Musings on 2014 Medicare Payment Data (Part 1)
by Brian S. Werfel, AAA Medicare Consultant | Updated February 2, 2016
Every year, the Centers for Medicare and Medicaid Services (CMS) releases data on Medicare payments for the preceding year.The 2015 Physician/Supplier Procedure Master File (PSP Master File) was released in late November 2015.This report contains information on all Part B and DME claims processed through the Medicare Common Working File with 2014 dates of service.
The headline number is that Medicare spent $4.968 million on ambulance services in 2014.This represents a slight increase (0.67%) over the amounts spent on ambulance services in 2013.
Over the next few blog posts, I will be digging a bit deeper into these numbers to highlight a few long-term trends that I believe are noteworthy.
Increase in Medicare Ambulance Volume Trails Increase in Medicare Enrollment
The number of allowed ambulance services has grown steadily since 2007.Using data from the annual PSP Master Files, the number of allowed ambulance transports increased from approximately 17.5 million transports in 2007 to 20.8 million transports in 2014.The Office of the Inspector General and other government agencies have pointed to numbers like these as evidence that ambulance services face an increasing program integrity problem.
While a superficial analysis might suggest that this growth is problematic, I would argue that this growth must be viewed in its proper context.Over this same period of time, CMS Medicare Enrollment Reports show that the Medicare beneficiary population has grown from 44.1 million beneficiaries to approximately 54 million beneficiaries.All things being equal, one would expect the volume of ambulance transports to increase as the total beneficiary population increases.
When one compares the growth of ambulance volume to the growth of the Medicare population, a different narrative becomes apparent.As the chart on the right shows, with the exception of 2011, the increase in ambulance transports has consistently trailed the overall growth of the Medicare population since 2010.This reflects the fact that the earliest members of the Baby Boomer generation started to turn 65 in 2010.In other words, once you adjust for the increase in the Medicare population, ambulance transport volume has been essentially flat over the past 5 years.
Something to keep in mind the next time someone cites the increase in ambulance transports as proof that our industry has failed to adequately police itself.
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