The Crimson Tsunami

Medicare Advantage Rate Analysis

ZHSG analyzed Medicare Advantage claims data from Simple's CORE Analytics' MAPAX tool.

UB-04 claims & contracts from 1,400+ SNFs:

• 1.4+ million days billed for dates of service 1/1/23 - 2/28/24.
• 83,000+ admissions.
• Rate data from counties with at least 10 SNFs or 1,500 MA admissions were compiled by ZHSG.
• Proxy comparative PDPM gross rate for HIPPS: KEIE
  • 27-day ALOS, day weighted.
  • Averaged for 2023 - 2024 AWI.
  • FFS RATE at respective AWI; MA rates are as contracted.