DataPoint: Medicare RUG Distribution
Ultra High therapy billing accounted for the largest percentage of Medicare fee-for-service therapy days both nationally (56.7%) and in New York State (57.1%). New York ranks 18th nationally in terms of Ultra High utilization percentage. New Jersey is the only neighboring state with a higher Ultra High utilization percentage (66.8%, third nationally). Massachusetts, Pennsylvania, Connecticut, and Vermont were all below 56% Ultra High therapy utilization. The Centers for Medicare and Medicaid Services' (CMS) newly released Skilled Nursing Facility Utilization and Payment Public Use File data reveal New York State’s comparability to national averages in Medicare therapy utilization.
CMS’ data was released in January 2017, and their recent release consists of 2014 data. The data is limited because it only includes Medicare’s fee-for-service population. Along with RUG distributions, this dataset also includes a variety of other cost and utilization information.
The complete CMS Skilled Nursing Facility and Payment Public Use File can be found here. A listing of state RUG utilization can be found here.
Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820