPPS hospitals with measure results for at least one measure. Maryland hospitals and closed hospitals as of the April 2017 closed list are excluded. 
FY 2019 Proposed Proxy Payment Adjustment Factor 	"The FY 2019 propsed proxy payment adjustment factor is based on data from the FY 2018 Hospital Readmissions Reduction Program performance period (i.e., July 1, 2013 to June 30, 2016). The methodology to calculate the payment adjustment factor is presented in the FY 2019 IPPS Proposed Rule and is based on Excess Readmission Ratios (ERR) for six conditions or procedures: Acute Myocardial Infarction (AMI), Chronic Obstructive Pulmonary Disease (COPD), Heart Failure (HF), Pneumonia, Coronary Artery Bypass Graft, and Total Hip/Total Knee Arthroplasty. The maximum payment adjustment factor is 0.97 (i.e., 3% maximum penalty)."
Dual proportion	"The dual proportion in the proportion of Medicare fee-for-service (FFS) and managed care stays in a specific hospital, where the patient was dually eligible for Medicare and full-benefit Medicaid during the FY 2018 Hospital Readmissions Reduction Program performance period (i.e., July 1, 2013 to June 30, 2016). CMS identifies full-benefit dual status (i.e., numerator) using data from the Medicare Beneficiary Summary File, which it sources from the State Medicare Modernization Act (MMA) files. Stays for full-benefit dual patient are stays where the patient was identified as full-benefit dual status for the month the beneficiary was discharged from the hospital. CMS identifies Medicare FFS and managed care stays using MedPAR files from FY 2013 to FY 2016."
Peer group assignment	"Hospitals are stratified into five peer groups, or quintiles, based on the dual proportion. Hospitals in the first peer group (i.e., peer group #1) represent the lowest dual proportion and hospitals in the fifth peer group (i.e., peer group #5) represent the highest dual proportion. The methodology in the FY 2019 IPPS Proposed Rule assesses performance relative to hospitals within the same peer group."
Neutrality modifier	"The neutrality modifier is the multiplicative factor that, when applied to hospital payment reductions, equates total Medicare savings under the non-stratified (FY 2013- FY 2018) and the methodology presented in the FY 2019 IPPS Proposed Rule (stratified methodology). "
Number of eligible discharges 	"The number of eligible discharges for a given hospital during the FY 2018 performance period (i.e., discharges from July 1, 2013 through June 30, 2016). Hospitals with fewer than 25 eligible discharges are not eligible for penalty. The payment adjustment factor formula will not include these hospitals’ ERRs. Hospitals with no eligible discharges have a value of NQ in this field to indicate that they have no qualifying cases for a measure."
ERR	Ratio of the predicted readmission rate to the expected readmission rate for a given measure. The ERR assesses excess readmissions for the payment adjustment factor calculation. Hospitals with no eligible discharges have a value of NQ in this field because CMS cannot calculate an ERR without qualifying cases for a measure.
Peer group median ERR	The median ERR for the hospital’s peer group for the measure. This is the threshold CMS uses to assess hospital performance relative to other hospitals within the same peer group. All hospitals in the same peer group will have the same median ERR.
Penalty indicator	"If the penalty indicator equals Y, the hospital has 25 or more eligible discharges and an ERR greater than the peer group median. If the hospital has less than 25 eligible discharges or the ERR is less than the peer group median ERR for that measure, the penalty indicator equals N. When the penalty indicator equals Y, the ERR will enter the payment adjustment factor formula and the hospital may be subject to a payment reduction."
DRG payment ratio	"The ratio of total base operating DRG payments for each measure among all base operating DRG payments. This is the weight attributed to excess readmissions for each measure (i.e., ERR minus peer group median ERR) in the payment adjustment factor formula. Hospitals with no eligible discharges express the value NQ in this field because they will have no base operating DRG payments for a measure.1 The data source to identify the DRG payment ratio is the FY13-FY16 MedPar files. The data provided here may not precisely match the data in the NPRM FY 2019 DRG info tab due to a difference is source files. "
"1 If a hospital has few eligible discharges for a given measure, the ratio of DRG payments to total payments may have a value of NQ. This is the result of minor discrepancies between the data sources CMS used to identify eligible discharges and calculate payments. In these cases, the number of eligible discharges is too small for the ERR for that measure to enter the hospital's payment adjustment formula. "	
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