CODEBASE: Refactor Medicare cost calculator using Backbone.js

[chrislkeller]

Ideas on how to improve * Group by similar hospitals for a procedure * Add hooks for local storage * Add URL routes for a given comparison * Allow for sharing of a given comparison * Group hospitals by hospital referral region * Allow user to search by location Views * Location elements * Choose from medical specialty area * Choose from MS-DRG associated with specialty area * Statewide comparison * Hospital comparison When Medicare unveiled hospitals' undiscounted sticker prices on healthcare services last May, executives quickly fired back that Medicare never pays those rates so the figures were meaningless. But that's not true. Virtually every hospital in America receives extra “outlier” payments from Medicare that are intended to offset costs for catastrophically expensive patients. Those billions of dollars in extra payments are based on hospitals' undiscounted charges, and a new study from HHS' watchdog office (PDF) has unearthed evidence that high sticker prices are indeed driving up Medicare payments. Report: http://ift.tt/1HfAsqX This is looking great, Chris, thanks so much for all of your work on it. Here are my notes. --Paul I think it’s more clear if we refer to a “bill” rather than “cost,” since the average reimbursement is what it actually ends up costing. I think we need to tweak and add to this graf in the introductory section, so that it reads: A caveat: The data show a wide variation in average bills, but experts note that the amounts charged have little bearing on your actual costs. You will see that difference in the amount shown as the “average reimbursement” for a procedure, which is the average amount actually paid to the hospital. I suggest tweaking the copy under “Statewide Comparisons” to read like this (and can we add a comma after each city name?): Average cost in California: $122,454 The lowest average bill for this procedure is about $58,911 at Clovis Community Medical Center in Clovis, based on 14 discharges. The highest average bill for this procedure is about $307,162 at Regional Medical Center Of San Jose in San Jose, based on 12 discharges. The difference in average bills between these hospitals is about $248,251 For the copy in the hospital drop down boxes, a couple of copy edits: For a facility that’s below the average (changing the period to a comma after “procedure,” removing the negative signs from in front of the numbers, and tweaking a few words of copy): Bakersfield Memorial Hospital in Bakersfield charges less than the state average for this procedure, based on 14 discharges. The average bill for this procedure is $72,278, which is $50,176 less than the state average. The average reimbursment for this procedure is $19,520, which is $2,934 less than the state average. For a facility that’s above the average (changing the period to a comma after “procedure,” adding and tweaking a few words): Cedars-Sinai Medical Center in Los Angeles charges more than the state average for this procedure, based on 144 discharges. The average bill for this procedure is $165,948, which is $43,494 more than the state average. The average reimbursment for this procedure is $26,526, which is $4,072 more than the state average. Good afternoon, The discrepancy you are observing is due to the state summaries using weighted averages. The files should not match. Thank you. From: Keller, Christopher [mailto:[email protected]] Sent: Friday, May 31, 2013 7:29 PM To: CMS MedicareProviderChargeData Cc: Keller, Christopher Subject: Question about method of determining overall average for a DRG within a state... Hello… I'm finishing a project that uses the Medicare charges data released earlier in May, and in the process of double-checking my work I came across a discrepancy in my calculations and wanted to see I could learn how you calculated some information contained in the National and State Summaries of Inpatient Charge Data Excel data file. In my project I'm looking solely at the state of California, and was calculating the average covered charges and average total payments for each DRG using the Inpatient Charge Data, FY2011 Excel file. Today I compared that data against the Averages By State Within DRG found in the National and State Summaries of Inpatient Charge Data Excel file. The total number of discharges for a procedure match between the two files, but the averages I calculate using data in the Inpatient Charge Data, FY2011 file do not match the averages contained in the National and State Summaries of Inpatient Charge Data Excel file. For instance… Inpatient Charge Data, FY2011 Excel File 039 - Extracranial Procedures without complications or major complications 1,715 $56,094.94 $8,387.93 057 - Degenerative Nervous System Disorders without major complications 1,469 $45,722.78 $8,528.81 064 - Intracranial Hemorrhage Or Cerebral Infarction with major complications 5,260 $89,387.62 $16,916.76 065 - Intracranial Hemorrhage Or Cerebral Infarction with complications 7,840 $52,628.36 $9,959.54 066 - Intracranial Hemorrhage Or Cerebral Infarction without complications or major complications 3,723 $42,299.58 $7,011.92 069 - Transient Ischemia 4,441 $37,044.38 $6,164.34 National and State Summaries of Inpatient Charge Data Excel file 039 - EXTRACRANIAL PROCEDURES W/O CC/MCC CA 1,715 $54,275.09 $8,251.97 057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC CA 1,469 $45,639.35 $8,555.32 064 - INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC CA 5,260 $95,325.99 $17,327.14 065 - INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC CA 7,840 $55,669.31 $9,836.85 066 - INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC CA 3,723 $42,437.58 $6,977.74 069 - TRANSIENT ISCHEMIA CA 4,441 $37,395.66 $6,119.99 I know you are very busy, but I'm wondering if I'm overlooking something that was used to calculate the data in the National and State Summaries of Inpatient Charge Data Excel file that isn't present in the Inpatient Charge Data, FY2011 Excel File? They should match right? Thanks in advance for any guidance you might be able to provide… Chris K. -- Chris Keller Data Journalist/News Applications Developer KPCC - Southern California Public Radio Web: scpr.org Email: [email protected] Desk: (626) 583-5214 Mobile: (323) 515-2485

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