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AD-A262 459 •I !!,.1=lil 'I! i, Il~l 1,i II! 11 11 Bl i,
TRI-SERVICE CHAMPUS STATISTICAL
DATABASE PROJECT(TCSDP)
Reproduced From
Best Available Copy
DEPARTMENT OF ARMY
HEALTH SERVICES COMMAND
CHAMPUS CATASTROPHIC PAYMENTS
FOR FIRST QUARTER, FISCAL YEAR 1993
GATEWAY CATCHMENT AREAS
GATEWAY TO CARE
MANAGEMENT ANALYSIS SERIES DTICRP 93-011 w'L
FEBRUARY 1993 APRO0 Z1993 1
- ... UNITED STATES ARMYHEALTH SERVICES COMMAND
FORT SAM HOUSTON, TEXAS 78234
I 93-0664598 3 8 4 3 3• liI 11111 1111•8111 0I8l liliii
NOTICE
The findings in this report arenot to be construed as an official
Department of the Army positionunless so designated by other
authorized documents.
Regular users of services of the Defense Technical Information Center(per DoD Instruction 5200.21) may purchase copies directly from thefollowing:
Defense Technical Information Center (DTIC)ATTN: DTIC-DDR
-Cameron StationAlexandria, VA 22304-6145
Telephones: DEN 2B4-7633, 4, or 5Commercial (703) 274-7633, 4, or 5
All other requests for reports will be directed to the following:
U.S. Department of CommerceNational Technical Information Service (NTIS)5285 Port Royal RoadSpringfield, VA 22161
Telephone: Commercial (703) 487-4600
UnclassifiedSECURITY CLASSIFICATION OF THIS PAGE
REPORT DOCUMENTATION PAGE Form Approved
I&. REPORT SECURITY CLASSIFiCATION Ib RESTRICTIVE MARKING5
Unclassified2&. SECURITY CLASSIFICATION AUTHORIT e 3 DISTRIBUTION /AVAILABILITY OF REPORT
2b. DECLASSIFICATION/ DOWNGRADING SCHEDULE Distribution Unlimited;_ _ _l__ir- _T__ _ Ablthnri 7pd
4. PERFORMING ORGANIZATION REPORT NUMBER(S) 5 MONITORING ORGANIZATION REPORT lNuM8ER(S)
RP 93-0116a. NAME OF PERFORMING ORGANIZATION 6b OFFICE SYMBOL 7a NAME OF MONITORING ORGANIZATION
Health Care Studies and (If applicable) HQ HSC, Coordinated Care Div.Clinical Investigation Acy HSHN-A
6c. ADDRESS (City, State, and ZIP Code) 7b. ADDRESS (City, State, and ZIP Code)
Bldg 2268Fort Sam Houston, TX 78234-6100 Fort Sam Houston, TX 78234-6000
Ba. NAME OF FUNDING/SPONSORING 8b. OFFICE SYMBOL 3. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBERORGANIZATION (if applicable)
HQ HSC, Coordinated Care Div.Sc. ADDRESS (City, State, andi ZIP Code) 10. SOURCE OF FUNDING NUMBERS
PROGRAM PROJECT TASK WORK UNITELEMENT NO. NO. • NO. ACCESSION NO.
Fort Sam Houston, TX 78234-6000 1 I11. TITLE (Include Securrty Classfication)
(U) Department of Army Health Services Command, CHAMPUS CatastrophicPayments For First Quarter, Fiscal Year 1993, Gateway Catchment Areas
12. PERSONAL AUTHOR(S)
Dr. Scott A. Optenbergoo Kathleen A. Moon, M.S.13a. TYPE OF REPORT 113b. TIME COVERED 14. DATE OF REPORT (Year, Month, Day) 15. PACE COUNT
Final I FRO•U.i 92 TQCn._S_2 1993 Feb 26 7816. SUPPLEMENTARY NOTATION
This is one in a series of Gateway Management Analysis Reports.
17. COSATI CODES 18. SUBJECT TERMS (Continue on reverse of 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 necessay and idtntify by block number)
his report presents in Appendix A the CHAMPUS Catastrophic Quarterly Paymenteports for the First Quarter Fiscal Year (FY) 1993 for each of the thirty-ight Army Gateway catchment areas. Each Payment Report lists Privacy Actrotected hospitalization patient cases having CHAMPUS claims totaling morehan the catchment area's specific FY 1993 catastrcphic cutoff amount at thend of the Fourth Quarter FY 1992 and/or at the end of the First Quarter FY993. The difference between the reported and prior quarters' net claimayments equals the catastrophic net payment made for each patient during theuarter. Table 1 at the end of the Summary contains the CHAMPUS Catastrophicuarterly Payment Schedule, summarizing for each catchment area theatastrophic cas'. cutoff limit, the total net claim payments for each of the1wo quarters, Lrie payment total between the quarters, and the number ofatastrophic cases comprising these First Quarter FY 1993 payment differences.
20. DISTRIBUTION /AVAILABILITY OF ABSTRACT 21. ABSTRACT jECq•RITY CLASSIFIC 1,TIONC3UNCLASSIFIEDAJNLIMITEO )t] SAME AS RPT, O' TIC USERS Unclassified
22a. NAME OF RESPONSIBLE INDIVIDUAL 122b. TELEPHONE (Include Area Code) 22c OFFICE SYM80LDr. Scott A. OptenbergI (210) 221-0278 1HSHN-A
DD Form 1473, JUN 86 Previous editonsare obsolete. SECURITY CLASSIFICATION OF THIS PAGE
Unclassifiedii
//
TABLE OF CONTENTS
S ACTION PAGESV,!7 11AIMER . . . . . . . . . . . . . . . . . . . . . . . . .. .. .
RLPORT DOCUMENTATION PAGE (DD Form 1473). . . . . .......... ii
TABLE OF CONTENTS. . . . . . . . . . . . . . . . . . . . . . .iii
SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . .. . 1-3
DISTRIBUTION LIST. . . . . . . . . . . . . . . . . . . . . . . 4-7
APPENDIX
A Army Gateway Program; CHAMPUS Catastrophic PaymentReports; September 30, 1992 Through December 31, 1992;By Catchment Area . . . . . . . . . . . . . . . . . A-1-61
LAocesslon ForINTIS
!J
DY . . . ..
CoCes
iii
IExecutive Summary
This report presents in Appendix A the CHAMPUS CatastrophicQuarterly Payment Reports for the First Quarter Fiscal Year (FY)1993 for each of the thirty-eight Health Services Command Gateway
3catchment areas. Each Payment Report lists Privacy Act protected"hospitalization patient cases having CHAMPUS claims totaling morethan the catchment area's specific FY 1993 catastrophic cutoff
i amount at the end of the Fourth Quarter FY 1992 and/or at the endof the First Quarter FY 1993. The difference between the report-ed and prior quarters' net claim payments equals the c.tastrophic
*I net payment made for each patient during the quarter. Table 1 at* the end of this Summary contains the CHAMPUS Catastrophic Quar-
terly Payment Schedule, summarizing for each catchment area thecatastrophic case cutoff limit, the total net claim payments foreach of the two quarters, the payment total between the quarters,and the number of catastrophic cases comprising these First
J- ~ Quarter FY 1993 payment differences.
I Appendix A (pp. A-1-61) contains the CRAMPUS CatastrophicQuarterly Payment Reports for the First Quarter FY 1993. Foreach of the Gateway catchment areas, Privacy Act protectedpatient cases having CHAMPUS claims totaling more than thecatchment area's specific catastrophic cutoff amount for FY 1993are listed with the changes in their net claim payments betweenthe reported First Quarter FY 1993 and the prior Fourth QuarterFY 1992. Each Paynent Report includes the following for eachcatastrophic patient: (1) the patient unique Inpatient RecordNumber; (2) the last hospital ending date on record; (3) the lastbospital and professional services voucher payment dates; (4) anindicator of whether the case involved a consolidation of hospi-tal stays due to FI adjudication action; (5) the DRG and diagno-sis codes and their shortened names; (6) number of days spent inthe hospital; (7) number of professional services; (6) patientage, sex and beneficiary category; (9) the catastrophic amounts
* above the site's specified catastrophic cutoff amount as of the* first and last days of the reported quarter; and (10) the differ-
- - ence of these two catastrophic totals which equals the cata-* |strophic net payment made for each patient during the quarter.
U The Payment Reports in Appendix A only include cases with
claim payment totals exceeding the catchment area's catastrophiccutoff amount in one or both of the two reported quarters.Quarterly catastrophic payment amuunts in the appendix are thedifferences between the most recent and the prior quarters'
* catastrophic totals. A negative payment amount represents netrecoupment actions/adjustments during the quarter. Each site'scutoff amount is noted in the footnote area of the catchmentarea's Payment Report output. An explanation of how the cata-strophic case limits were computed for the Gateway catchmentareas for FY 1993 is presented in the Health Services CommandPublication Fiscal Year 1993 CHAMPUS Catastrophic Case Limits.Gateway Catchment Areas, RP 93-009, DTIC: In Press, February1993.
1In
-.. *
In general, finding the status of any catastrophic patientcase from quarter to quarter is accomplished by comparing theInpatient Record Numbers (INPT RCD 1's) from the previc¢s quar-terly report with those on the current Catastrophic PaymentReport. However, these reports for the First Quarter FY 1993were computed using catastrophic cutoff amounts derived from FY1992 data. Prior published catastrophic payments reports pre-sented cases for only the thirteen initial Gateway areas whosecutoffs were computed from Calendar Year (CY) 1990 data. Withdifferent cutoff amounts for the previously reported sites andtwenty-five catchment areas having no earlier recounted cata-strophic case history, the comparison method of tracking cata-strophic patient cases from quarter to quarter is not applicableat present; beginning with the Second Quarter FY 1993, correla-tions may be made. If the Inpatient Record Number is on both theprevious report and the current one, the catastrophic patienthad positive or negative net claims in at least one quarter andis a continuing catastrophic case. Otherwise, a catastrophiccase can appear to be newly added or dropped when compared with aprevious report depending on whether a ca~e surpasses or dropsbelow the catastrophic cutoff for that catchrmient area, andwhether or not claim payment activity took place during thereporting quarter. An example of how cases can appear anddisappear from quarterly Payment Reports is given on the secondpage of the Executive Summary in the Health Services CommandPublication CHAMPUS Catastrophic Payments. First Through ThirdQuarter. Fiscal Year 1992, Gateway Catchment Areas, RP 92-015,DTIC: AD B166-677, July 1292. Another example will be presentedin the forthcoming Second Quarter FY 1993 Catastrophic Paymentspublished report.
Table 1 at the end of this Summary (p. 3) contains theCHAMPUS Catastrophic Quarterly Payment Schcdule and lists thesummary totals of each catchment area's number of catastrophiccases and catastrophic totals from the Payment Reports for thequarter. Each site's FY 1993 cutoff amount is additionallylisted. Table 1 shows that CHAMPUS catastrophic re-insurancepayments for the First Quarter FY 1993 had lows of $-33,137 at
Ki -Fort Leonard Wood MEDDAC with ten catastrophic cases and a cutoffamount of $88,500, and at Beaumont AMC with payments of $2,404for two cases with a cutoff at $231,000. At the high end of therange, Fort Meade MEDDAC with a $94,000 cutoff amount had 15cases on their Payment Report and catastrophic re-insurancepayments of $785,740, and Fort Bragg MEDDAC had $608,360 inpayments, 49 cases with a $28,500 cutoff amount. Quarterly cata-strophic payments totaled to $7,881,675 over all Gateway sitesfor the First Quarter and included care for a total of 553catastrophic patients.
Technical Note. The following TCSDP data were utilized forreport:
A) Composite Institutional Record (CIR) V2.0B) Composite Professional Record (CPR) V1.0C) TCSDP Indexing Logic Module #C3B13.
2
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I
I 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)
i HQDA (DASG-PSZ), 5111 Leesburg Pike, Falls Church, VA... 22041-3258 (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, Ale':andria, VA 22304-6145 (2)
Commandant, Academy Health Science, ATTN: HSHA-Z,Fort Sam Houston, TX 78234-6100 (1)
' Director, Joint Medical Library, DASG-AAFJML, Offices of- the Surgeons General, Army/Air Force, Rm 670, 5109 Leesburg
Pike, 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 Braendel, Fort Sam Houston, TX
78234-6000 (5)'I 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 (ArmyStudies), Rmi 1A518, The Pentagon, Washington, DC 20310 (1)
Defense Logistics Studies Information Exchange, U.S. ArmyLogistics 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 cf Defense (PAQA),ATTN: Cdr St. Andre, The Pentagon, DC 20301 (5)
Office of the Assistant Secretary of Defense (HA), Health ServicesFinancing (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, Beaumont Army Medical Center, Fort Bliss,
TX 79920-5001 (1)Commander, Brooke Army Medical Center, Fort Sam Houston,
TX 78234-6000 (1)Commander, Eisenhower Army Medical Center, Fort Gordon,
GA 30905-5650 (1)
4
Commander, Fitzsimons Army Medical Center, Aurora, CO80045-5001 (1)
Commander, Letterman Army Medical Center, San Francisco, CAI94129-6700 (1)
Commander, Madigan Army Medical Center, Tacoma, WA98431-5000 (1)
Commander, Tripler Army Medical Center, TAIMC, HI96859-5000 (1)
Commander, Walter Reed Army Medical Center, Washington, DC20307-5000 (1)
Commander, U.S. Army Medical Department Activity, FortBelvoir, VA 22060-5000 (1)
Commander, U.S. Army Medical Department Activity, FortBenjamin Harrison, IN 46216-7000 (1)
Commander, U.S. Army Medical Department Activity, FortBenning, GA 31905-6100 (1)
Commander, U.S. Army Medical Department Activity, Fort Bragg,NC 28307-5000 (1)
Commander, U.S. Army Medical Department Activity, FortCampbell, KY 42223-1498 (1)
Commander, U.S. Army Medical Department .Activity, Fort Carson,CO 80913-5000 (1)
Commander, U.S. Army Mediical Department Activity, Fort Devens,MA 01433-5000 (1)
Commander, U.S. Army Medical Department Activity, Fort Dix,NJ 08640-6650 (1)
Commander, U.S. Army Medical Department Activity, Fort Drunr,NY 13602-5004 (1)
Commander, U.S. Army Medical Department Activity, Fort Eustis,VA 23604-5564 (1)I
Commander, U.S. Army Medical Department Activity, Fort Hood,TX 76544-5063 (1)
Commander, U.S. Army Medical Department Activit~y, FortHuachuca, AZ 85613-704')' (1)
Commander, U.S. Army Medical Department Activity, Fort Irwin,CA 92311-5065 (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 36205-5000 (1)
Commander, U.S. Army Medical Department Activity, FortGeorge G. Meade, MD 20755-5800 (1)
5I
I
I Commander, U.S. Army Medical Department Activity, FortMonmouth, NJ 07703-5504 (1)
Commander, U.S. Army Medical Department Activity, Fort Ord,CA 92941-5000 (1)
Commander, U.S. Army Medical Department Activity, Fort PoJk,LA 71459-6000 (1)
Commander, U.S. Army Medical Department Activity, RedstoneArsenal, AL 35809-7000 (1)
Commander, U.S. Army Medical Department Activity, Fort Riley,KS 66442-5038 (1)
Commander, U.S. Army Medical Department Activity, Fort Rucker,AL 36362-5333 (1)Commander, U.S. Army Medical Department Activity, Fort Sill,
OK 73503 (1)\I Commander, U.S. Army Medical Department Activity, Fort
Stewart, GA 31314-5300 (1)Commander, U.S. Army Medical Department Activity, Fort
Wainwright, AK 99703-7300 (1)Commander, U.S. Army Medical Departmert Activity, West Point,NY 10996-1197 (1)
Director, Coordinated Care, Beaumont Army Medical Center, FortBliss, TX 79920-5001 (1)
Director, Coordinated Care, Brooke Army Medical Center, Fort SamHouston, TX 78234-6000 (1)
Director, Coordinated Care, Eisenhower Army Medical Center, FortGordon, GA 30905-5650 (1)
Director, Coordinated Care, Fitzsimons Army Medical Center, Aurora,CO 80045-5001 (1)
Director, Coordinated Care, Letterman Army Medical Center, SanFrancisco, CA 94129-6700 (1)
Director, Coordinated Care, Madigan Army Medical Center, Tacoma, WA98431-5000 (1)
Director, Coordinated Care, Tripler Army Medical Center, TAMC, HIm 96859-5000 (1)
Director, Coordinated Care, Walter ReeC Army Medical Center,Washington, DC 20307-5000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Belvoir, VA 22060-5000 (1)
Director, Coo? linated Care, U.S. Army Medical Department Activity,Fort Benjanin Harrison, IN 46216-7000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Benning, GA 31905-6100 (1) 1
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Bragg, NC 28307-5000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activi y,Fort Campbell, KY 42223-1498 (1)
Director, Coordinated Care, U.S. 1-my Medical Department Activity,Fort Carson, CO 80913-5000 (1)Director, Coordinated Care, U.S. Army Medical Department Activity,
Fort Devens, MA 01433-5000 (1)
6I
II
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Dix, NJ 08640-6650 (1)
Director, Coordinated Care U.S. Army Medical Department Activity,Fort Drun, NY 13602-5004 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity, IFort Eustis, VA 23604-5564 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Hood, TX 76544-5063 (1)
Director, Coordinated Care, U.S. Armny Medical Department Activity,Fort Huachuca, AZ 85613-704.0 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Irwin, CA 92311-5065 (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)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Leavenworth, KS 66027-5400 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort 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 Medi-al Department Activity,Fort McClellan, AL 36205-5000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort George G. Meade, MD 20755-5800 (1)
Director, Coordinated Care, U.S. Army Medical nepartment Activity,Fort Monmouth, NJ 07703-5504 (1)
Director, Coordinated Care, U.S. Army Medic al Department Activity, IFort Ord, CA 93941-5000 (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,Redstone Arsenal, AL 35809-7000 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Riley, KS 66442-5038 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,Fort Rucker, AL 36362-5333 (1)
Director, Coordinated Car'e, U.S. Army Medical Department Activity,Fort Sill, OK 73503 (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,Fort Wainwright, AK 99703-7300 (1)
Director, Coordinated Care, U.S. Army Medical Department Activity,West Point, NY 10996-1197 (1)
7 I
APPENDIX A
ARMY GATEWAY PR•OGRAM
CHAMPUS CATASTROPHIC PAYMENT REPORTS
SEPTEMBER 30, 1992 THROUGH DECEMBER 31, 1992
BY CATCHMENT AREA
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