NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Prospective Payment System (PPS) Data


PPS is a system of Medicare reimbursement for Part A benefits which bases most hospital payments on the patient's diagnosis at the time of hospital admission. PPS data was created by the Centers for Medicare & Medicaid Services' (CMS).

"The Inpatient Minimum Datasets contain cost, statistical, financial, and other information from the Medicare Hospital Cost Report. The datasets include only the most current cost report (as submitted, final settled, or reopened) submitted for a Medicare-certified hospital by the Medicare fiscal intermediary to HCFA. These datasets are updated at the end of each calendar quarter and are available on the last day of the following month."

"The Capital Datasets contain selected data for capital-related costs, interest expense and related information, and complete balance sheet data from the Medicare Hospital Cost Report."

"The Outpatient Datasets contain Part B Medicare cost and charges by cost center from the Medicare Hospital Cost Report."

Quotes are from "Data Users Reference Guide". U.S. Department of Health and Human Services, Health Care Financing Administration, Bureau of Data Management and Strategy. September 1995.

Updates and changes.
 

Prospective Payment System (PPS)

File Fiscal Year Manual Begin Date End Date
Layout and Tables
Ebcdic
Data
Stata
Data
SAS
Data
SAS
Prog
TEFRA 1983 2552-83 1982-10-01 1983-09-30
tefra.pdf
--
tefra tefra
--
PPS I Minimum 1984 possibly
2552-84
1983-10-01 1984-09-30
--
PPS II Minimum 1985 probably
2552-85
1984-10-01 1985-09-30
min2.pdf
min2 min2 min2 2_5.sas
PPS III Minimum 1986
2552-85
1985-10-01 1986-09-30 min3 min3 min3
PPS IV Minimum 1987 1986-10-01 1987-09-30
min4.pdf
min4 min4 min4
PPS V Minimum 1988 1987-10-01 1988-09-30
min5.pdf
min5 min5 min5
PPS VI Minimum 1989 2552-85
and
2552-89
1988-10-01 1989-09-30
min6.pdf
min6 min6 min6 6_8.sas
PPS VII Minimum 1990
2552-89
1989-10-01 1990-09-30
min7.pdf
min7 min7 min7
PPS VIII Minimum 1991 1990-10-01 1991-09-30 min8 min8 min8
PPS XIX Minimum 1992
2552-92
1991-10-01 1992-09-30 min9-10.pdf
covr9-12.pdf
tbl9-12.pdf
min9 min9 min9 9_10.sas
PPS X Minimum 1993 1992-10-01 1993-09-30 min10 min10 min10
PPS XI Minimum 1994 1993-10-01 1994-09-30 min9-12.pdf min11 min11 min11 11_12.sas
PPS XII Minimum 1995 1994-10-01 1995-09-30 min12 min12 min12
The most up-to-date hospital data for fiscal year 1996 on is the Healthcare Cost Report Information System (HCRIS) data.
PPS 16 / fiscal year 1999 is the last year hospital data was released in PPS format.
Means and Frequencies of these files are available.
The Stata files were created via Stat/Transfer. Stat/Transfer imposed a limit of 2,047 variables. So, the files were split into two pieces. The medicare provider number, f1, is in both datasets.
PPS XIII Minimum 1996
2552-96
1995-10-01 1996-09-30 min13-15.pdf
covr13-15.wpd
tbl13-15.wpd
min13 min13a
min13b
min13 13_15.sas
PPS XIV Minimum 1997 1996-10-01 1997-09-30 min14 min14a
min14b
min14
PPS XV Minimum 1998 1997-10-01 1998-09-30 min15 min15a
min15b
min15 15_16.sas
PPS XVI Minimum 1999 1998-10-01 1999-09-30 min16.xls
covr16.wpd
tbl16.doc
min16 min16a
min16b
min16

PPS II Part B 1985 possibly
2552-85
1984-10-01 1985-09-30
--
2b
--
PPS III Part B 1986 1985-10-01 1986-09-30 3b
PPS IV Part B 1987 1986-10-01 1987-09-30 4b
PPS V Part B 1988 1987-10-01 1988-09-30 5b
PPS VI Part B 1989 2552-85
and
2552-89
1988-10-01 1989-09-30
6b
6b
PPS VII Part B 1990 2552-89 1989-10-01 1990-09-30
7_8b
7b
PPS VIII Part B 1991 1990-10-01 1991-09-30 8b

PPS IV Capital 1987
DK
1986-10-01 1987-09-30
cap1_8.pdf
4cap
sample program
PPS V Capital 1988 1987-10-01 1988-09-30 5cap
PPS VI Capital 1989 1988-10-01 1989-09-30 6cap
PPS VII Capital 1990 1989-10-01 1990-09-30 7cap
PPS VIII Capital 1991 1990-10-01 1991-09-30 8cap
* -- TEFRA stands for Tax Equity and Fiscal Responsibility Act.
This 1982 act defines the primary and secondary coverage responsibilities of the Medicare program and also the provisions to be used by health plans in their contracts with the HCFA (Health Care Financing Administration).


Send questions to Jean Roth.

Last Update: February 22, 2010 Created by Jean Roth February 2, 2004

 
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