The link below provides national-level statistics for areas identified as at-risk for improper payments in critical access hospitals. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all hospitals in the nation. For more information on the areas identified as at risk for improper payments, please see the Critical Access Hospital PEPPER User’s guide (PDF, 11th Edition).

A listing of the top 20 DRGs by volume of Medicare discharges for all critical access hospitals in the nation. The data are aggregated at the national level. The data include the number of discharges, proportion of discharges for the DRG to total discharges and national average length of stay for each DRG. The data represent the most recent four quarters of discharges.

The link below provides state-level statistics for areas identified as at-risk for improper payments in critical access hospitals. The data include the number of Medicare discharges for the numerator and denominator for each target area, proportion for each target area, average Medicare payment for a claim in each target area and the sum of total Medicare payments for each target area for all hospitals in each state with three or more CAHs. Target area statistics are reported when there are at least three hospitals with 11+ target area discharges. For more information on the areas identified as at risk for improper payments, please see the Critical Access Hospital PEPPER User’s guide (PDF, 11th Edition).

A listing of the top DRGs (up to 20) by volume of Medicare discharges for all critical access hospitals in each state with three or more CAHs. The data are aggregated at the state level. The data include the number of discharges, proportion of discharges for the DRG to total discharges and average length of stay for each DRG. The data represent the most recent four quarters of discharges. DRGs are included in the report if there are at least 11 discharges for the DRG in the most recent four quarters.

Charts displaying, for each of the areas identified as potentially at risk for improper Medicare payments, the target area percents that are at the 80th, 50th and 20th percentiles for critical access hospitals in three categories: total number of discharges, location and ownership type. The statistics were calculated for CAH discharges ending in fiscal year 2021 (October 1, 2020-September 30, 2021). For a listing of all CAHs and their peer group classification please see the CAHs by peer group file (XLSX, updated 04/21/22). Note: use Control+F or the “Find” button to search the file for a CMS Certification Number (provider number) or provider name.