Provider Almanac
Provider Almanac is for healthcare contracting, public relations, marketing
and consultants. The almanac provides complete detailed information for all
Medicare/Medicaid healthcare providers and suppliers. This information
covers up to a six year history. The main group of financial information is obtained
from CMS - Center for Medicare/Medicaid Services. This information
is the Medicare Cost Reports, inpatient data from the MEDPAR file, outpatient data from
the Cost Summary, NPI information, POS - Provider of Service
information and UPIN - Universal Physician Identification Number.
The cost reports provide financial information for hospitals, skilled
nursing facilities, home health agencies, hospice and End Stage
Renal Dialysis (ESRD) facilities. The discharge data has cases, days, DRG payment and charges for each hospital at
the MDC, DRG, Diagnosis (3 digit) and Procedure (2 digit) level. The POS information shows patient
services, employee counts, bed counts and current status of compliance with CMS
regulations.
Basic Design
Output Formats
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Cost Reports
The cost reports consist of worksheets prepared by healthcare providers.
These cost worksheets are sent to a fiscal intermediary for processing.
After validation and desk checking, the cost reports are sent to CMS. At
CMS, the cost reports are placed in the cost report database that is part of
Provider Almanac. Healthcare providers are required to report five months
after their fiscal year end. The cost reports today are used to reimburse
healthcare providers for cost mandated by acts of Congress. The cost
reports are divided into many worksheets that have letter codes.
Worksheet A is the adjustment trial balance used by the fiscal intermediary for
payment processing. Worksheet S is the statistical worksheet that
provides compliance information, case counts and a number of elections made by
the healthcare provider. Worksheet G is a standard financial
statement. Worksheet B is for cost allocation. Worksheet C and D contains the cost to charge
ratios. There are other worksheets to support the financial
statements.
Sample reports are available to show the Provider Reference
Report, Provider Custom Report, Provider Comparison Report and Provider Status Report. These reports can be previewed, printed or exported to a
PDF, DOC or Excel format.
Hospital Reference Report - Worksheet A
SNF Reference - All Worksheets
Hospital Reference Report - Worksheet B
Hospital Reference Report - Worksheet C
Hospital Reference Report - Worksheet D
Hospital Reference Report - Worksheet E
Hospital Reference Report - Worksheet H
Hospital Reference Report - Worksheet G
Hospital Reference Report - Worksheet S
Hospital Custom Report
Hospital Analysis Report
Hospital Compare Report
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Medicare - Inpatient
CMS provides UB-92 patient discharge for all Part A cases. There are over
12 million cases each year. The actual cases are summarized to the DRG level
by Hospital for cases, days, revenue and charges. The data for less than ten
cases is summarized due to privacy requirements. The Hospital Market Area file from
CMS is used to provide zip code level information for cases, days and charges.
This information can be used for market share calculations. This information
in available in several report formats for a four year period. The reference
report format shows the total revenue by hospital for cases, days, revenue
and charges. The custom report shows information by DRG for each hospital.
The analysis report shows infomation by hospital for each DRG. The zip code
report shows information by county. The compare report shows DRG information
by hospital for four years.
MEDPAR MDC Reference Report
MEDPAR MDC Compare Report
MEDPAR DRG Reference Report
MEDPAR DRG Compare Report
MEDPAR Diagnosis Reference Report
MEDPAR Diagnosis Compare Report
MEDPAR Procedure Reference Report
MEDPAR Procedure Compare Report
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Provider of Service/UPIN
Provider Almanac has a directory of healthcare providers based on publicly
available information. The almanac uses information from the Provider of
Service file obtained directly from the Center for Medicare/Medicaid
Service. The POS file contains information on the following types of
providers
- Hospitals
- Skilled Nursing Facilities and Nursing Facilities
- Home Healthcare Agency
- End Stage Renal Disease
- Hospice
- Ambulatory Surgery Centers
- Rehabilitation Centers
- Rural Clinics
- Therapy Facilities
- Mental Health Facilities
- Labs
Hospital Reference Report
Hospital Custom
Hospital Analysis Hospital Compare
SNF Reference Report
HHA Reference Report
ESRD Reference Report
Hospice Reference Report
ASCtr Reference Report
Rehabilation Reference Report
Rural Reference_Report
Therapy Referenece Report
Mental Reference Report
Labs Reference Report
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UPIN/NPI
NPI information was released in October, 2007. The NPI data is an enumeration of all Medicare Providers. This data replaced the UPIN information.
The NPI file is very large and we are currently looking at the data for a way to
provide information similar to the UPIN information. The NPI file consists
of NPI code, Name, demographic information and a very limited amount of provider
information on services. There are currently over 2 million providers in the
file. Our current plan is to divide the information into files based on the
type of Provider.
UPIN Reference Report
The NPI information will be added in the next release.
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