1. 1 Update on Medicare Data Collection & Analysis February 2016 Data contained in this document represent analyses prepared by HSCRC staff based on data summaries provided by the Federal Government. The intent is to provide early indications of the spending trends in Maryland for Medicare patients, relative to national trends. HSCRC staff has added some projections to the summaries. This data has not yet been audited or verified. Claims lag times may change, making the comparisons inaccurate. ICD-10 implementation could have an impact on claims lags. These analyses should be used with caution and do not represent official guidance on performance or spending trends. These analyses may not be quoted until public release.

2. 2 Medicare Hospital Payments Per Capita Month to Month Growth Compared to Same Month in Prior Year Maryland vs. Nation The most recent projected month shows Maryland trending lower than national Medicare.

3. 3 Medicare Per Capita Hospital Payments Maryland vs. Nation by Hospital Setting

4. 4 Medicare Per Capita Hospital Payments – Observations Maryland vs. Nation  On a cumulative basis since the 2013 base year, Maryland has a lower per capita trend of 2% relative to national Medicare spending.  In year two (CYTD through Oct 2015), Maryland hospital spending grew faster than the nation, reducing savings compared to year one.  For the year over year trend, Maryland growth rate exceeds the national Medicare growth rate by about 0.4 percent  November data shows a correction made to the October figures for the nation. This appears to be due to the implementation of ICD-10 and could have an impact on data through the end of the year.

5. 5 Medicare Total Cost of Care Per Capita Maryland vs. Nation Hospital Excess Growth = $17.4 M Non- Hospital Excess Growth = $39 M

6. 6 Medicare Total Cost of Care – Observations Maryland vs. Nation  Cumulative Growth – The trend in Maryland spending continues to stay at about.6% lower than the national trend since 2013.  Year to Date Growth – The trend in Maryland spending is.9% higher than the national trend for 2015 vs. 2014. Contract guardrails for TCOC are calculated on a year over year basis.  Year to Date Growth by Care Setting – Growth outside hospitals continue to exceed the nation, while growth in the hospitals are trending upward.  Non-Hospital Year to Date Growth – Both Maryland Part A and Part B are contributing to a growth in spending. The delta in Non-Hospital spending between Maryland and the US stayed constant at 1.4%.

7. 7 MD Part A Cost Trend (2015 Jan-Jul vs.2014 Jan-Jul) PROV TYPE2014 Cost 2014 Cost per Capita2015 Cost 2015 Cost per CapitaTotal Cost Change Per Capita Change % Per Capita Change INPATIENT$1,988,597,509$2,447.70$2,081,566,529$2,482.44$92,969,020$34.741.4% SNF$368,958,041$454.14$392,332,490$467.89$23,374,449$13.753.0% HHA$150,850,222$185.68$163,367,102$194.83$12,516,880$9.154.9% HOSPICE$97,828,622$120.41$105,821,245$126.20$7,992,623$5.794.8% OTHER PART A$617,636,886$760.23$661,520,838$788.92$43,883,952$28.693.9% PART A TOTAL$2,606,234,395$3,207.93$2,743,087,367$3,271.36$136,852,972$63.432.0%

8. 8 Maryland Total Cost of Care Payment Per Capita Month to Month Growth CY 2014 through July 2015* Maryland vs. Nation * Reflects actual experience without completion factor. The most recent months show national Medicare data continuing to trend lower than Maryland for Total Cost of Care.

9. 9 Medicare FFS Beneficiary Growth Calendar Year to Date Cumulative Growth Jan- Aug 2015 vs. Jan –July 2014 Maryland & Nation – Part A & Part B Maryland beneficiary growth is trending at about 3%, while the US is trending at about 0.6%.

10. 10 *This graph reflects data from CMMI Data Run 2011-2014

11. 11 *This graph reflects data from CMMI Data Run 2011-2014.