IPPS Dashboard Definitions
PPS Profile - Cost Report Based
The key measurements in this section are based on a hospital's annual cost report. The cost report contains 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) which is updated quarterly and is based on a hospital's fiscal year.
Total IPPS Payment
The 2552-10 format calculates IP Reimbursement across several potential sheets.
The NPR Settlement Amount is the Balance due provider/(Program). It is the difference between the Total IP Reimbursement (above) and the total interim payments for the cost reporting period less any tentative settlements previously made by the MAC.
Settlement Amount as % of Total Payment
A Settlement Amount percentage is calculated as the Settlement Amount (above) divided by Total IPPS Payment (above).
Medicare makes additional payments to hospitals for patients with costs that are extraordinarily high due to severity of illness and/or complicating conditions. The amount of outlier payments is from Worksheet E, Part A, line 2.
Outlier as % of Total
An Outlier percentage is calculated as the Outlier Amount (above) divided by Total IPPS Payment (above).