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Medicare Spending Per Beneficiary (MSPB) - Hospital

CBE ID
2158
Endorsed
New or Maintenance
Endorsement and Maintenance (E&M) Cycle
Is Under Review
No
Measure Description

The MSPB Hospital measure evaluates hospitals’ risk-adjusted episode costs relative to the risk-adjusted episode costs of the national median hospital. Specifically, the MSPB Hospital measure assesses the cost to Medicare for Part A and Part B services performed by hospitals and other healthcare providers during an MSPB Hospital episode, which is comprised of the periods 3-days prior to, during, and 30-days following a patient’s hospital stay. The MSPB Hospital measure is not condition specific and uses standardized prices when measuring costs. Beneficiary populations eligible for the MSPB Hospital calculation include Medicare beneficiaries enrolled in Medicare Parts A and B who were discharged between January 1 and December 1 in a calendar year from short-term acute hospitals paid under the Inpatient Prospective Payment System (IPPS).

  • Measure Structure
    Resource Use Measure Type
    Brief Description Of Measure Clinical Logic

    Objective: The MSPB Hospital measure aims to improve care coordination and care quality in the period between 3 days prior to an acute inpatient hospital admission through the period 30 days after discharge.

    Clinical Topic Area: Inpatient Admissions, all conditions

    Accounting for Comorbidities: Application of a variant of the CMS-HCC risk adjustment model. The model includes a full set of interaction terms between comorbidities and MDC of the index admission, as well as a select number of interaction terms between comorbidities.

    Measure of Episode Severity: Risk adjustment model includes indicators for the MS-DRG of the index admission.

    Concurrency of Clinical Events. The MSPB Hospital episode spans the period 3 days prior to the index hospital admission through 30-days post-discharge. All Medicare Part A and B claim-based events initiated during this period are included in the MSPB Hospital episode.

    National Quality Strategy Priorities
    Affordable Care
    Cost/Resource Use
  • Most Recent Endorsement Activity
    Endorsed Cost and Efficiency Fall Cycle 2020
    Initial Endorsement
    Next Planned Maintenance Review
    Cost and Efficiency Fall 2024
    Endorsement Status
    Last Updated