Common use of Discount Adjustment Factor Clause in Contracts

Discount Adjustment Factor. An adjustment was also applied to some HC reported expenditure data because an evaluation of matched HC/MPC data showed that respondents who reported that charges and payments were equal were often unaware that insurance payments for the care had been based on a discounted charge. To compensate for this systematic reporting error, a weighted sequential hot-deck imputation procedure was implemented to determine an adjustment factor for HC reported insurance payments when charges and payments were reported to be equal. As for the other imputations, selected predictor variables were used to form groups of donor and recipient events for the imputation process. Expenditure data for newborns were edited to exclude discharges after birth when the newborn left the hospital on the same day as the mother. As a result, inpatient expenditures reported for 1997 births were usually applied to the mother and not treated as separate expenditures for the infant. However, if a newborn was discharged at a later date than the mother, then the hospitalization was treated as a separate hospital stay for the newborn. This means that in most cases, expenditure data for the newborn is included on the mother’s record. A separate record for the newborn only exists if the newborn was discharged after the mother. In this case, the expenditure for the newborn is on the newborn’s record. In addition, the user should note that for the purposes of the expenditure imputation, deliveries were identified using the variable RSNINHOS which has not been reconciled with pregnancy and delivery ICD-9 codes on this file as well as on HC-018. As mentioned previously, in most instances where RSNINHOS = 4 delivery, the ICD-9 code indicates a pregnancy rather than a delivery. Although a person may have indicated that there was an emergency room visit that preceded this hospital stay (EMERROOM), there was no verification that, in fact, the emergency room visit was actually recorded within the Emergency Room Section of the questionnaire. While it is true that all of the event files can be linked by DUPERSID, there is no unique record link between hospital inpatient stays and emergency room visits. That is, a person could have one hospital inpatient stay and three emergency room visits during the calendar year. While the hospital inpatient stay record may indicate that it was preceded by an emergency room visit, there is no unique record link to the appropriate (of the three) emergency room visit. However, where ever this relationship could be identified (using MPC start and end date of the events as well as information from the provider), the expenditure associated with the emergency room visit was moved to the hospital facility expenditure (see ERHEVIDX in Section 2.5.1.2). Hence, for some hospital stays, expenditures for a preceding emergency room visits are included. In these situations, the corresponding emergency room record on HC-016E:the MEPS 1997 Emergency Room Visit File will have its expenditure information zeroed out to avoid double-counting. The variable ERHEVIDX identifies these hospital stays whose expenditures include the expenditures for the preceding emergency room visit. It should also be noted that for these cases, there is only one hospital stay associated with the emergency room stay. In addition to total expenditures, variables are provided which itemize expenditures according to major sources of payment categories. These categories are:

Discount Adjustment Factor. An adjustment was also applied to some HC HC-reported expenditure data because an evaluation of matched HC/MPC data showed that respondents who reported that charges and payments were equal were often unaware that insurance payments for the care had been based on a discounted charge. To compensate for this systematic reporting error, a weighted sequential hot-deck imputation procedure was implemented to determine an adjustment factor for HC HC-reported insurance payments when charges and payments were reported to be equal. As for the other imputations, selected predictor variables were used to form groups of donor and recipient events for the imputation process. Expenditure data for newborns were edited to exclude discharges after birth when the newborn left the hospital before or on the same day as the mother. As a result, inpatient expenditures reported for 1997 2021 births were usually applied to the mother and not treated as separate expenditures for the infant. However, if a newborn was discharged at a later date than the mother’s discharge date, then the hospitalization was treated as a separate hospital stay for the newborn. This means that that, in most cases, expenditure data for the newborn is included on the mother’s record. A separate record for the newborn only exists if the newborn was discharged after the mother. In this case, the expenditure for the newborn is on the newborn’s record. In addition, Records in the user should note that for MEPS 2021 data files include the purposes of the expenditure imputation, deliveries were identified HC survey data collected using the variable RSNINHOS which has not been reconciled with pregnancy and delivery ICD-9 codes on this file as well as on HC-018new CAPI instrument. As mentioned previously, in most instances where RSNINHOS = 4 delivery, the ICD-9 code indicates a pregnancy rather than a delivery. Although a person may have indicated that there was For persons reporting an emergency room visit that preceded this a hospital stay, the instrument creates links between the two events. For events where provider-reported data are not available, a final link between a hospital inpatient stay (EMERROOM)and an emergency room visit of a person is created using the household-reported information in addition to the CAPI generated links. For a given person and facility provider pair, there was no verification that, in fact, if the emergency room visit was actually recorded occurred anytime within two days before and one day after the Emergency Room Section hospital inpatient event, then the two events are linked. The facility expenditures, if any, reported for the emergency room visit are rolled onto the facility expenditures of the questionnaire. While it is true that all of inpatient event linked to the event files can be linked by DUPERSID, there is no unique record link between hospital inpatient stays and emergency room visitsvisit. For events where the provider-reported data are available, the provider-reported information is used. That is, such a person could have one hospital inpatient stay and three emergency room visits during the calendar year. While the hospital inpatient stay record may indicate that it was preceded by an emergency room visit, there is no unique record link to the appropriate (of the three) emergency room visit. However, where ever this relationship could be identified (using the MPC start and end date dates of the events as well as other information from the provider), ) where the expenditure facility expenditures associated with the preceding emergency room visit was moved to were included in the hospital facility expenditure (see ERHEVIDX in Section 2.5.1.2)expenditures. Hence, for some hospital stays, expenditures for The record of a linked preceding emergency room visits are included. In these situations, the corresponding emergency room record visit on HC-016E:the MEPS 1997 2021 Emergency Room Visit Visits File will have its facility expenditure information zeroed out to avoid double-counting. The variable ERHEVIDX identifies these hospital stays whose expenditures include the facility expenditures for the preceding emergency room visitvisit (see ERHEVIDX in “Record Identifiers”). It should also be noted that for these cases, there is only one hospital stay associated with the emergency room stay. In addition to total expenditures, variables are provided which itemize expenditures according to major sources source of payment categories. These categories are:

Discount Adjustment Factor. An adjustment was also applied to some HC HC-reported expenditure data because an evaluation of matched HC/MPC data showed that respondents who reported that charges and payments were equal were often unaware that insurance payments for the care had been based on a discounted charge. To compensate for this systematic reporting error, a weighted sequential hot-deck imputation procedure was implemented to determine an adjustment factor for HC HC-reported insurance payments when charges and payments were reported to be equal. As for the other imputations, selected predictor variables were used to form groups of donor and recipient events for the imputation process. Expenditure data for newborns were edited to exclude discharges after birth when the newborn left the hospital before or on the same day as the mother. As a result, inpatient expenditures reported for 1997 2022 births were usually applied to the mother and not treated as separate expenditures for the infant. However, if a newborn was discharged at a later date than the mother’s discharge date, then the hospitalization was treated as a separate hospital stay for the newborn. This means that that, in most cases, expenditure data for the newborn is included on the mother’s record. A separate record for the newborn only exists if the newborn was discharged after the mother. In this case, the expenditure for the newborn is on the newborn’s record. In addition, Records in the user should note that for MEPS 2022 data files include the purposes of the expenditure imputation, deliveries were identified HC survey data collected using the variable RSNINHOS which has not been reconciled with pregnancy and delivery ICD-9 codes on this file as well as on HC-018CAPI instrument. As mentioned previously, in most instances where RSNINHOS = 4 delivery, the ICD-9 code indicates a pregnancy rather than a delivery. Although a person may have indicated that there was For persons reporting an emergency room visit that preceded this a hospital stay, the instrument creates links between the two events. For events where provider-reported data are not available, a final link between a hospital inpatient stay (EMERROOM)and an emergency room visit person is created using the household-reported information in addition to the CAPI generated links. For a given person and facility provider pair, there was no verification that, in fact, if the emergency room visit was actually recorded occurred anytime within two days before and one day after the Emergency Room Section hospital inpatient event, then the two events are linked. The facility expenditures, if any, reported for the emergency room visit are rolled onto the facility expenditures of the questionnaire. While it is true that all of inpatient event linked to the event files can be linked by DUPERSID, there is no unique record link between hospital inpatient stays and emergency room visitsvisit. For events where the provider-reported data are available, the provider-reported information is used. That is, such a person could have one hospital inpatient stay and three emergency room visits during the calendar year. While the hospital inpatient stay record may indicate that it was preceded by an emergency room visit, there is no unique record link to the appropriate (of the three) emergency room visit. However, where ever this relationship could be identified (using the MPC start and end date dates of the events as well as other information from the provider), ) where the expenditure facility expenditures associated with the preceding emergency room visit was moved to were included in the hospital facility expenditure (see ERHEVIDX in Section 2.5.1.2)expenditures. Hence, for some hospital stays, expenditures for The record of a linked preceding emergency room visits are included. In these situations, the corresponding emergency room record visit on HC-016E:the MEPS 1997 2022 Emergency Room Visit File Visits PUF will have its facility expenditure information zeroed out to avoid double-counting. The variable ERHEVIDX identifies these hospital stays whose expenditures include the facility expenditures for the preceding emergency room visitvisit (see ERHEVIDX in “Record Identifiers”). It should also be noted that for these cases, there is only one hospital stay associated with the emergency room stay. In addition to total expenditures, variables are provided which itemize expenditures according to major sources source of payment categories. These categories are: