Other Inpatient Hospital Covered Days

SAS Name
OIP_COV_DAYS

This variable is the count of covered days in the non-acute inpatient hospital setting for the year. This variable equals the sum of the CLM_UTLZTN_DAY_CNT variables on the source claims.

These “other” inpatient (OIP) claims are a subset of the claims in the IP data file consisting of data from IP settings such as long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

Comments

We consider fully-covered days, days where the beneficiary was liable for coinsurance, and lifetime reserve days to all be Medicare-covered days. Non-covered days, leave of absence days, and the day of discharge or death are not included. There are 2 cost/use categories from the IP data files: Acute and the OIP.

Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics” (see: http://www.medpac.gov/-documents-/payment-basics).

Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (see the list of MLN publications at: http://www.cms.gov/Outreach-andEducation/Medicare-Learning-Network-MLN/MLNProducts/MLN- Publications.html)

Source: CCW (derived)

Null/missing or 1-XXX.