AD-A274 762 · Alexandria, VA 22304-6145 Telephones: DSN 284-7633, 4, or 5 Commercial (703)...
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AD-A274 762 I TRI-SERVICE CHAMPUS STATISTICAL DATABASE PROJECT * (TCSDP) I I DEPARTMENT OF ARMY I HEALTH SERVICES COMMAND CHAMPUS CATASTROPHIC PAYMENTS FOR FOURTH QUARTER, FISCAL YEAR 1993 I GATEWAY CATCHMENT AREAS I * 94-01370 DTIC Ellllll• nELECTE RP 94-006 S JAN 1219 94 3D * NOVEMBER 1993 E I UNITED STATES ARMY HEALTH SERVICES COMMAND FORT SAM HOUSTON, TEXAS 78234 I 9 "4 T 11 159 "
Transcript of AD-A274 762 · Alexandria, VA 22304-6145 Telephones: DSN 284-7633, 4, or 5 Commercial (703)...
AD-A274 762
I TRI-SERVICE CHAMPUS STATISTICALDATABASE PROJECT
* (TCSDP)
I
I DEPARTMENT OF ARMY
I HEALTH SERVICES COMMANDCHAMPUS CATASTROPHIC PAYMENTS
FOR FOURTH QUARTER, FISCAL YEAR 1993
I GATEWAY CATCHMENT AREASI
* 94-01370 DTICEllllll• nELECTE
RP 94-006 S JAN 121994 3D* NOVEMBER 1993 E
I UNITED STATES ARMYHEALTH SERVICES COMMAND
FORT SAM HOUSTON, TEXAS 78234
I 9 "4 T 11 159 "
TRI-SERVICE CHAMPUS STATISTICALI DATABASE PROJECT(TCSDP)
DEPARTMENT OF ARMY
* HEALTH SERVICES COMMAND
CHAMPUS CATASTROPHIC PAYMENTS
FOR FOURTH QUARTER, FISCAL YEAR 1993
GATEWAY CATCHMENT AREAS
GATEWAY TO CAREMANAGEMENT ANALYSIS SERIES
ISCOTT A. OPTENBERG, GM-'.
Chief, Health Care Analysis Division
KATHLEEN MOON. M.S.* Statistician
Directorate of Health Care* Studies and Analyses
RP 94-006NOVEMBER 1993
UNITED STATES ARMYHEALTH SERVICES COMMAND
FORT SAM HOUSTON, TEXAS 78234-6100
NOTICE
The findings in this report arenot to be construed as an officialDepartment of the Army position
unless so designated by otherauthorized documents. II
Address of author's organization:
Directorate of Health Care Stud as and Analyses (D/HCS&A)ATTN: HSHN-ABuilding 22681608 Stanley RoadFort Sam Houston, Texas 78234-6125 3
II
Reports may be purchased directly from the following:
Defense Technical Information Center (DTIC) IATTN: DTIC-DDRCameron StationAlexandria, VA 22304-6145
Telephones: DSN 284-7633, 4, or 5Commercial (703) 274-7633, 4, or 5
U.S. Department of CommerceNational Technical Information Service (NTIS)5285 Port Royal RoadSpringfield, VA 22161 ITelephone: Commercial (703) 487-4600
ii I
UnclassifiedSECURITY CLASSIFICATION OF THIS PAGE
REPORT DOCUMENTATION PAGE oB NAo. 0704-088
la. REPORT SECURITY CLASSIFICATION lb. RESTRICTIVE MARKINGSUnclassified
2a. SECURITY CLASSIICATION AUTHORITY 3. DISTRIBUTION IAVAILABILITY OF REPORT
2b. DECLASSIFICATION /DOWNGRADING SCHEDULE Distribution Unlimited;Public Use Authorized.
4. PERFORMING ORGANIZATION REPORT NUMBER(S) S. MONITORING ORGANIZATION REPORT NUMBER(S)
RP 94-0066a. NAME OF PERFORMING ORGANIZATION 6b. OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATIONDirectorate of Health Care (If applicable) HQ HSC, Coordinated Care Div.Studies and Analyses HSHN-A6c. ADDRESS (City, State, and ZIP Code) 7b. ADDRESS (City, State, and ZIP Code)
Bldg 2268, 1608 Stanley RoadFort Sam Houston, TX 78234-6125 Fort Sam Houston, TX 78234-6000
Ba. NAME OF FUNDING/SPONSORING Sb. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBERORGANIZATION (If applicable)
HQ HSC, Coordinated Care *v.8c. ADDRESS (City, State, and ZIP Code) 10. SOURCE OF FUNDING NUMBERS
PROGRAM PROJECT TASK IWORK UNIT*ELEMENT NO. NO. NO. JACCESSION NO.
Fort Sam Houston, TX 78234-6000 I I11. TITLE (Include Security Classification)
(U) Department of Army Health Services Command, CHAMPUS CatastrophicPayments For Fourth Quarter, Fiscal Year 1993, Gateway Catchment Areas
12. PERSONAL AUTHOR(S)Dr. Scott A. Optenberg, Kathleen A. Moon, M.S.
a. TYPE OF REPORT 3b. TIME COVERED 14. DATE OF REPORT (Year, Month, Day) 15. PAGE COUNT
Final |FPgUl 93 SD 9 3 1993 Nov 091 7116. SUPPLEMENTARY NOTATION
This is one in a series of Gateway Management Analysis Reports.
17. COSATICODES 18. SUBJECT TERMS (Continue on reverse if necessary and identify by block number)FIELD ( GROUP SUB-GROUP CHAMPUS, Medical Treatment Costs, Catastrophic
Care, U.S. Army, Gateway To Care
19, ABSTRACT (Continue on reverse if necessary and identify by block number)
is report presents in Appendix A the CHAMPUS Catastrophic Quarterly Paymentports for the Fourth Quarter Fiscal Year (FY) 1993 for each of the Armyteway catchment areas. Each Payment Report lists Privacy Act protected5 spitalization patient cases having CHAMPUS claims totaling more than thetchment area's specific FY 1993 catastrophic cutoff amount at the end of theird Quarter and/or at the end of the Fourth Quarter FY 1993. The differencetween the reported and prior quarters' net claim payments equals theI atastrophic net payment made for each patient during the quarter. Table 1 ate end of the Summary contains the CHAMPUS Catastrophic Quarterly Payment
Shedule, summarizing for each catchment area the catastrophic case cutoffmit, the net claim totals for each of the two quarters, the payment totaltween the quarters, and the number of catastrophic cases comprising theseurth Quarter FY 1993 payment differences.
20. DISTRIBUTION/AVAILABILITY OF ABSTRACT 21. AQSTRAC UR CLASSIFICATIONUNCLASSIFIEDAUNLIMITEDX 10 SAME AS RPT. 0 OTIC USERS Unc'assiLie
22a. NAME OF RESPONSIBLE INDIVIDUAL 22b. TELEPHONE (Include Area Code) 22c. OFFICE SYMBOLDr. Scott A. Optenberg (210) 221-0278 1 HSHN-A
DD Form 1473, JUN 86 Previous editions are obsolete. SECURITY CLASSIFICATION OF THIS PAGE
UnclassifiedI iii
TABLE OF CONTENTS
SECTION PAGE
DISCLAIMER ......................... ii
REPORT DOCUMENTATION PAGE (DD Form 1473) ...... ............ .
TABLE OF CONTENTS ............ ........................ ... v
SUMMARY .................................................... 1-3
DISTRIBUTION LIST ................................... .. 5-8
APPENDIX
A. Army Gateway Program; CHAMPUS Catastrophic PaymentReport; July 1, 1993 Through September 30, 1993;By Catchment Area .......................... .. A-1-59
Accslon ForDTIC QUALrry iNsPECTED 5 NTSCA
OTIC TABUnannounced E3Justification
Dizit ibution I
Availability Codes
S- Avail and I orDist Special
UVI
IIv
I
Executive Summary
This report presents in Appendix A the CHAMPUS CatastrophicQuarterly Payment Report for the Fourth Quarter, Fiscal Year (FY)1993. For each of the Health Services Command (HSC) Gatewaycatchment areas, Privacy Act protected patient cases havingCHAMPUS claims totaling more than the catchment area's specificFY 1993 catastrophic cutoff amount are listed with the changes intheir net claim payments between the reported and prior quarters.Each Payment Report includes the following for each patient: (1)the patient unique Inpatient Record Number; (2) the last hospitalending date on record; (3) the last hospital and professionalservices voucher payment dates; (4) an indicator of whether thecase involved a consolidation of hospital stays due to FI adjudi-cation action; (5) the DRG and diagnosis codes and their short-ened names; (6) number of days spent in the hospital; (7) numberof professional services; (8) patient age, sex and beneficiarycategory; (9) the catastrophic amounts above the site's specifiedcatastrophic cutoff amount on the first and last days of theIreported quarter; and (10) the difference of these two cata-strophic totals which equals the catastrophic net payment madefor each patient during the quarter. Dollar amounts are summedover all patients to total for the Payment Report within acatchment area. Table 1 at the end of this Summary (p. 3)contains the CHAMPUS Catastrophic Quarterly Payment Schedule. Itlists the summary totals of each catchment area's number ofcatastrophic cases and catastrophic totals from the PaymentReports, and totals these amounts over all catchment areas.
Only cases with CHAMPUS claim payment totals exceeding thecatchment area's catastrophic cutoff amount are presented. Eachcutoff amount is noted in the footnote area on the catchmentarea's output in the Catastrophic Payment Report (Appendix A, pp.A-1-59) and on the CHAMPUS Catastrophic Payment Schedule (Table1). The specific cutoff amounts used for each of the Gatewaysites and the methods used to derive them were reported in theHealth Services Command Publication Fiscal Year 1993 CHAMPUSCatastrophic Case Limits, Gateway Catchment Areas, RP 93-009,DTIC: AD A262 324, February 1993. Quarterly catastrophic paymentamounts are the differences between the most recent and the priorquarters' CHAMPUS catastrophic claim totals. A negative paymentamount represents net recoupment actions/adjustments during thequarter. Third Quarter FY 1993 quarterly catastrophic paymentamounts for the thirty-eight sites were reported in the HealthServices Command Publication CHAMPUS Catastrophic Payments ForThe Third Ouarter. Fiscal Year 1993. Gateway Catchment Areas, RP93-017, DTIC: AD A268 644, July 1993.
Finding the status of any catastrophic patient case fromquarter to quarter is accomplished by comparing the InpatientRecord Numbers (INPT RCD #'s) from previous quarterly reportswith those on the current Catastrophic Payment Report (Appendix
1
1
A). If the Inpatient Record Number is on both the previousreport and the current one, the catastrophic patient had positiveor negative net claims in at least one of the quarters and is acontinuing catastrophic case. Otherwise, a catastrophic case canappear to be newly added or dropped when compared with a previousreport depending on whether a case surpasses or drops below thecatastrophic cutoff amount for that catchment area, or whether ornot claim payment activity took place during the reportingquarter. An example of catastrophic case quarter to quarteractivity is presented in the Summary of the Third Quarter FY 1993Catastrophic Payments publication (see RP 93-017 listed above).
Table 1 at the end of this Summary (p. 3) contains theFourth Quarter FY 1993 CHAMPUS Catastrophic Quarterly PaymentSchedule and lists the summary totals of each catchment area'snumber of catastrophic cases and catastrophic totals from thePayment Report for the quarter. Additionally, each site's FY1993 cutoff amount is listed. Table 1 shows that CHAMPUS cata- Istrophic re-insurance payments for the Fourth Quarter had lows of$-163,158 at Fort Riley MEDDAC with six catastrophic cases and acutoff amount of $117,000, and at Fort Meade MEDDAC with a cutoff Iamount of $94,000 where payments were $-14,174 for six patients.At the high end of the range, Womack AMC at Fort Bragg with a$28,500 cutoff amount had 49 cases on its Payment Report andcatastrophic re-insurance payments of $630,062, while Fort HoodMEDDAC had $537,793 in payments and 24 patient cases with its$91,000 case limit. Fort Benjamin Harrison MEDDAC showed zerocatastrophic patient activity during the Fourth Quarter. Having Ino catastrophic cases appear on their Fourth Quarter PaymentsReport could either have been caused by zero claim payments/recoupments being made against any catastrophic cases during the Iquarter, or by none of Fort Benjamin Harrison MEDDAC's patientcases surpassing the $74,000 catchment area catastrophic cutoffamount. Quarterly catastrophic payments for the Fourth QuarterFY 1993 totaled to $6,210,350 over all Gateway sites and includedcare for a total of 509 catastrophic patients.
Technical Note. The following Tri-Service CHAMPUS Statistical IDatabase Project (TCSDP) data were utilized for report:
A) Composite Institutional Record (CIR) V2.0B) Composite Professional Record (CPR) V1.0 IC) TCSDP Indexing Logic Module #C3B43.
II
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DISTRIBUTION LIST
HQDA (DASG-ZA), 5109 Leesburg Pike, Falls Church, VA22041-3258 (1)
HQDA (DASG-ZB), 5109 Leesburg Pike, Falls Church, VA22041-3258 (1)
HQDA (DASG-HCD-D), 5109 Leesburg Pike, Falls Church, VA22041-3258 (2)
HQDA (DASG-PSZ), 5111 Leesburg Pike, Falls Church, VA22041-3258 (1)
HQDA (DASG-RMZ), ATTN: COL Gray, Room 564, 5111 LeesburgPike, Falls Church, VA 22041-3258 (3)
HQDA (SGPS-PSA), Room 611, Skyline 5, 5111 Leesburg Pike,Falls Church, VA 22041-3258 (3)
Defense Technical Information Center, ATTN: DTIC-OOC (Selection),Bldg 5, Cameron Station, Alexandria, VA 22304-6145 (2)
Commandant, Academy Health Science, ATTN: HSHA-Z,Fort Sam Houston, TX 78234-6100 (1)
Offices of the Surgeons General, Army/Air Force, ATTN: DASG-AAFJML,5109 Leesburg Pike, Rm 670, Falls Church, VA 22041-3258 (1)
HQ HSC, ATTN: HSCG, Fort Sam Houston, TX 78234-6000 (1)HQ HSC (HSCL-M), ATTN: COL Beumler, Fort Sam Houston, TX
78234-6000 (3)HQ HSC (HSRM), ATTN: COL Cahill, Fort Sam Houston, TX
78234-6000 (5)Stimson Library, Academy of Health Sciences, Bldg 2840,
Fort Sam Houston, TX 78234-6100 (1)Medical Library, Brooke Army Medical Center, Reid Hall,
Bldg. 1001, Fort Sam Houston, TX 78234-6200 (1)Director, The Army Library, ATTN: ANR-AL-RS (Army
Studies), Rm 1A518, The Pentagon, Washington, DC 20310 (1)Defense Logistics Studies Information Exchange, U.S. Army
Logistics Management College, Fort Lee, VA 23801-8043 (1)HQ USAF/SGHA, ATTN: Managed Care, Bldg 5681, Bolling AFB,
Washington, DC 20332-6188 (5)Chief, Bureau of Medicine and Surgery (BUMED-03), ATTN:
Coordinated Care, Washington, DC 20372-5120 (5)Office of the Assistant Secretary of Defense (PAQA),
ATTN: Cdr St. Andre, The Pentagon, DC 20301 (1)Office of the Assistant Secretary of Defense (HA), Health Services
Financing (HSF), ATTN: Dr. Velthuis, Coordinated Care Policy, Rm1B657, The Pentagon, DC 20301-1200 (1)
Office of the Assistant Secretary of Defense (HA), HSF-MUMP, ATTN:Ms. Eunice Bryden, Rm 3E343, The Pentagon, DC 20301 (1)
OCHAMPUS, ATTN: Mr. Fred Hammer, Aurora, CO 80045 (2)Commander, William Beaumont Army Medical Center, El Paso,
TX 79920-5001 (1)Commander, Brooke Army Medical Center, Fort Sam Houston,
TX 78234-6200 (1)Commander, Dwight David Eisenhower Army Medical Center, Fort
Gordon, GA 30905-5650 (1)
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Commander, Fitzsimons Army Medical Center, Aurora, CO I80045-5000 (1)
Commander, Madigan Army Medical Center, Tacoma, WA98431-5000 (1)
Commander, Tripler Army Medical Center, TAMC, HI96859-5000 (1)
Commander, Walter Reed Army Medical Center, Washington, DC20307-5000 (1)
Commander, Womack Army Medical Center, Fort Bragg, NC28307-5000 (1)
Commander, U.S. Army Medical Department Activity, FortBelvoir, VA 22060-5141 (1)
Commander, Hawley Army Community Hospital, Fort BenjaminHarrison, IN 46216-7000 (1)
Commander, U.S. Army Medical Department Activity, FortBenning, GA 31905-6100 (1)
Commander, U.S. Army Medical Department Activity, FortCampbell, KY 42223-1498 (1) I
Commander, U.S. Army Medical Department Activity, Fort Carson,CO 80913-5101 (1)
Commander, U.S. Army Medical Department Activity, Fort Devens,MA 01433-6401 (1)
Commander, U.S. Army Medical Department Activity, Fort Drum,NY 13602-5004 (1)
Commander, U.S. Army Medical Department Activity, Fort Hood,TX 76544-5063 (1)
Commander, U.S. Army Medical Department Activity, FortHuachuca, AZ 85613-7040 (1)
Commander, U.S. Army Medical Department Activity, Fort Irwin,CA 92310-5065 (1)
Commander, U.S. Army Medical Department Activity, FortJackson, SC 29207-5720 (1)
Commander, U.S. Army Medical Department Activity, Fort Knox,KY 40121-5520 (1)
Commander, U.S. Army Medical Department Activity, Fort Leaven-worth, KS 66027-5400 (1)
Commander, U.S. Army Medical Department Activity, Fort Lee,VA 23801-5260 (1) I
Commander, U.S. Army Medical Department Activity, Fort LeonardWood, MO 65473-5700 (1)
Commander, U.S. Army Medical Department Activity, FortMcClellan, AL 36205-5083 (1)
Commander, U.S. Army Medical Department Activity, FortGeorge G. Meade, MD 20755-5800 (1)
Commander, U.S. Army Medical Department Activity, Fort UMonmouth, NJ 07703-5000 (1)
Commander, U.S. Army Medical Department Activity, Fort Ord,CA 93941-5800 (1) I
Commander, U.S. Army Medical Department Activity, Fort Polk,LA 71459-6000 (1) 16 U
Commander, U.S. Army Medical Department Activity, Presidioof SF, CA 94129-6700 (1)
Commander, U.S. Army Medical Department Activity, RedstoneArsenal, AL 35809-7000 (1)
Commander, U.S. Army Medical Department Activity, Fort Riley,KS 66442-5036 (1)
Commander, U.S. Army Aeromedical Center, Fort Rucker, AL36362-5333 (1)
Commander, U.S. Army Medical Department Activity, Fort Sill,OK 73503-6300 (1)
Commander, U.S. Army Medical Department Activity, FortStewart, GA 31314-5300 (1)
Commander, U.S. Army Medical Department Activity, Alaska, FortWainwright, AK 99703-7300 (1)
Commander, U.S. Army Medical Department Activity, West Point,NY 10996-1197 (1)
Commander, USAF Academy Hospital, 4102 Pinon Drive, USAF Academy,CO 80840-4000 (1)
Director, Coordinated Care, William Beaumont Army Medical Center,El Paso, TX 79920-5001 (1)
Director, Coordinated Care, Brooke Army Medical Center, Fort SamHouston, TX 78234-6200 (1)
Director, Coordinated Care, Dwight David Eisenhower Army MedicalCenter, Fort Gordon, GA 30905-5650 (1)
Director, Coordinated Care, Fitzsimons Army Medical Center, Aurora,CO 80045-5000 (1)
Director, Coordinated Care, Madigan Army Medical Center, Tacoma, WA98431-5001 (1)
Director, Coordinated Care, Tripler Army Medical Center, TAMC, HI96859-5000 (1)
Director, Coordinated Care, Walter Reed Army Medical Center,Washington, DC 20307-5001 (1)
Director, Coordinated Care, Womack Army Medical Center, Fort Bragg,NC 28307-5000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Belvoir, VA 22060-5141 (1)
Director, Coordinated Care, Hawley Army Community Hospital, FortBenjamin Harrison, IN 46216-7000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Benning, GA 31905-6100 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Campbell, KY 42223-1498 %i)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Carson, CO 80913-5101 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Devens, MA 01433-6401 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Drum, NY 13602-5004 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Hood, TX 76544-5063 (1)
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Director, Coordinated Care, U.S. Army Medical Department Activity, iFort Huachuca, AZ 85613-7040 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Irwin, CA 92310-5065 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Jackson, SC 29207-5720 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Knox, KY 40121-5520 (1) I
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Leavenworth, KS 66027-5400 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity, IFort Lee, VA 23801-5260 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Leonard Wood, MO 65473-5700 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort McClellan, AL 36205-5083 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort George G. Meade, MD 20755-5800 (1) I
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Monmouth, NJ 07703-5000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Ord, CA 93941-5800 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Polk, LA 71459-6000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Presido of SF, CA 94129-6700 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Redstone Arsenal, AL 35809-7000 (1) I
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Riley, KS 66442-5036 (1)
Director, Coordinated Care, U.S. Army Aeromedical Center, FortRucker, AL 36362-5333 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Sill, OK 73503-6300 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Stewart, GA 31314-5300 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Alaska, Fort Wainwright, AK 99703-7300 (1) U
Director, Coordinated Care, U.S. Army Medical Department Activity,West Point, NY 10996-1197 (1)
HQ USAFA/SGAM, ATTN: MS Linda Davis, 4102 Pinon Drive - Suite 100,USAF Academy, CO 80840-4000 (1)
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APPENDIX A
ARMY GATEWAY PROGRAM
CHAMPUS CATASTROPHIC PAYMENT REPORT
JULY 1, 1993 THROUGH SEPTEMBER 30, 1993
BY CATCHMENT AREA
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