Others titles
- Average Per Member Per Month Part D Payment
- Health Insurance Payment
- Medicare Prescription Drug Plans
- Insurance Companies Payments of Part D Plans
Keywords
- Medicare Part D
- Medicare Part D Plans
- Medicaid Plan D
- Medicare
Medicare Part D Plan Payment
This dataset contains information by insurance companies contracts regarding average payment per member per month for Medicare Part D Plans.
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Description
Medicare Part D plans offer prescription drug coverage to eligible patients. These are offered through private insurance companies that are contracted by Medicare, so costs and availability may differ between carriers and by location. Part D plans include the Prescription Drug Plans and Medicare Advantage Prescription Drug plans.
CMS releases summary Part C and Part D payment data after the reconciliation of Part C and Part D payments, as provided in 42 CFR
§422.504(n)(1) and 42 CFR §423.505(o)(1). Additional information on the summary Part C and Part D payment data that CMS releases, can be found in CMS April 15, 2011 final rule, “Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2012 and Other Changes,” published in the Federal Register at 76 FR 21432. The categories of data are expressed at a summary level only. In addition, in instances where the level of aggregation identified in a data category was determined to be potentially insufficient to provide adequate protection against any disaggregation, such data is not included in said category. Any risk-adjusted payment is standardized to a 1.0 risk score, meaning that the included numbers are equal to the average risk-adjusted amount divided by the average risk score.
About this Dataset
Data Info
Date Created | 2012-02-23 |
---|---|
Last Modified | 2021-09-28 |
Version | 2021-09-28 |
Update Frequency |
Semiannual |
Temporal Coverage |
2019 |
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 | Medicare Part D, Medicare Part D Plans, Medicaid Plan D, Medicare |
Other Titles | Average Per Member Per Month Part D Payment, Health Insurance Payment, Medicare Prescription Drug Plans, Insurance Companies Payments of Part D Plans |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Contract_Number | Insurance contract number, help identify the insurance plan | string | - |
Plan_Benefit_Package | Benefit Package of the insurance plan the beneficiary is availing, help identify the insurance plan | string | - |
Contract_Name | Name of insurance provider providing Part C medical cover for the beneficiary | string | - |
Organization_Type | Type of organization providing the medical care | string | - |
Average_PartD_Direct_Subsidy_PMPM_Payment | Average Part D direct subsidy per member per month payment for a part D plan | number | - |
Average_PartD_Risk_Score | Average Part D health risk score of the beneficiary is used to calculate the insurance premiums or payments of part D plan | number | level : Ratio |
Average_Reinsurance_PMPM_Payment | Average reinsurance per member per month payment for a part D plan | number | - |
Average_Low_Income_Cost_Sharing_PMPM_Payment | Average low income cost sharing per member per month payment for a part D plan | number | - |
Data Preview
Contract Number | Plan Benefit Package | Contract Name | Organization Type | Average PartD Direct Subsidy PMPM Payment | Average PartD Risk Score | Average Reinsurance PMPM Payment | Average Low Income Cost Sharing PMPM Payment |
E0654 | 801 | IBT VOLUNTARY EMPLOYEE BENEFITS TRUST | Employer/Union Only Direct Contract PDP | 13.43 | 0.88 | 36.09 | |
E3014 | 801 | PSERS HOP PROGRAM | Employer/Union Only Direct Contract PDP | 7.37 | 0.76 | 36.03 | |
E4744 | 801 | MODOT/MSHP MEDICAL AND LIFE INSURANCE PLAN | Employer/Union Only Direct Contract PDP | 10.95 | 0.82 | 36.06 | |
H0022 | 1 | BUCKEYE COMMUNITY HEALTH PLAN, INC. | Demo | 51.24 | 1.72 | 158.9 | 187.1 |
H0028 | 4 | CHA HMO, INC. | Local CCP | 16.88 | 0.86 | 29.35 | 24.89 |
H0028 | 7 | CHA HMO, INC. | Local CCP | 35.99 | 1.85 | 226.05 | 200.43 |
H0028 | 11 | CHA HMO, INC. | Local CCP | 18.1 | 1.0 | 72.63 | 42.38 |
H0028 | 13 | CHA HMO, INC. | Local CCP | 17.6 | 0.97 | 56.39 | 35.01 |
H0028 | 14 | CHA HMO, INC. | Local CCP | 19.43 | 1.08 | 62.4 | 43.47 |
H0028 | 15 | CHA HMO, INC. | Local CCP | 28.15 | 1.71 | 189.84 | 195.92 |