Diag Trend Report Based On: HHA Paid Claims Data: Jul 13 Dec 13 Three Digit Primary Diag Codes in each state Graphs show trend in top five diag codes (Identified in terms of % diag beneficiaries during paid dates Jul 13 Dec 13) in each state. 1
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Alaska 3 30.60 31.94 3 28.15 27.68 27.02 Alaska Alaska 2 2 1 9.00 11.01 10.09 11.09 11.06 Alaska Alaska Alaska 6.73 6.35 7.36 4.83 5.53 5.31 4.66 5.15 4.52 4.67 5.78 3.97 3.47 4.11 3.81 V57 V54 707 V58 428 Alaska Alaska Alaska Alaska Alaska 02 AK V57 REHABILITATION PROCEDURE* 28.15 27.68 27.02 30.60 31.94 02 AK V54 OTH ORTHOPEDIC AFTERCARE* 9.00 11.01 10.09 11.09 11.06 02 AK 707 CHRONIC ULCER OF SKIN* 6.73 6.35 7.36 4.83 5.53 02 AK V58 ENCOUNTR PROC/AFTRCR NEC* 5.31 4.66 5.15 4.52 4.67 02 AK 428 HEART FAILURE* 5.78 3.97 3.47 4.11 3.81 3 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Arizona 1 1 13.60 14.19 13.21 14.07 13.47 Arizona Arizona 10.85 10.70 11.53 10.72 10.13 11.32 11.02 10.24 10.44 9.21 5.39 5.19 5.37 4.87 5.38 Arizona Arizona Arizona 4.14 4.73 5.12 2.44 3.45 3.42 V54 V58 V57 250 728 Arizona Arizona Arizona Arizona Arizona 03 AZ V54 OTH ORTHOPEDIC AFTERCARE* 13.60 14.19 13.21 14.07 13.47 03 AZ V58 ENCOUNTR PROC/AFTRCR NEC* 10.85 10.70 11.53 10.72 10.13 03 AZ V57 REHABILITATION PROCEDURE* 11.32 11.02 10.24 10.44 9.21 03 AZ 250 DIABETES MELLITUS* 5.39 5.19 5.37 4.87 5.38 03 AZ 728 DIS OF MUSCLE/LIG/FASCIA* 3.45 3.42 4.14 4.73 5.12 2.44 4 2
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in California 1 California California 13.00 California California 11.00 9.00 7.00 10.50 10.14 10.95 10.57 10.84 9.50 9.18 9.47 9.73 9.72 9.41 9.06 9.34 8.66 8.71 9.10 9.23 8.76 8.77 8.55 California 3.43 4.29 5.25 5.35 5.95 3.00 1.82 1.00 1.00 250 V57 V58 V54 402 California California California California California 05 CA 250 DIABETES MELLITUS* 10.50 10.14 10.95 10.57 10.84 05 CA V57 REHABILITATION PROCEDURE* 9.50 9.18 9.47 9.73 9.72 05 CA V58 ENCOUNTR PROC/AFTRCR NEC* 9.41 9.06 9.34 8.66 8.71 05 CA V54 OTH ORTHOPEDIC AFTERCARE* 9.10 9.23 8.76 8.77 8.55 05 CA 402 HYPERTENSIVE HEART DIS* 3.43 4.29 5.25 5.35 5.95 1.82 5 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Hawaii 3 26.64 Hawaii Hawaii Hawaii 2 23.86 23.29 23.56 21.78 Hawaii Hawaii 2 1 10.02 8.86 9.58 8.65 8.48 5.27 7.52 5.79 6.59 7.92 6.58 7.06 7.06 5.90 4.60 4.80 4.53 5.22 5.33 V57 250 V54 707 428 Hawaii Hawaii Hawaii Hawaii Hawaii 12 HI V57 REHABILITATION PROCEDURE* 26.64 23.86 23.29 23.56 21.78 12 HI 250 DIABETES MELLITUS* 10.02 8.86 9.58 8.65 8.48 12 HI V54 OTH ORTHOPEDIC AFTERCARE* 5.27 7.52 5.79 6.59 12 HI 707 CHRONIC ULCER OF SKIN* 7.92 6.58 7.06 7.06 5.90 12 HI 428 HEART FAILURE* 4.60 4.80 4.53 5.22 5.33 6 3
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Idaho 2 Idaho Idaho 1 1 1 16.77 16.34 15.92 15.96 15.03 13.62 13.98 14.73 13.95 14.09 Idaho Idaho Idaho 8.60 8.35 8.38 8.59 8.65 7.16 8.05 7.89 5.72 6.21 5.58 5.18 5.89 5.35 5.18 2.44 V54 V57 V58 728 250 Idaho Idaho Idaho Idaho Idaho 13 ID V54 OTH ORTHOPEDIC AFTERCARE* 16.77 16.34 15.92 15.96 15.03 13 ID V57 REHABILITATION PROCEDURE* 13.62 13.98 14.73 13.95 14.09 13 ID V58 ENCOUNTR PROC/AFTRCR NEC* 8.60 8.35 8.38 8.59 8.65 13 ID 728 DIS OF MUSCLE/LIG/FASCIA* 7.16 8.05 7.89 5.72 6.21 2.44 13 ID 250 DIABETES MELLITUS* 5.58 5.18 5.89 5.35 5.18 7 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Michigan 1 11.31 11.83 12.28 12.28 12.27 8.67 8.73 8.98 9.21 9.33 8.45 8.52 8.79 8.29 8.50 8.45 8.39 8.34 8.25 8.15 Michigan Michigan Michigan Michigan Michigan 7.57 7.68 7.31 7.61 7.67 V57 V54 V58 250 428 Michigan Michigan Michigan Michigan Michigan 23 MI V57 REHABILITATION PROCEDURE* 11.31 11.83 12.28 12.28 12.27 23 MI V54 OTH ORTHOPEDIC AFTERCARE* 8.67 8.73 8.98 9.21 9.33 23 MI V58 ENCOUNTR PROC/AFTRCR NEC* 8.45 8.52 8.79 8.29 8.50 23 MI 250 DIABETES MELLITUS* 8.45 8.39 8.34 8.25 8.15 23 MI 428 HEART FAILURE* 7.57 7.68 7.31 7.61 7.67 8 4
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Minnesota 2 2 18.98 20.03 22.80 21.70 21.38 Minnesota Minnesota Minnesota Minnesota Minnesota 1 12.06 12.25 12.73 12.20 13.04 6.03 6.27 5.94 6.36 6.41 9.70 9.87 9.26 8.39 8.88 3.14 3.05 3.02 2.94 3.11 V57 V54 V58 428 707 Minnesota Minnesota Minnesota Minnesota Minnesota 24 MN V57 REHABILITATION PROCEDURE* 18.98 20.03 22.80 21.70 21.38 24 MN V54 OTH ORTHOPEDIC AFTERCARE* 12.06 12.25 12.73 12.20 13.04 24 MN V58 ENCOUNTR PROC/AFTRCR NEC* 9.70 9.87 9.26 8.39 8.88 24 MN 428 HEART FAILURE* 6.03 6.27 5.94 6.36 6.41 24 MN 707 CHRONIC ULCER OF SKIN* 3.14 3.05 3.02 2.94 3.11 9 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Nevada 1 Nevada Nevada 1 13.67 12.75 13.19 13.21 13.25 8.49 9.27 9.36 8.98 9.62 9.10 8.95 9.00 8.55 8.26 10.83 8.43 8.33 8.02 Nevada Nevada Nevada 4.94 5.30 4.87 5.40 4.91 3.37 3.17 250 V54 V58 401 491 Nevada Nevada Nevada Nevada Nevada 29 NV 250 DIABETES MELLITUS* 13.67 12.75 13.19 13.21 13.25 29 NV V54 OTH ORTHOPEDIC AFTERCARE* 8.49 9.27 9.36 8.98 9.62 29 NV V58 ENCOUNTR PROC/AFTRCR NEC* 9.10 8.95 9.00 8.55 8.26 29 NV 401 ESSENTIAL HYPERTENSION* 10.83 8.43 8.33 8.02 3.37 29 NV 491 CHRONIC BRONCHITIS* 4.94 5.30 4.87 5.40 4.91 3.17 10 5
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in New Jersey 1 1 14.59 14.63 14.48 13.84 14.58 13.32 13.80 13.71 13.31 14.14 New Jersey New Jersey New Jersey New Jersey 8.67 9.08 8.32 8.88 8.21 4.93 4.76 4.91 5.01 5.29 New Jersey 4.69 4.58 4.25 4.15 4.13 V58 V54 428 707 250 New Jersey New Jersey New Jersey New Jersey New Jersey 31 NJ V58 ENCOUNTR PROC/AFTRCR NEC* 14.59 14.63 14.48 13.84 14.58 31 NJ V54 OTH ORTHOPEDIC AFTERCARE* 13.32 13.80 13.71 13.31 14.14 31 NJ 428 HEART FAILURE* 8.67 9.08 8.32 8.88 8.21 31 NJ 707 CHRONIC ULCER OF SKIN* 4.93 4.76 4.91 5.01 5.29 31 NJ 250 DIABETES MELLITUS* 4.69 4.58 4.25 4.15 4.13 11 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in New York 1 12.35 11.89 12.33 11.64 11.64 11.01 11.24 11.23 11.39 10.96 New York New York New York New York New York 7.93 8.10 7.82 8.06 7.82 7.42 7.40 7.56 6.96 7.81 5.84 5.91 6.20 6.01 5.69 V58 V54 428 250 707 New York New York New York New York New York 33 NY V58 ENCOUNTR PROC/AFTRCR NEC* 12.35 11.89 12.33 11.64 11.64 33 NY V54 OTH ORTHOPEDIC AFTERCARE* 11.01 11.24 11.23 11.39 10.96 33 NY 428 HEART FAILURE* 7.93 8.10 7.82 8.06 7.82 33 NY 250 DIABETES MELLITUS* 7.42 7.40 7.56 6.96 7.81 33 NY 707 CHRONIC ULCER OF SKIN* 5.84 5.91 6.20 6.01 5.69 12 6
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Oregon 3 Oregon Oregon Oregon 2 22.93 23.05 24.27 24.39 24.05 Oregon Oregon 2 1 12.09 11.49 10.45 10.77 10.17 7.97 7.43 7.17 6.88 7.38 6.06 6.68 6.73 6.64 6.98 5.32 5.67 5.27 5.41 5.75 V57 V54 V58 707 428 Oregon Oregon Oregon Oregon Oregon 38 OR V57 REHABILITATION PROCEDURE* 22.93 23.05 24.27 24.39 24.05 38 OR V54 OTH ORTHOPEDIC AFTERCARE* 12.09 11.49 10.45 10.77 10.17 38 OR V58 ENCOUNTR PROC/AFTRCR NEC* 7.97 7.43 7.17 6.88 7.38 38 OR 707 CHRONIC ULCER OF SKIN* 6.06 6.68 6.73 6.64 6.98 38 OR 428 HEART FAILURE* 5.32 5.67 5.27 5.41 5.75 13 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Puerto Rico 2 Puerto Rico Puerto Rico Puerto Rico 2 19.40 17.85 18.67 20.24 19.64 17.78 17.42 18.06 17.81 17.51 Puerto Rico Puerto Rico 1 7.92 7.87 7.77 7.11 2.44 6.23 5.23 4.93 4.99 5.94 5.67 4.19 5.05 5.26 5.03 4.99 V57 707 250 728 V54 Puerto Rico Puerto Rico Puerto Rico Puerto Rico Puerto Rico 40 PR V57 REHABILITATION PROCEDURE* 19.40 17.85 18.67 20.24 19.64 40 PR 707 CHRONIC ULCER OF SKIN* 17.78 17.42 18.06 17.81 17.51 40 PR 250 DIABETES MELLITUS* 7.92 7.87 7.77 6.23 7.11 40 PR 728 DIS OF MUSCLE/LIG/FASCIA* 5.23 4.93 4.99 5.94 5.67 2.44 40 PR V54 OTH ORTHOPEDIC AFTERCARE* 4.19 5.05 5.26 5.03 4.99 14 7
Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Washington 2 21.99 23.24 Washington Washington Washington Washington 2 17.81 18.90 18.87 Washington 1 13.71 14.09 13.95 13.56 14.40 7.67 7.62 7.10 6.72 6.80 6.36 6.85 6.87 6.12 6.66 5.62 5.46 5.59 5.81 5.62 V57 V54 V58 707 428 Washington Washington Washington Washington Washington 50 WA V57 REHABILITATION PROCEDURE* 17.81 18.90 18.87 21.99 23.24 50 WA V54 OTH ORTHOPEDIC AFTERCARE* 13.71 14.09 13.95 13.56 14.40 50 WA V58 ENCOUNTR PROC/AFTRCR NEC* 7.67 7.62 7.10 6.72 6.80 50 WA 707 CHRONIC ULCER OF SKIN* 6.36 6.85 6.87 6.12 6.66 50 WA 428 HEART FAILURE* 5.62 5.46 5.59 5.81 5.62 15 Trend in Top Five (for Paid Dates Jul'13 - Dec'13) in Wisconsin 2 1 17.21 18.35 18.43 17.58 17.50 Wisconsin Wisconsin Wisconsin Wisconsin 1 Wisconsin 1 9.63 10.23 9.14 9.90 10.32 10.11 10.35 11.31 10.18 9.95 6.79 7.19 6.58 7.38 6.70 4.59 4.16 4.57 4.33 4.65 V57 V54 V58 428 707 Wisconsin Wisconsin Wisconsin Wisconsin Wisconsin 52 WI V57 REHABILITATION PROCEDURE* 17.21 18.35 18.43 17.58 17.50 52 WI V54 OTH ORTHOPEDIC AFTERCARE* 9.63 10.23 9.14 9.90 10.32 52 WI V58 ENCOUNTR PROC/AFTRCR NEC* 10.11 10.35 11.31 10.18 9.95 52 WI 428 HEART FAILURE* 6.79 7.19 6.58 7.38 6.70 52 WI 707 CHRONIC ULCER OF SKIN* 4.59 4.16 4.57 4.33 4.65 16 8
Home Health Claims Statistics by J6 - States: Paid Dates Jul 13 Dec 13 State State Benes Episodes per Bene % LUPAs Visits per Episode % Outlier Claims Alaska 1,049 1.38 11.78 13.52 2.43 Arizona 15,071 1.40 9.41 15.75 1.95 California 171,257 1.52 7.53 15.89 4.97 Hawaii 1,933 1.46 10.66 13.76 1.14 Idaho 7,260 1.52 6.84 19.32 4.04 Michigan 94,663 1.51 9.19 15.17 0.88 Minnesota 18,416 1.36 12.01 15.63 2.73 Nevada 13,679 1.65 5.60 17.25 3.90 New Jersey 51,423 1.37 11.68 15.06 1.57 New York 107,324 1.62 9.05 22.95 10.30 Oregon 10,971 1.45 13.04 13.78 1.05 Puerto Rico/ Virgin Islands 4,232 1.54 12.76 14.89 1.19 Washington 17,835 1.40 12.33 13.82 0.70 Wisconsin 19,805 1.41 11.99 15.96 3.52 NGS 656,393 1.47 9.65 17.22 4.61 9
Home Health Claims Statistics: Visits per Beneficiary by Discipline (2 Digit Group) State 42x (Physical 43x (Occupational 44x (Speech 55x (Skilled Nursing) 56x (Medical Social Services) 57x (Home Health Aide) Alaska 8.24 4.90 4.17 11.40 2.11 14.07 Arizona 8.62 4.94 6.26 11.75 1.60 11.95 California 8.28 4.06 4.21 16.97 1.61 12.31 Hawaii 8.91 4.58 4.06 12.74 2.25 11.67 Idaho 12.35 5.60 6.19 14.82 2.08 15.98 Michigan 11.40 5.54 6.33 11.37 2.12 11.57 Minnesota 7.32 4.57 5.64 11.56 1.45 12.48 Nevada 9.03 5.94 3.98 16.96 1.29 15.62 New Jersey 7.60 5.01 4.72 10.23 1.45 12.94 New York 8.18 5.48 5.71 15.63 1.95 34.28 Oregon 8.19 4.23 4.53 12.02 2.05 11.37 Puerto Rico/ Virgin Islands 13.04 5.98 9.31 16.49 2.62 20.39 Washington 8.51 4.43 4.78 10.97 1.58 9.48 Wisconsin 7.45 5.03 4.92 13.71 1.83 18.26 NGS 8.84 5.02 5.20 14.30 1.84 20.20 19 Home Health Claims Statistics: Visits per Episode by Discipline (2 Digit Group) State 42x (Physical 43x (Occupational 44x (Speech 55x (Skilled Nursing) 56x (Medical Social Services) 57x (Home Health Aide) Alaska 7.08 4.45 3.43 8.05 1.95 9.76 Arizona 7.20 4.39 5.63 8.56 1.46 8.77 California 6.87 3.63 3.77 11.17 1.40 8.58 Hawaii 7.19 4.16 3.63 8.42 1.93 8.35 Idaho 9.65 4.83 5.21 9.83 1.80 10.88 Michigan 8.69 5.34 7.77 1.84 8.02 Minnesota 6.22 4.02 5.03 8.45 1.35 9.22 Nevada 7.10 5.04 3.47 10.50 1.16 9.96 New Jersey 6.40 4.45 4.18 7.60 1.30 9.60 New York 6.49 4.63 4.81 10.43 1.58 21.77 Oregon 6.83 3.75 3.90 8.22 1.77 7.95 Puerto Rico/ Virgin Islands 10.87 5.45 7.56 10.22 2.17 13.85 Washington 7.10 3.91 4.25 7.87 1.43 7.15 Wisconsin 6.40 4.44 4.45 9.63 1.63 12.30 NGS 7.16 4.37 4.52 9.72 1.59 13.64 20 10