New CMS Data Tool: Rural PA Has High Ambulance Usage
July 28, 2017
The Centers for Medicare & Medicaid Services (CMS) released a market saturation and utilization data tool for analyzing and depicting geographic differences in the numbers of:
- Medicare Fee-for-Service (FFS) beneficiaries who use different kinds of health care services
- Providers available to serve those beneficiaries
HAP’s preliminary analysis shows that many parts of Pennsylvania—including rural counties—have high utilization of emergency ambulance services.
This map depicts emergency ambulance utilization in Pennsylvania counties. According to the CMS data, 40 out of 67 (60%) Pennsylvania counties had high numbers of users for emergency ambulance services from October 1, 2015, to September 30, 2016.
Surprisingly, rural counties were among these high utilizers despite their relatively sparse population density.
The highest (or extreme values) usage occurred in high-density population areas as well as in three rural counties. The next highest usage (the top quartile for usage less the “extreme” usage) occurred in 18 rural counties as well as in those with more residents.
These findings are fairly consistent with HAP’s analysis of Pennsylvania Department of Health emergency department utilization (visits to emergency room) across regions.
The new CMS tool includes these kinds of health care services and facilities:
- Ambulance (emergency and non-emergency)
- Clinical lab
- Independent diagnostic testing facilities
- Physical and occupational therapy
- Home health
- Skilled nursing facilities
- Long-term care facilities
Data provided in the tool looks at the following metrics:
- Number of Medicare FFS beneficiaries
- Number of beneficiaries who are service users
- Percentage of beneficiaries who are service users
- Number of providers
- Average number of providers per county
- Average number of service users per provider
CMS anticipates that this tool can be used to:
- Monitor market saturation as a means to prevent fraud, waste, and abuse
- Assess the use of a service related to the number of providers serving a geographic region
- Help health care providers make informed decisions about their service locations and the Medicare FFS beneficiaries those providers serve
For more information about the CMS data tool, contact Phillip M. Burrell, HAP’s director, health market research.