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Appendix F: Description of Three Optional Sources for Facility Wage Index Data
Pages 181-186

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From page 181... ... to remove wages from data would include total Data can be captured by non-IPPS subproviders wages and total hours paid, occupation code across all and to add benefits and aggregated at the SOC industries, across health contract labor; further level, and will be submitted care industries only, or by adjusted every 3 years directly from annual payroll health care sector (e.g., to account for variation files. Average wages could hospitals, SNFs, HHAs) Read the entire page →
From page 182... ... providers only wages wages Timeliness 4-year lag from reported Potentially as little as a Data are from 3 to 5 wage data to applied 1-year lag if facilities submit years old when applied to index payroll data at the end of index (due rolling sample the calendar year method) Volatility Data are unstable year Likely to be Some Found to be The sample to year due to large improved improvement less volatile sizes for numbers of one- and over S-3 over S-3 in testing; hospital-only two-hospital markets survey data, if data are likely due respondents because collected from to rolling are likely to be more all hospitals sample too small for providers are rather than method and stability contributing IPPS only, but all-employer data to any still suffers data given market from small numbers within many markets Read the entire page →
From page 183... ... providers only wages wages Reporting Annual One-time burden on No added burden to burden (to S-3 and tri-annual providers to load OES hospitals providers) occupation mix surveys occupation categories; after have many exceptions, that reporting is a once/ and often require manual year electronic file with input individual employee hours and pay or summed by OES group Data All IPPS providers submit Assuming all providers Depends on the level completeness, data, and nearly all would be required to of detail for the chosen hourly wages submit the occupation submit data for complete occupation codes; many mix survey payroll areas show missing data in many SOC codes that will require imputation a hospital-specific version would have more missing data than all-industry Data accuracy, CMS reviews and sends Data would be tied to a Accurate for large "cells" hourly wages out data for extra payroll system which is but subject to sampling provider review, and already heavily reviewed error, with some large allows all providers and audited standard errors in smaller to see other provider markets and/or less submissions common occupations; hospital-specific estimates have larger standard errors than all-industry estimates. Read the entire page →
From page 184... ... providers only wages wages Data accuracy, Survey has instructions Depends on alternative Depends on alternative other for adding other forms of source source compensation compensation; probably some difficulties in measuring pension costs; benefits may not be as accurate as hourly wages Data provider Data represent IPPS Data would Data still Data would Data still specificity hospitals only but are come from would not come from would not used for other hospitals, the specific reflect prices all-industry reflect prices SNFs, and HHAs (Note: industry, and for other Part wages, but for other Part surveys exist for other be weighted A providers could be A providers providers but are not by labor weighted used) shares for by labor that industry shares for each specific industry Representative Most health care Most health care Most all Most of the entire occupations occupations occupations health care labor market occupations Some non-health care Some non-health care occupations occupations Some non health care occupations Contract Yes No, unless on additional No labor costs survey included? Read the entire page →
From page 185... ... providers only wages wages Auditability Subject to annual review Payroll data subject to Only by BLS staff (not by MACs and audit if review by multiple public available to stakeholders) requested by CMS agencies, and can be reviewed or audited by MAC if requested by CMS Transparency Average wage data Provider-level wages by Sampling is reviewed by by provider is made SOC code probably not BLS staff, but data cannot available to all providers considered public data, be audited by providers but average occupation- or by CMS; missing data adjusted wage by provider issues are also likely to could still be released for create confusion each year provider review Administrative Current surveys are time After a one-time investment No data collection or burden to consuming; reviews, in coding for fixed-weight auditing burden, and CMS audits and appeals are indices, the collection and a moderate amount of numerous review of data should be analysis depending on the manageable; depends in remaining exception and/or part on the remaining smoothing techniques exception processes and/or smoothing techniques Flexibility in Yes; access to firm-level Yes; access to firm-level Data only available at MSA/ defining and/ data data balance-of-state levels, or smoothing which provide limited wage markets opportunity for boundary smoothing NOTE: BLS = Bureau of Labor Statistics; CMS = Centers for Medicare and Medicaid Services; HHA = home health agency; IPPS = Inpatient Prospective Payment System; MAC = Medicare Administrative Contractor; MSA = metropolitan statistical area; NAICS = North American Industry Classification System; OES = Occupational Employment Statistics; SNF = skilled nursing facility; SOC = Standard Occupational Classification. Read the entire page →

From page 181...

... to remove wages from data would include total Data can be captured by non-IPPS subproviders wages and total hours paid, occupation code across all and to add benefits and aggregated at the SOC industries, across health contract labor; further level, and will be submitted care industries only, or by adjusted every 3 years directly from annual payroll health care sector (e.g., to account for variation files. Average wages could hospitals, SNFs, HHAs)

Read the entire page →

From page 182...

... providers only wages wages Timeliness 4-year lag from reported Potentially as little as a Data are from 3 to 5 wage data to applied 1-year lag if facilities submit years old when applied to index payroll data at the end of index (due rolling sample the calendar year method) Volatility Data are unstable year Likely to be Some Found to be The sample to year due to large improved improvement less volatile sizes for numbers of one- and over S-3 over S-3 in testing; hospital-only two-hospital markets survey data, if data are likely due respondents because collected from to rolling are likely to be more all hospitals sample too small for providers are rather than method and stability contributing IPPS only, but all-employer data to any still suffers data given market from small numbers within many markets

Read the entire page →

From page 183...

... providers only wages wages Reporting Annual One-time burden on No added burden to burden (to S-3 and tri-annual providers to load OES hospitals providers) occupation mix surveys occupation categories; after have many exceptions, that reporting is a once/ and often require manual year electronic file with input individual employee hours and pay or summed by OES group Data All IPPS providers submit Assuming all providers Depends on the level completeness, data, and nearly all would be required to of detail for the chosen hourly wages submit the occupation submit data for complete occupation codes; many mix survey payroll areas show missing data in many SOC codes that will require imputation a hospital-specific version would have more missing data than all-industry Data accuracy, CMS reviews and sends Data would be tied to a Accurate for large "cells" hourly wages out data for extra payroll system which is but subject to sampling provider review, and already heavily reviewed error, with some large allows all providers and audited standard errors in smaller to see other provider markets and/or less submissions common occupations; hospital-specific estimates have larger standard errors than all-industry estimates.

Read the entire page →

From page 184...

... providers only wages wages Data accuracy, Survey has instructions Depends on alternative Depends on alternative other for adding other forms of source source compensation compensation; probably some difficulties in measuring pension costs; benefits may not be as accurate as hourly wages Data provider Data represent IPPS Data would Data still Data would Data still specificity hospitals only but are come from would not come from would not used for other hospitals, the specific reflect prices all-industry reflect prices SNFs, and HHAs (Note: industry, and for other Part wages, but for other Part surveys exist for other be weighted A providers could be A providers providers but are not by labor weighted used) shares for by labor that industry shares for each specific industry Representative Most health care Most health care Most all Most of the entire occupations occupations occupations health care labor market occupations Some non-health care Some non-health care occupations occupations Some non health care occupations Contract Yes No, unless on additional No labor costs survey included?

Read the entire page →

From page 185...

... providers only wages wages Auditability Subject to annual review Payroll data subject to Only by BLS staff (not by MACs and audit if review by multiple public available to stakeholders) requested by CMS agencies, and can be reviewed or audited by MAC if requested by CMS Transparency Average wage data Provider-level wages by Sampling is reviewed by by provider is made SOC code probably not BLS staff, but data cannot available to all providers considered public data, be audited by providers but average occupation- or by CMS; missing data adjusted wage by provider issues are also likely to could still be released for create confusion each year provider review Administrative Current surveys are time After a one-time investment No data collection or burden to consuming; reviews, in coding for fixed-weight auditing burden, and CMS audits and appeals are indices, the collection and a moderate amount of numerous review of data should be analysis depending on the manageable; depends in remaining exception and/or part on the remaining smoothing techniques exception processes and/or smoothing techniques Flexibility in Yes; access to firm-level Yes; access to firm-level Data only available at MSA/ defining and/ data data balance-of-state levels, or smoothing which provide limited wage markets opportunity for boundary smoothing NOTE: BLS = Bureau of Labor Statistics; CMS = Centers for Medicare and Medicaid Services; HHA = home health agency; IPPS = Inpatient Prospective Payment System; MAC = Medicare Administrative Contractor; MSA = metropolitan statistical area; NAICS = North American Industry Classification System; OES = Occupational Employment Statistics; SNF = skilled nursing facility; SOC = Standard Occupational Classification.

Read the entire page →

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Appendix F: Description of Three Optional Sources for Facility Wage Index Data Pages 181-186

Appendix F: Description of Three Optional Sources for Facility Wage Index Data
Pages 181-186