The risk-adjusted cost to Medicare for services performed as a result of a clinician's care for a patient's inpatient hospital stay during the period 3 days prior to a hospital stay, through 30 days after discharge.

The sum of the ratio of payment-standardised observed to expected episode costs for all episodes attributed to the clinician group, as identified by a unique Medicare Taxpayer Identification Number (TIN), or to the clinician, as identified by a unique TIN and National Provider Identifier pair (TIN-NPI). The sum is then multiplied by the national average payment-standardised observed episode cost to generate a dollar figure.

The total number of episodes attributed to a clinician or clinician group.

• Patients not enrolled in both Medicare Parts A and B for the entirety of the lookback period plus episode window. • Patients enrolled in a private Medicare health plan for any part of the lookback period plus episode window • Orthopaedic procedures for episodes triggered by DRG under Disorders of Gastrointestinal System (MDC 06 and MDC 07) • Valvular procedures for episodes triggered by DRG under Disorders of the Pulmonary System (MDC 04) • Hospice costs • The patient's date of birth is missing • The patient's death date occurred before or during the episode

• The MS-DRG of the index hospitalisation and indicators for any prior acute hospital admission. • Comorbidities captured by 86 Hierarchical Condition Category (HCC) codes • Interaction variables accounting for a range of comorbidities • Patient age category • Patient disability status • Patient end-stage renal disease (ESRD) status • Recent use of institutional long-term care

By hospital and state.

Medicare Parts A and B claims data from the Common Working File (CWF); Enrolment Data Base (EDB); Long-Term Care Minimum Data Set (LTC MDS)

MSPB Measure data is displayed at data.cms.gov

www.cms.gov/medicare/quality/value-based-programs/hospital-purchasing

qpp.cms.gov/docs/cost_specifications/2022-12-02-mif-mspb-clinician.pdf