WASHINGTON, D.C. (October 8, 2021)—The Centers for Medicare & Medicaid Services (CMS) has posted the annual update of the Post-Acute Care and Hospice Provider Public Use File (PAC PUF) with data for 2019. The PAC PUF now has data available for years 2013-2019.
The PAC PUF presents summarized information on services provided to Medicare beneficiaries by home health agencies, hospices, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs). It contains information on demographic and clinical characteristics of beneficiaries served, professional and paraprofessional service utilization, submitted charges, and payments at the provider, state and national levels. Additionally, the PAC PUF includes payment information at the payment system level for home health agencies, SNFs and IRFs.
Although the PAC PUF provides a wealth of payment and utilization information about home health, hospice and other Medicare services and the National Association for Home Care & Hospice (NAHC) recommends that all home health and hospice providers review their own data and that of their peers, the dataset also has several limitations. The information presented in this file does not indicate the quality of care provided by individual providers; it only contains cost and utilization information.
The data are not risk-adjusted and thus do not account for differences in the underlying severity of disease of patient populations treated by providers. For additional limitations, please review the methodology document available on the website.
For 2019, CMS modified the data for SNFs presented in the PAC PUF. Specifically, SNF data are reported in a separate file and only cover the period between Jan. 1, 2019, and Sept.30, 2019, because the SNF Prospective Payment System (PPS) changed from RUG IV to the Patient Driven Payment Model (PDPM) on October 1, 2019. To minimize confusion, CMS has only reported data for RUG IV in the 2019 PAC PUF; PDPM payment system data will be incorporated as part of the next annual release of the PAC PUF.
In addition, beginning with the 2019 PAC PUF, CMS applied an updated crosswalk from the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (AHRQ) to classify primary diagnoses using the Clinical Classifications Software Refined (CCSR) for ICD-10-CM version 2021.2. Previous releases of the PAC PUF used the Clinical Classifications Software (CCS) for ICD-10-CM/PCS (Beta version). More information can be found in the supplemental methodology document.
The 2019 PAC PUF summarizes information on nearly 15 million claims and over $69 billion in Medicare payments for 2019. It contains information on 9,001 home health agencies, 4,584 hospices, 14,532 SNFs, 1,106 IRFs, and 358 LTCHs. CMS protects beneficiaries’ personal information in all public data releases.
NAHC is advising reviewers to exercise caution when comparing more recent PAC PUF data with older data sets (particularly those that were released individually on a provider-by-provider basis) since data definitions may have changed between legacy data set and the more current releases.