Actual Total Costs of Medicare Fee for Service Beneficiaries

$79 / year

This dataset contains health indicator information about the total Medicare costs for Medicare fee-for-service beneficiaries. The variable used equals the total amount that Medicare paid for a particular claim, revenue center record, claim line, or service category.

Complexity

This variable equals the total amount that Medicare paid for a particular claim, revenue center record, claim line, or service category. The exact method used to derive the variable differs based on the nature of the original claim, but the meaning of the variable is the same. Part A Claim File: For services provided by any type of hospital, this variable equals the sum of the claim payment amount and the claim pass-through payment amount on the original claim. Medicare uses pass-through payments to provide funding for direct graduate medical education, coverage of some bad debt, and other purposes. The amounts on the claim are interim payments; the final amount is determined when hospitals file their cost reports. For non-hospital services (SNF, home health, and hospice), this variable equals the claim payment amount (CLM_PMT_AMT).

Part B Institutional Revenue Center File: This variable equals the revenue line payment amount (REV_CNTR_PRVDR_PMT_AMT). Can add ACTUAL_PMT for each revenue center record on the claim to get the total payment amount for the claim, which is already summed in the GVDB and called the CLM_PMT variable. Part B Non-Institutional Claim Line File: This variable equals the line payment amount (LINE_NCH_PMT_AMT) from the original claim. Can add up the line-level payments for a claim to get the total amount that Medicare paid for the claim. Medicare FFS beneficiaries limited to those who (a) have no months of HMO enrollment and (b) have both Part A and Part B for whatever portion of the year that they are covered by FFS Medicare (i.e., they have no months of A-only or B-only coverage)..

Date Created

2007

Last Modified

2013

Version

2013

Update Frequency

Annual

Temporal Coverage

2013

Spatial Coverage

United States

Source

John Snow Labs => Health Indicators Warehouse (HIW); Chronic Condition Data Warehouse (CCW); Centers for Medicare and Medicaid Services (CMS)

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

CMS Medicare, Medicare Doctors, Hospital Reimbursements, Actual Total Costs CMS Medicare, Medicare Doctors Fee for Service, Medicare Actual Total Service Costs, Medicare Beneficiary Expenditures

Other Titles

CMS Medicare Total Costs, Medicare Doctors and Medicare Total Costs

Name Description Type Constraints
Indicator_IDUnique ID assigned to sampling statistic. A health indicator is a measure of the health of people in a community, such as infant mortality rates, rates of obesity, or incidence of diabetes.integerrequired : 1 level : Nominal
Dimension_ListDimension covers Age limit and Total.string-
Time_FrameTime frame corresponds to the data years; 2007-2013 in this case.date-
Numeric_Value_in_USDValue of total cost in U.S Dollarsnumberlevel : Ratio
Missing_Value_FlagMissing value flag, alternatively DSU (Data statistically unreliable) indicates that data do not meet the criteria for statistical reliability, data quality, or confidentiality and therefore data are suppressed.string-
Locale_IDID assigned to a Locality of the sample populationintegerrequired : 1 level : Nominal
LocaleLocality of the sample populationstringrequired : 1
Locale_LevelLocality level of the sample populationstringrequired : 1
Locale_State_FIPS_CodeFederal Information Processing Standard state code. Federal Information Processing Series codes (FIPS codes) are a standardized set of numeric or alphabetic codes issued by the National Institute of Standards and Technology (NIST) to ensure uniform identification of geographic entities through all federal government agencies.integerlevel : Nominal
Locale_County_FIPS_CodeFederal Information Processing Standard County code. Federal Information Processing Series codes (FIPS codes) are a standardized set of numeric or alphabetic codes issued by the National Institute of Standards and Technology (NIST) to ensure uniform identification of geographic entities through all federal government agencies.integerlevel : Nominal
Locale_HRR_CodeHospital Referral Region Code. Hospital referral regions are defined by the Dartmouth Atlas Group by documenting where patients were referred for major cardiovascular surgical procedures and for neurosurgeryintegerlevel : Nominal
AgeAge of the beneficiarystring-
Indicator_IDDimension_ListTime_FrameNumeric_Value_in_USDMissing_Value_FlagLocale_IDLocaleLocale_LevelLocale_State_FIPS_CodeLocale_County_FIPS_CodeLocale_HRR_CodeAge
416208759Total20135742707042AlaskaState22
415497903Total20125407319162AlaskaState22
414787047Total20115258204102AlaskaState22
414076191Total20104908224612AlaskaState22
413365335Total20094536742092AlaskaState22
412654479Total20084077058142AlaskaState22
411943623Total20073663441132AlaskaState22
416208756Total201356918878741AlabamaState11
416208762Total201351253894894ArizonaState44
416208801Total2013355677750619IowaState1919