How Do You Stack Up? CMS Unveils Chronic Condition Dashboard

Want to see how your facility compares to the averages of other providers in your state or across the nation? The Centers for Medicare and Medicaid Services have unveiled a terrific online tool that compares state and national Medicare spending data related to chronic conditions.

According to the website, the CMS Chronic Conditions Dashboard “presents statistical views of information on the prevalence, utilization and Medicare spending for Medicare beneficiaries with chronic conditions.” The description continues:

The Dashboard displays information on a subset of the predefined chronic conditions available in the Chronic Condition Warehouse (CCW) at the national, state, and hospital referral region (HRR) levels for 2011.

The information in this Dashboard is limited to Medicare fee-for-service (FFS) beneficiaries residing in the 50 U.S. states and the District of Columbia, who were continuously enrolled in Medicare FFS, parts A and B, for 2011. Beneficiaries who were enrolled in a Medicare Advantage (MA) plan were excluded as were beneficiaries who first became eligible for Medicare after January of the calendar year. Beneficiaries who died during the year were included up to their date of death if they met the other inclusion criteria.

The set of 15 chronic conditions included in the Dashboard is consistent with the list of conditions included in CMS’s program statistics examining chronic conditions among Medicare beneficiaries. Also, this set of conditions corresponds with the conditions suggested by the HHS Strategic Framework on Multiple Chronic Conditions .

Alzheimer’s disease, related disorders, or senile dementia

Arthritis (including rheumatoid and osteoarthritis)

Asthma

Atrial fibrillation

Cancer (breast, colorectal, lung, and prostate)

Chronic kidney disease

COPD

Depression

Diabetes (excluding diabetic conditions related to pregnancy)

Heart failure

Hyperlipidemia (High cholesterol)

Hypertension (High blood pressure)

Ischemic heart disease

Osteoporosis

Stroke/Transient ischemic attack

Chronic conditions were identified through Medicare administrative claims. Medicare beneficiaries were considered to have a chronic condition if the CMS administrative data had a claim indicating that they were receiving a service or treatment for the specific condition. Detailed information on the identification of chronic conditions in the CCW is available here.

The statistics in the Dashboard include

The prevalence of Medicare beneficiaries with the specific 15 conditions,

The prevalence and per capita Medicare spending for beneficiaries with multiple chronic conditions, based upon counting the number of conditions from the set of 15 conditions and

Utilization metrics for 30-day hospital readmissions and emergency department (ER) visits by the number of chronic conditions.

In addition to the information being available at the state, HRR, and national levels, the Dashboard also allows the user to select information for specific beneficiary sub-groups defined by gender, age group and dual eligibility status. Dual eligibles are those beneficiaries that receive benefits from both Medicare and Medicaid. Medicare beneficiaries were classified as dual eligibles if in any month in the given calendar year they were receiving full or partial Medicaid benefits.

Information presented on the individual chronic conditions does not mean that the beneficiary has only that condition as beneficiaries with any of the specific conditions may have any of the other conditions examined or conditions not included in our list.

Medicare spending includes total Medicare payments for all Medicare covered services. Medicare spending is presented as standardized costs per beneficiary (per capita costs). We standardize spending to remove geographic differences in payment rates for individual services as a source of variation. To standardize spending, we examined Medicare’s various FFS payment systems and identified the factors that lead to different payment rates for the same service. In general, those factors are adjustments that Medicare makes to account for local wages or input prices, and extra payments that Medicare makes to advance other program goals, such as compensating certain hospitals for the cost of training doctors. We then estimated what Medicare would have paid for each claim without those adjustments.

CMS is obligated by the federal Privacy Act, 5 U.S.C. Section. 552a and the HIPAA Privacy Rule, 45 C.F.R Parts 160 and 164, to protect the privacy of individual beneficiaries and other persons. All direct identifiers have been removed from this data file. In addition, information is suppressed that is based upon fewer than eleven (11) beneficiaries in the population.

The data for this Dashboard come from the 2011 CMS administrative claims data for 100 percent of Medicare beneficiaries enrolled in the FFS program, which are available from the CMS Chronic Conditions Warehouse.