Medicare Spending Claims Based by Price Age Sex and Race HRR Level

$79 / year

Data on Medicare spending are claims-based and adjusted for price, age, sex, and race (20% sample for 2003-2009, 100% sample for 2010-2013). This dataset includes the Hospital Referal Region (HRR) level Medicare spending claims based data by price, age, sex and race. Hospital referral regions (HRRs) represent regional health care markets for tertiary medical care that generally requires the services of a major referral center. The regions were defined by determining where patients were referred for major cardiovascular surgical procedures and for neurosurgery. Each hospital service area (HSA) was examined to determine where most of its residents went for these services. The result was the aggregation of the 3,436 hospital service areas into 306 HRRs. Each HRR has at least one city where both major cardiovascular surgical procedures and neurosurgery are performed.

Complexity

Medicare spending is concentrated among a few high-cost beneficiaries who are often targeted by cost-saving interventions. Rapidly rising health care costs pose a serious threat not only to the future of public and private health insurance coverage, but also to the sustainability of efforts to expand coverage to the millions of uninsured Americans. Many policy experts have concluded that excessive growth in health care spending is a foregone conclusion, driven by inexorable forces such as advancing technology. Some conclude that only by rationing beneficial care will the U.S. be able to achieve a sustainable and affordable future.
Neither of these conclusions is inevitable. Both rest on the assumption that all of the additional spending in high spending regions areas is buying services that are necessary and beneficial. However, studies comparing similar patients have found that those in higher-spending regions are more likely to be admitted to the hospital, spend more time in the hospital, receive more discretionary tests, see more medical specialists, and have many more different physicians involved in their care. The extra care does not produce better outcomes overall or result in better quality of care, whether one looks at measures of technical quality (such as providing appropriate medication to heart attack patients), or survival following such serious conditions as a heart attack or hip fracture. Higher spending also does not result in improved patient perceptions of the accessibility or quality of medical care.
Slowing the rate of Medicare spending growth is both necessary and achievable. Taking steps now to limit future spending increases such as slowing the growth of capacity, developing better evidence on the risks and benefits of many common treatments (and countering the assumption that more medical care necessarily means better medical care), and reforming the payment system to reward the value, rather than volume, of care will result in better health care for those enrolled in Medicare and better fiscal health for Medicare itself.

Date Created

2013

Last Modified

2014

Version

2014

Update Frequency

Annual

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs => The Dartmouth Atlas of Health Care

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Claims, Medicare Spending, Medicare Spending Claims, Medicare Cost Report, Medicare Hospital, Medicare Spending by HRR Level, Hospital Referral Regions (HRRs), Claims-based Reimbursement Measures

Other Titles

Medicare Home Healthcare, Medicare Services Reimburesement Measures, Medicare Doctors, Medicare Reimbursements Data, HRR Level Medicare Spending Claims

Name Description Type Constraints
HRR_NumberHospital Referral Region Identification Number.integerrequired : 1 level : Nominal
HRR_NameName of Hospital Referral Region.Hospital referral regions (HRRs) represent regional health care markets for tertiary medical care that generally requires the services of a major referral center. The regions were defined by determining where patients were referred for major cardiovascular surgical procedures and for neurosurgery.stringrequired : 1
StateTwo-letter state abbreviation in the mailing address of the hospital. This includes information on hospitals in:stringrequired : 1
Medicare_Enrollees_2014Number of medicare benificiaries in the year 2014.integerrequired : 1 level : Ratio
Total_Medicare_Reimb_Per_Enrollee_Parts_A_B_2014_Age_Sex_Race_AdjThe amount of money reimbursed per enrollee for year 2014 and adjusted by age, sex and race.integerrequired : 1 level : Ratio
Total_Med_Reimb_Per_Enrollee_Parts_A_B_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed per enrollee for year 2014 and adjusted by price, age, sex and race.integerrequired : 1 level : Ratio
Hosp_Skilled_Nursing_Fac_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to Hospital skilled nursing facility.integerrequired : 1 level : Ratio
Hosp_Skilled_Nursing_Fac_Reimb_Per_Enroll_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to Hospital skilled nursing facility.integerrequired : 1 level : Ratio
Physician_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to phsician.integerrequired : 1 level : Ratio
Physician_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to phsician.integerrequired : 1 level : Ratio
Outpatient_Facility_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to medicare outpatient facility.integerrequired : 1 level : Ratio
Outpatient_Facility_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to medicare outpatient facility.integerrequired : 1 level : Ratio
Home_Health_Agency_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to home health agency.integerrequired : 1 level : Ratio
Home_Health_Agency_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to home health agency.integerrequired : 1 level : Ratio
Hospice_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to hospice facility.integerrequired : 1 level : Ratio
Hospice_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to home health agency.integerrequired : 1 level : Ratio
Durable_Med_Equip_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to Durable Medical Equipment facility.integerrequired : 1 level : Ratio
Durable_Med_Equip_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to Durable Medical Equipment facility.integerrequired : 1 level : Ratio
HRR_NumberHRR_NameStateMedicare_Enrollees_2014Total_Medicare_Reimb_Per_Enrollee_Parts_A_B_2014_Age_Sex_Race_AdjTotal_Med_Reimb_Per_Enrollee_Parts_A_B_2014_Price_Age_Sex_Race_AdjHosp_Skilled_Nursing_Fac_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjHosp_Skilled_Nursing_Fac_Reimb_Per_Enroll_2014_Price_Age_Sex_Race_AdjPhysician_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjPhysician_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjOutpatient_Facility_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjOutpatient_Facility_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjHome_Health_Agency_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjHome_Health_Agency_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjHospice_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjHospice_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjDurable_Med_Equip_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjDurable_Med_Equip_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_Adj
324MinotND153987701782835103635129013582653258473716271132126
11MesaAZ8365898649849392139803581358811671121406389596565182194
62NapaCA3526995297584458133372356217518681460331270232186152139
6MobileAL7630884399860327542172557270212791462561645543638245224
31ChicoCA4594393568247461440092160205318241508355301177160226212
280RenoNV8242984757825381834752263218214971321332297316318232218
300ElmiraNY31515829488893909431823942497148415572572718695218200
321BismarckND272297852810534163673194319952200214393916072165155
341BendOR2897076547183299827392286225714121288244219502481187175
351EriePA6786788479525419645772154224217461908368397182211219205