1 Inpatient acute claims included both prospective payment system (PPS) and critical access hospital (CAH) claims.
2 Because there is no national physician fee schedule, state-level physician fee schedule amounts were used in this calculation. RTI selected one state, Kansas (although any state could have been selected), for the purposes of this analysis and applied Kansas rates to all hospital outpatient therapy claims. By applying the rates from one state to all of the data, we were able to achieve the goal of understanding levels of utilization in the absence of wage adjustments and other geographic differences in payments.
3 The percentage of beneficiaries with an acute readmission does not vary from Episode Definition A (30 Day Fixed) to Episode Definition C (30 Day Fixed [prorated]) because these episode definitions vary only in the method of handling the last claim in the episode. Similarly, the percent of beneficiaries with an acute readmission does not vary between Episode Definition E (60 Day Fixed) and Episode Definition G (60 Day Fixed [prorated]) or between Episode Definition I (90 Day Fixed) and Episode Definition K (90 Day Fixed [prorated]).
4 MS-DRG specific analyses were also performed as part of this work, although the complete set results by MS-DRG are not presented in this report.
5 Episodes ending prior to an acute hospital readmission exclude the readmission and any subsequent PAC use following the readmission.
6 Although the proportion of beneficiaries discharged to PAC is lowest in Texas of the four states shown here (29.2 percent Texas) and not an expected result given the supply of acute and PAC providers in Texas and prior work looking a utilization of services across states, this may be caused by the sample of beneficiaries in the analysis (beneficiaries with an index acute hospital stay following a period of 60 days without acute or PAC service use) or by differences in the types of beneficiaries using acute services in Texas.
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