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.
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Last updated:January 20, 2021
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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
The above dataset plays an important role in the use of generative AI in healthcare organizations to improve workflows and communication.
About this Dataset
Data Info
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
No data
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
Indicate if the total number of chronic conditions is two or more
boolean
-
Is_Dual_Eligibile
Indicate if the beneficiary is dual eligible
boolean
-
Count_Of_Beneficiaries_PartA_1To12_Months
The number of beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar year
integer
level : Ratio
Average_Months_Of_Enrollment_PartA_1To12_Months
Average months of enrollment for beneficiaries enrolled in Medicare Part A for at least 1 month but less than 12 months in the calendar year
number
level : Ratio
Average_Payment_PartA_1To12_Months
Average 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 year
number
-
Average_Payment_Inpatient_1To12_Months
Average 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 year
Average 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 year
number
-
Average_Payment_Other_Services_PartA_1To12_Months
Average 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 year
number
-
Average_Inpatient_Admissions_1To12_Months
Average 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 year
Average 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 year
number
level : Ratio
Count_Of_Beneficiaries_PartA_12_Months
Count of beneficiaries enrolled in Medicare Part A for 12 months in the calendar year
integer
level : Ratio
Average_Payment_PartA_12_Months
Average Medicare payment per beneficiary for all Part A services for beneficiaries enrolled in Medicare Part A for 12 months in the calendar year
number
-
Average_Payment_Inpatient_12_Months
Average Medicare payment for inpatient services per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar year
Average Medicare payment for skilled nursing facility services per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar year
number
-
Average_Payment_Other_Services_PartA_12_Months
Average 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 year
number
-
Average_Inpatient_Admissions_For_12_Months
Average number of inpatient admissions per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar year
Average number of skilled nursing facility covered days per beneficiary for beneficiaries enrolled in Medicare Part A for 12 months in the calendar year
number
level : Ratio
Count_Of_Beneficiaries_PartB_1To12_Months
Count of beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar year
integer
level : Ratio
Average_Months_Of_Enrollment_PartB_1To12_Months
Average months of enrollment for beneficiaries enrolled in Medicare Part B for at least 1 month but less than 12 months in the calendar year
number
level : Ratio
Average_Payment_PartB_1To12_Months
Average 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 year
number
-
Average_Payment_Carrier_Physician_1To12_Months
Average 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 year
number
-
Average_Payment_Outpatient_1To12_Months
Average 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 year
number
-
Average_Payment_Other_Services_PartB_1To12_Months
Average 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 year
number
-
Average_Visits_Carrier_Physician_1To12_Months
Average 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 year
number
level : Ratio
Average_Outpatient_Visits_1To12_Months
Average 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 year
number
level : Ratio
Count_Of_Beneficiaries_PartB_12Months
Count of beneficiaries enrolled in Medicare Part B for 12 months in the calendar year
integer
level : Ratio
Average_Payment_PartB_12Months
Average Medicare payment per beneficiary for all Part B services for beneficiaries enrolled in Medicare Part B for 12 months in the calendar year
number
-
Average_Payment_Carrier_Physician_12Months
Average Medicare payment for carrier/physician services per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar year
number
-
Average_Payment_Outpatient_12Months
Average Medicare payment for outpatient services per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar year
number
-
Average_Payment_Other_Services_PartB_12Months
Average 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 year
number
-
Average_Visits_Carrier_Physician_12Months
Average number of carrier/physician visits per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar year
number
level : Ratio
Average_Visits_Outpatient_12Months
Average number of outpatient visits per beneficiary for beneficiaries enrolled in Medicare Part B for 12 months in the calendar year
number
level : Ratio
Count_Of_Beneficiaries_PartC_1To12Months
Count of beneficiaries enrolled in Medicare Part C (HMO) for at least 1 month but less than 12 months in the calendar year
integer
level : Ratio
Average_Months_Of_Enrollment_PartC_1To12_Months
Average months of enrollment for beneficiaries enrolled in Medicare Part C (HMO) for at least 1 month but less than 12 months in the calendar year
number
level : Ratio
Count_Of_Beneficiaries_PartC_12Months
Count of beneficiaries enrolled in Medicare Part C (HMO) for than 12 months in the calendar year
integer
level : Ratio
Count_Of_Beneficiaries_PartD_1To12_Months
Count of beneficiaries enrolled in Medicare Part D for at least 1 month but less than 12 months in the calendar year
integer
level : Ratio
Average_Months_Of_Enrollment_PartD_1To12_Months
Average months of enrollment for beneficiaries enrolled in Medicare Part D for at least 1 month but less than 12 months in the calendar year
number
level : Ratio
Average_Drug_Cost_1To12_Months
Average 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 year
number
-
Average_Prescriptions_1To12_Months
Average 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 year
number
level : Ratio
Count_Of_Beneficiaries_PartD_12Months
Count of beneficiaries enrolled in Medicare Part D for 12 months in the calendar year
integer
level : Ratio
Average_Drug_Cost_12Months
Average prescription drug cost per beneficiary for beneficiaries enrolled in Medicare Part D for 12 months in the calendar year
number
-
Average_Prescriptions_12Months
Average number of prescriptions per beneficiary for beneficiaries enrolled in Medicare Part D for 12 months in the calendar year
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