Medicare Spending Claims Based by Price Age Sex and Race HSA 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 Service Areas (HSA) level Medicare spending claims based data by price, age, sex and race. Hospital service areas (HSAs) are local health care markets for hospital care. An HSA is a collection of ZIP codes whose residents receive most of their hospitalizations from the hospitals in that area. HSAs were defined by assigning ZIP codes to the hospital area where the greatest proportion of their Medicare residents were hospitalized. Minor adjustments were made to ensure geographic contiguity. This process resulted in 3,436 HSAs. When these regions were created in the early 1990s, most hospital service areas contained only one hospital. In the intervening years, hospital closures have left some HSAs with no hospital; these HSAs have been maintained as distinct areas in order to preserve the continuity of the database.

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, Hospital Service Areas (HSAs), Medicare Spending by HSA Level, Claims-based Reimbursement Measures

Other Titles

Medicare Home Healthcare, Medicare Suffix, Medicare Doctors, Medicare Reimbursements Data, HSA Level Medicare Spending Claims

Name Description Type Constraints
HSA_NumberHospital Service Area Identification Number.integerrequired : 1 level : Nominal
HSA_NameName of Hospital Service Area. Hospital service areas (HSAs) are local health care markets for hospital care. An HSA is a collection of ZIP codes whose residents receive most of their hospitalizations from the hospitals in that area. HSAs were defined by assigning ZIP codes to the hospital area where the greatest proportion of their Medicare residents were hospitalized.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_And_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_Medicare_Reimb_Per_Enroll_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
Hospital_Skilled_Nursing_Fac_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to Hospital skilled nursing facility.integerlevel : Ratio
Hosp_Skilled_Nursing_Fac_Reimb_Per_Enroll_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to Hospital skilled nursing facility.integerlevel : 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.integerlevel : Ratio
Home_Health_Agency_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to home health agency.integerlevel : Ratio
Hospice_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to hospice facility.integerlevel : Ratio
Hospice_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to home health agency.integerlevel : Ratio
Durable_Med_Equip_Reimb_Per_Enrollee_2014_Age_Sex_Race_AdjThe amount of money reimbursed to Durable Medical Equipment facility.integerlevel : Ratio
Durable_Med_Equip_Reimb_Per_Enrollee_2014_Price_Age_Sex_Race_AdjThe amount of money reimbursed to Durable Medical Equipment facility.integerlevel : Ratio
HSA_NumberHSA_NameStateMedicare_Enrollees_2014Total_Medicare_Reimb_Per_Enrollee_Parts_A_And_B_2014_Age_Sex_Race_AdjTotal_Medicare_Reimb_Per_Enroll_Parts_A_B_2014_Price_Age_Sex_Race_AdjHospital_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
43023HovenSD45529752981299131923662299
2008NomeAK3731327194015111276914491130491440394642
35041TiogaND651640863732915291910661084233422727874
2002CordovaAK239976375785127371118381563230019019277
2016BarrowAK3541275168998088319818031496204116855753
2017BethelAK1152913864804860300927572335127810524437
5013AvalonCA3021145089556420455524052196240520109885
6018EadsCO194100309168480639551130113237143728393369
24027CookMN49074947471310929691305157223782270278268
27039PoplarMT280734270623112293117371709197019189295