Chronic Conditions Public Use File

$179 / year

The dataset Chronic Conditions Public Use Files has information from Medicare claims. The 100% Beneficiary Summary File is created annually and contains demographic, entitlement and enrollment data for beneficiaries who were: documented as being alive for some part of the reference year of the Beneficiary Summary File, are entitled to Medicare benefits during the reference year, and enrolled in Medicare Part A and/or Part B for at least one month in the reference year.

Complexity

The CMS Chronic Conditions PUF provides various measures of utilization as averages for different groups of Medicare beneficiaries, or profiles. The 100% Beneficiary Summary File contains approximately 48 million beneficiaries, all of whom are represented in the PUF. As a result, the PUF provides utilization measures for Medicare beneficiaries who are enrolled in Fee-for-Service (FFS) plans. The averages are calculated for different types of Medicare beneficiaries by months of enrollment. Beneficiaries with 12 months of enrollment in FFS Part A or Part B are separated from beneficiaries with less than 12 months of enrollment.

Bellow are listed the chronic conditions included in this dataset:
– Alzheimer’s Disease and Related Disorders or Senile Dementia
– Cancer
– Heart Failure
– Chronic Kidney Disease
– Chronic Obstructive Pulmonary Disease
– Depression
– Diabetes
– Ischemic Heart Disease
– Osteoporosis
– Rheumatoid Arthritis/Osteoarthritis Arthritis
– Stroke / Transient Ischemic Attack

Date Created

2011

Last Modified

2017-02-10

Version

2017-02-10

Update Frequency

Biennial

Temporal Coverage

2010

Spatial Coverage

United States

Source

John Snow Labs; Centers for Medicare and Medicaid Services;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Chronic Conditions Claims, Chronic Conditions Part A Enrollement Claims, Chronic Conditions Part B Enrollement Claims, Chronic Conditions Part C Enrollment Claims, Chronic Conditions Part D Enrollment Claims, Medicare Reimbursment for Chronic Conditions, CMS Chronic Conditions PUF, Chronic Conditions PUF, Chronic Condition Benefits

Other Titles

Medicare Chronic Conditions Claims PUF, Medicare Covered Chronic Conditions Services Claims, Medicare Reimbursment For Chronic Conditions

NameDescriptionTypeConstraints
GenderBeneficiary's genderstring-
AgeBeneficiary’s age reported in six categoriesstring-
Is_Alzheimers_Disease_And_Related_Disorders_Or_Senile_DementiaIndicate if the condition existsboolean-
Is_CancerIndicate if the condition existsboolean-
Is_Heart_FailureIndicate if the condition existsboolean-
Is_Chronic_Kidney_DiseaseIndicate if the condition existsboolean-
Is_Chronic_Obstructive_Pulmonary_DiseaseIndicate if the condition existsboolean-
Is_DepressionIndicate if the condition existsboolean-
Is_DiabetesIndicate if the condition existsboolean-
Is_Ischemic_Heart_DiseaseIndicate if the condition existsboolean-
Is_OsteoporosisIndicate if the condition existsboolean-
Is_Rheumatoid_Or_Osteoarthritis_ArthritisIndicate if the condition existsboolean-
Is_Stroke_Or_Transient_Ischemic_AttackIndicate if the condition existsboolean-
Is_Two_Or_More_Chronic_ConditionsIndicate if the total number of chronic conditions is two or moreboolean-
Is_Dual_EligibileIndicate if the beneficiary is dual eligibleboolean-
Count_Of_Beneficiaries_PartA_1To12_MonthsThe number of beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearintegerlevel : Ratio
Average_Months_Of_Enrollment_PartA_1To12_MonthsAverage months of enrollment for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Average_Payment_PartA_1To12_MonthsAverage Medicare payment per beneficiary for all Part A services for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Payment_Inpatient_1To12_MonthsAverage Medicare payment for inpatient services per beneficiary for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Payment_Skilled_Nursing_Facility_1To12_MonthsAverage Medicare payment for skilled nursing facility services per beneficiary for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Payment_Other_Services_PartA_1To12_MonthsAverage Medicare payment for the sum of home health agency and hospice services per beneficiary for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Inpatient_Admissions_1To12_MonthsAverage number of inpatient admissions per beneficiary for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Average_Skilled_Nursing_Facility_Covered_Days_1To12_MonthsAverage number of skilled nursing facility covered days per beneficiary for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Count_Of_Beneficiaries_PartA_12_MonthsCount of beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearintegerlevel : Ratio
Average_Payment_PartA_12_MonthsAverage Medicare payment per beneficiary for all Part A services for beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearnumber-
Average_Payment_Inpatient_12_MonthsAverage Medicare payment for inpatient services per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearnumber-
Average_Payment_Skilled_Nursing_Facility_12_MonthsAverage Medicare payment for skilled nursing facility services per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearnumber-
Average_Payment_Other_Services_PartA_12_MonthsAverage Medicare payment for the sum of home health agency and hospice services per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearnumber-
Average_Inpatient_Admissions_For_12_MonthsAverage number of inpatient admissions per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearnumberlevel : Ratio
Average_Skilled_Nursing_Facility_Covered_Days_12_MonthsAverage number of skilled nursing facility covered days per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar yearnumberlevel : Ratio
Count_Of_Beneficiaries_PartB_1To12_MonthsCount of beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearintegerlevel : Ratio
Average_Months_Of_Enrollment_PartB_1To12_MonthsAverage months of enrollment for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Average_Payment_PartB_1To12_MonthsAverage Medicare payment per beneficiary for all Part B services for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Payment_Carrier_Physician_1To12_MonthsAverage Medicare payment for carrier/physician services per beneficiary for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Payment_Outpatient_1To12_MonthsAverage Medicare payment for outpatient services per beneficiary for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Payment_Other_Services_PartB_1To12_MonthsAverage Medicare payment for the sum of home health agency services and durable medical equipment per beneficiary for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Visits_Carrier_Physician_1To12_MonthsAverage number of carrier/physician visits per beneficiary for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Average_Outpatient_Visits_1To12_MonthsAverage number of outpatient visits per beneficiary for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Count_Of_Beneficiaries_PartB_12MonthsCount of beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearintegerlevel : Ratio
Average_Payment_PartB_12MonthsAverage Medicare payment per beneficiary for all Part B services for beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearnumber-
Average_Payment_Carrier_Physician_12MonthsAverage Medicare payment for carrier/physician services per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearnumber-
Average_Payment_Outpatient_12MonthsAverage Medicare payment for outpatient services per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearnumber-
Average_Payment_Other_Services_PartB_12MonthsAverage Medicare payment for the sum of home health agency services and durable medical equipment per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearnumber-
Average_Visits_Carrier_Physician_12MonthsAverage number of carrier/physician visits per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearnumberlevel : Ratio
Average_Visits_Outpatient_12MonthsAverage number of outpatient visits per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar yearnumberlevel : Ratio
Count_Of_Beneficiaries_PartC_1To12MonthsCount of beneficiaries enrolled in Medicare Part C (HMO) for at least 1 month but less than 12 months in the calendar yearintegerlevel : Ratio
Average_Months_Of_Enrollment_PartC_1To12_MonthsAverage months of enrollment for beneficiaries enrolled in Medicare Part C (HMO) for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Count_Of_Beneficiaries_PartC_12MonthsCount of beneficiaries enrolled in Medicare Part C (HMO) for than 12 months in the calendar yearintegerlevel : Ratio
Count_Of_Beneficiaries_PartD_1To12_MonthsCount of beneficiaries enrolled in Medicare Part D for at least 1 month but less than 12 months in the calendar yearintegerlevel : Ratio
Average_Months_Of_Enrollment_PartD_1To12_MonthsAverage months of enrollment for beneficiaries enrolled in Medicare Part D for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Average_Drug_Cost_1To12_MonthsAverage prescription drug cost per beneficiary for beneficiaries enrolled in Medicare Part D for at least 1 month but less than 12 months in the calendar yearnumber-
Average_Prescriptions_1To12_MonthsAverage number of prescriptions per beneficiary for beneficiaries enrolled in Medicare Part D for at least 1 month but less than 12 months in the calendar yearnumberlevel : Ratio
Count_Of_Beneficiaries_PartD_12MonthsCount of beneficiaries enrolled in Medicare Part D for 12 months in the calendar yearintegerlevel : Ratio
Average_Drug_Cost_12MonthsAverage prescription drug cost per beneficiary for beneficiaries enrolled in Medicare Part D for 12 months in the calendar yearnumber-
Average_Prescriptions_12MonthsAverage number of prescriptions per beneficiary for beneficiaries enrolled in Medicare Part D for 12 months in the calendar yearnumberlevel : Ratio
GenderAgeIs_Alzheimers_Disease_And_Related_Disorders_Or_Senile_DementiaIs_CancerIs_Heart_FailureIs_Chronic_Kidney_DiseaseIs_Chronic_Obstructive_Pulmonary_DiseaseIs_DepressionIs_DiabetesIs_Ischemic_Heart_DiseaseIs_OsteoporosisIs_Rheumatoid_Or_Osteoarthritis_ArthritisIs_Stroke_Or_Transient_Ischemic_AttackIs_Two_Or_More_Chronic_ConditionsIs_Dual_EligibileCount_Of_Beneficiaries_PartA_1To12_MonthsAverage_Months_Of_Enrollment_PartA_1To12_MonthsAverage_Payment_PartA_1To12_MonthsAverage_Payment_Inpatient_1To12_MonthsAverage_Payment_Skilled_Nursing_Facility_1To12_MonthsAverage_Payment_Other_Services_PartA_1To12_MonthsAverage_Inpatient_Admissions_1To12_MonthsAverage_Skilled_Nursing_Facility_Covered_Days_1To12_MonthsCount_Of_Beneficiaries_PartA_12_MonthsAverage_Payment_PartA_12_MonthsAverage_Payment_Inpatient_12_MonthsAverage_Payment_Skilled_Nursing_Facility_12_MonthsAverage_Payment_Other_Services_PartA_12_MonthsAverage_Inpatient_Admissions_For_12_MonthsAverage_Skilled_Nursing_Facility_Covered_Days_12_MonthsCount_Of_Beneficiaries_PartB_1To12_MonthsAverage_Months_Of_Enrollment_PartB_1To12_MonthsAverage_Payment_PartB_1To12_MonthsAverage_Payment_Carrier_Physician_1To12_MonthsAverage_Payment_Outpatient_1To12_MonthsAverage_Payment_Other_Services_PartB_1To12_MonthsAverage_Visits_Carrier_Physician_1To12_MonthsAverage_Outpatient_Visits_1To12_MonthsCount_Of_Beneficiaries_PartB_12MonthsAverage_Payment_PartB_12MonthsAverage_Payment_Carrier_Physician_12MonthsAverage_Payment_Outpatient_12MonthsAverage_Payment_Other_Services_PartB_12MonthsAverage_Visits_Carrier_Physician_12MonthsAverage_Visits_Outpatient_12MonthsCount_Of_Beneficiaries_PartC_1To12MonthsAverage_Months_Of_Enrollment_PartC_1To12_MonthsCount_Of_Beneficiaries_PartC_12MonthsCount_Of_Beneficiaries_PartD_1To12_MonthsAverage_Months_Of_Enrollment_PartD_1To12_MonthsAverage_Drug_Cost_1To12_MonthsAverage_Prescriptions_1To12_MonthsCount_Of_Beneficiaries_PartD_12MonthsAverage_Drug_Cost_12MonthsAverage_Prescriptions_12Months
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Male75-79 years oldtruetruetruetruetruetruetruetruefalsetruefalsetruetrue
Male80-84 years oldtruetruetruetruetruetruetruetruefalsefalsetruetruetrue
Male65-69 years oldtruetruetruetruetruetruetruetruefalsefalsefalsetruetrue
Male70-74 years oldtruefalsetruetruetruefalsetruetruetruetruefalsetruetrue
Male70-74 years oldtruefalsetruetruetruetruefalsetruefalsetruetruetruetrue
Male70-74 years oldtruetruetruetruetruefalsetruetruefalsetruefalsetruetrue
Male75-79 years oldtruefalsefalsetruetruetruetruetruefalsetruetruetruetrue
Male75-79 years oldtruefalsetruetruetruetruefalsetruetruetruefalsetruetrue
Male75-79 years oldtruetruetruefalsetruetruetruetruefalsetruefalsetruetrue