What is CCR costing?
The total amount of money required to operate a hospital, divided by the sum of the revenues received from patient care and all other operating revenues.
How do you calculate cost to charge ratio?
The charge-to-cost ratio is calculated as a hospital’s total gross charges divided by its total Medicare-allowable cost.
How is HCUP collected?
HCUP is based on statewide data collected by individual data organizations across the United States and provided to AHRQ through the HCUP partnership. HCUP would not be possible without statewide data collection projects.
What is the HCUP program?
The Healthcare Cost and Utilization Project (HCUP, pronounced “H-Cup”) is a family of healthcare databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
What is a CMS cost report?
The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).
What is the cost-to-charge ratio used for?
The Healthcare Cost and Utilization Project (HCUP) Cost-to-Charge Ratio Files (CCR Files) are hospital-level files that facilitate the conversion of total charges into hospital costs (expenses) for providing care, which can be linked to HCUP inpatient databases and HCUP emergency department databases.
How do hospitals decide how much to charge?
Hospitals charge the same amount for a service regardless of whether or not the patient is in the hospital. Anyone getting routine tests or a diagnostic workup from a hospital is likely to be charged five to ten times what an insurance company would pay for it (five to ten times what the service is really worth).
What is the average cost-to-charge ratio for hospitals?
California hospitals set charges of $4.51 for every $1 of their cost, exceeding the national hospital average of $3.31 per $1 of cost. In statistical terms, that is a charge to cost ratio of a whopping 451 percent for California hospitals, compared to the national average of 331 percent.
What agency administers HCUP?
The HCUP (pronounced “H-CUP”) family of healthcare databases and related software tools and products is made possible by a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ).
Who uses HCUP data?
Researchers and policymakers use the NIS to identify, track, and analyze national trends in healthcare utilization, access, charges, quality, and outcomes. The inpatient data contained in the NIS represent more than 97 percent of inpatient discharges from community hospitals in the United States.
Why is HCUP useful?
Why is HCUP important? HCUP provides reliable, comprehensive information that can be used to answer questions about healthcare use, access, outcomes, and costs related to hospital inpatient stays, ambulatory surgery and services, emergency department visits, and readmissions.
How much does Medicare cost the federal government?
In fiscal year 2020, the Medicare program cost $776 billion — about 12 percent of total federal government spending. Medicare was the second largest program in the federal budget last year, after Social Security.
Where can I find the cost-to-charge ratio files for HCUP?
HCUP Cost-to-Charge Ratio Files are provided as separate files available with the HCUP Central Distributor SID, SEDD, NIS, KID, and NRD. These supplemental files are available free of charge from the HCUP Central Distributor.
What are the CCR files for HCUP?
The CCR files are provided as complimentary files that are automatically included with download orders for the HCUP NIS, KID, and NRD databases. The CCR files for the HCUP SID and SEDD can be added to an order for the accompanying SID or SEDD – they are not automatically included with the order. Internet Citation: Cost-to-Charge Ratio Files.
What is HCUP data?
HCUP is the Nation’s most comprehensive source of hospital care data, including information on in-patient stays, ambulatory surgery and services visits, and emergency department encounters.
What is the CCR file for the HCUP Sid and Sedd?
The CCR files for the HCUP SID and SEDD can be added to an order for the accompanying SID or SEDD – they are not automatically included with the order. Internet Citation: Cost-to-Charge Ratio Files. Healthcare Cost and Utilization Project (HCUP). September 2020.