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Appendix G RTI Analysis Data Sources T o assist with the analysis of data accuracy and methodological questions of the current geographic adjusters and to model the impact analysis, the Institute of Medicine (IOM) engaged RTI International as consultants to the committee. The RTI analyses presented in the report’s tables and figures are primarily computed with Centers for Medicare and Medicaid Services (CMS) and Bureau of Labor Statistics (BLS) Occupational Employment Statistics (OES) data. The CMS data are publically available through the CMS websites. Please note that many of RTI’s computations used data from multiple CMS public access files. BLS data for most areas are publically available on the BLS website. However, to produce wage index values for all areas, BLS computed wage index values from non-publically available data. Researchers may apply to work on-site at BLS to validate computations using unpublished data. HOSPITAL WAGE INDEX DATA SOURCES The CMS wage index data files encompass files for market and provider-level hourly wages, occupation mix adjustments, reclassifications and other adjustment files, outmigration data, and actual wage index data. The term “CMS FY 2011 IPPS files,” used in table source notes, encompass these wage index files, plus the Impact File, DRG files, case mix index files, and standardizing file, among other files. The CMS files used in the report analyses can be found at: Centers for Medicare and Medicaid Services. FY 2011 Final Rule Data Files. http://www.cms.gov/AcuteInpatientPPS/IPPS2011/itemdetail.asp?filterType=none&filter B yDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS1237932&intNumPer Page=10. 187
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188 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT The occupational mix data on hospitals was obtained from the BLS OES: Bureau of Labor Statistics. Occupational employment statistics: May 2009 national industry- specific occupational employment and wage estimates, NAICS 622000 - Hospitals. http://www.bls.gov/oes/current/naics3_622000.htm. Data on national hourly wage by health sector was obtained from the BLS OES: Bureau of Labor Statistics. Occupational employment statistics: May 2009 national industry- specific occupational employment and wage estimates, Sector 62 - Health care and Social Assistance. http://www.bls.gov/oes/current/naics2_62.htm#29-0000. GEOGRAPHIC PRACTICE COST INDEX DATA SOURCES The 2010 current locality GAFs incorporating congressionally mandated floors for the work and practice expense GPCIs were obtained from Addendum D (pages 40643-5) of the Proposed Rule: Centers for Medicare and Medicaid Services. Addendum D: Proposed FY 2011 Geographic Adjustment Factors (GAFs). Federal Register 75(133):40643-40645. h ttp://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=uidDw6/0/2/0& WAISaction=retrieve. The 2012 current locality GAFs incorporating congressionally mandated floors for the frontier states were obtained from CMS: Centers for Medicare and Medicaid Services. Addendum E: Final CY 2011 Geographic Practice Cost Indices (GPCIs) by State and Medicare Locality. Federal Register 75(228):73817-73819. h ttp://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=PmHLJ6/5/2/0& WAISaction=retrieve. The county-level, locality-level, and MSA actual GAFs were derived from county-level 2012 fully transitioned GPCIs that were calculated by CMS and Acumen: Centers for Medicare and Medicaid Services. Physician Fee Schedule: Federal Regulation Notices, 6th GPCI Update County Data File. http://www.cms.gov/PhysicianFeeSched/PFSFRN/itemdetail.asp?itemID=CMS1240932. O’Brien-Strain, Margaret, West Addison, Nick Theobald. Preliminary Report on the Sixth Update of the Geographic Practice Cost Index for the Medicare Physician Fee Schedule. June 2010. http://www.cms.gov/PhysicianFeeSched/downloads/GPCI_Report.pdf.
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189 APPENDIX G The occupational mix data on physician offices were obtained from the BLS OES: Bureau of Labor Statistics. Occupational employment statistics: May 2009 national industry-specific occupational employment and wage estimates, NAICS 621100 - Offices of Physicians. http://www.bls.gov/oes/current/naics4_621100.htm.
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