Hospital Claims Information

Hospital Information


Hospital general information.

 Updated: Quarterly

 Current: Q2 2018

Field Description
NPI The National Provider Identifier is a unique number required for covered health care providers.
Hospital Type The type of hospital.
County The hospital's county.
Geographic Class Geographic classification of the hospital.
Ownership The ownership type of the hospital.
Market Concentration Index A measure of how competitive a hospital's CBSA is using the Herfindahl index. The Herfindahl index measures the amount of competition between firms in a market. The Herfindahl index ranges is from 0 to 1. A larger index indicates a less competitive market.
Date Pulled Date the data was received by Enquire.
CBSA Code The Core Based Statistical Area (CBSA) code for the hospital. CBSA's are geographic areas consisting of one more counties and at least 10,000 people.
CBSA Population The total number of people for the CBSA code.
CBSA Growth The percentage of growth compared to the previous years data.
Network Group/system of the hospital.
Medicare Administrative Contractor A private health care insurer that has been awarded a geographic jurisdiction to process various Medicare claims.
Medicare School Affiliation A hospital's degree of association with a medical school.
Accreditation Agency The agency responsible for accreditating the hospital.
Medicare Provider Number Unique number used to identify the hospital and its practicing location.
Total Hospitals in Network Total number of hospitals in the specified network.
Staffed Beds  The number of beds the hospital has.
Medicare Certified Beds The number of beds in the Medicare or Medicaid certified areas in the hospital.
Discharges Total discharges
Affiliated Physicians (Primary) Number of Primary Physicians affiliated with the hospital.
Affiliated Physicians (Second) Number of Secondary Physicians affiliated with the hospital.
Avg Length of Stay The average number of days a pateint resides at the hospital.
Total Acute Days Total hospital admit days.
Readmits Total number of readmits for the hospital

Top 10 Companies


The top 10 companies the hospital refers to based on the number of referrals.

 Updated: Annually in the fall

 Current: 2016

Column Description
Beds Total number of beds at the specified company.
Referral Total number of referrals.
Unique Bene Total number of unique persons receiving benefits under healthcare insurance through medicaid or medicare.
Percent of Total The percentage of total for Referrals.
Referral to Hospital Referrals given from the specified company to the hospital.

Top Counties


Top counties for the hospital based on claims.

 Updated: Annually in the fall

 Current: 2016

Column Description
Claims Total number of Medicare claims.
Percent The percent of total for Claims.

Patient Satisfaction


A hospital's rating for each Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measure.

 Updated: Quarterly

 Current: Q2 2017

Column Description
Rating The hospital's rating for the HCAHAPS measure.
National Rate The national average for the HCAHAPS measure.
National Percentile The hospital's percentile rank for the HCAHAPS measure. 99 is best.
State Percentile The state average for the HCAHAPS measure.

Readmission and Mortality Rates


30-day readmission rates for various readmission measures.

 Updated: Quarterly

 Current: Q2 2017

Column Description
Rate The hospital's rate for the readmission measure.
National Rate The national rate for the readmission measure.
National Percentile The hospital's percentile rank for the readmission measure. 99 is best.

Diagnosis Breakdown - ICD-10 Category


The top 10 ICD-10 Categories by the percentage of total claims.

 Updated: Annually in the fall

 Current: 2016

Top 10 Drg


The top 10 Diagnosis-related groups (DRG) based on the total number of claims.

 Updated: Annually in the fall

 Current: 2016

Column Description
DRG Description The description of the DRG.
DRG Code The code for the DRG.
Total Claims The total number of claims for the DRG.
Total Percentage The percent of total claims for the DRG.
Total Charge The estimated total charges for the DRG.
Total Payment The estimated total payments for the DRG.
Medicare Claims The number of Medicare claims for the DRG.
Medicare Charges The total of Medicare charges for the DRG.
Medicare Payment The total of Medicare payments for the DRG.

Payer Mix


The total revenue coming from private insurance, government insurance, and self-paying individuals.

 Updated: Quarterly

 Current: Q2 2017

Pie Chart

The percentage of Total Days for each payor type.

payer_mix_pie_chart.png

Column Description
Payor The type of payor.
Net Patient Revenue Total revenue for the payor type.
% of Total Net Patient Revenue The percent of total for Net Patient Revenue.
Charges Total charges for the payor type.
% of Total Charges The percent of total for Charges.
Discharges Total discharges for the payor type.
% of Total Discharges The percent of total for discharges.
Days ***
% of Total Days The percentage of total for Days
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