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

$179 / year

This dataset includes the State level Medicare spending claims based data by price, age, sex and race. The variables included are: state, number of Medicare enrollees, total Medicare reimbursements per enrollee, hospital and skilled nursing facility reimbursements per enrollee, physician reimbursements per enrollee, outpatient facility reimbursements per enrollee, home health agency reimbursements per enrollee, hospice reimbursements per enrollee, and durable medical equipment per enrollee.

Complexity

Medicare spending is concentrated among a few high-cost beneficiaries who are often targeted by cost-saving interventions. 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). Rapidly rising healthcare 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

2005-11-02

Last Modified

2018-10-11

Version

2018-10-11

Update Frequency

Annual

Temporal Coverage

2014-2016

Spatial Coverage

United States

Source

John Snow Labs; The Dartmouth Atlas of Health Care;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

Medicare Claims, Medicare Spending, Medicare Spending Claims, Medicare Spending by State Level, Claim Based Medicare Spending, Health Insurance Claim

Other Titles

Hospice Reimburesement, Medicare Reimbursement, Claim Based Medicare Spending Reimbursements Data, State Level Medicare Spending Claims for years 2014-2016

NameDescriptionTypeConstraints
YearThe year in which data is recordeddate-
State_NumberState Identification Number.integerlevel : Nominal
State_NameName of USA States.string-
Medicare_EnrolleesNumber of medicare benificiaries in the year 2014.integerlevel : Ratio
Medicare_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed per enrollee for year 2014 and adjusted by age, sex and race.numberlevel : Ratio
Medicare_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed per enrollee for year 2014 and adjusted by price, age, sex and race.numberlevel : Ratio
Hosp_Skilled_Nursing_Fac_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed to Hospital skilled nursing facility.numberlevel : Ratio
Hosp_Skilled_Nursing_Fac_Reimb_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed to Hospital skilled nursing facility.numberlevel : Ratio
Physician_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed to physician.numberlevel : Ratio
Physician_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed to physician.numberlevel : Ratio
Outpatient_Fac_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed to medicare outpatient facility.numberlevel : Ratio
Outpatient_Fac_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed to medicare outpatient facility.numberlevel : Ratio
Home_Health_Agency_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed to home health agency.numberlevel : Ratio
Home_Health_Agency_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed to home health agency.numberlevel : Ratio
Hospice_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed to hospice facility.integerlevel : Ratio
Hospice_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed to hospice facility.integerlevel : Ratio
Durable_Med_Equip_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedThe amount of money reimbursed to Durable Medical Equipment facility.integerlevel : Ratio
Durable_Med_Equip_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedThe amount of money reimbursed to Durable Medical Equipment facility.integerlevel : Ratio
YearState_NumberState_NameMedicare_EnrolleesMedicare_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedMedicare_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedHosp_Skilled_Nursing_Fac_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedHosp_Skilled_Nursing_Fac_Reimb_Price_Age_Sex_Race_AdjustedPhysician_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedPhysician_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedOutpatient_Fac_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedOutpatient_Fac_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedHome_Health_Agency_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedHome_Health_Agency_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedHospice_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedHospice_Reimb_Per_Enrollee_Price_Age_Sex_Race_AdjustedDurable_Med_Equip_Reimb_Per_Enrollee_Age_Sex_Race_AdjustedDurable_Med_Equip_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adjusted
20162Alaska618589525.327393.934601.983291.252545.982157.301790.531446.12220.00180.001911728174
201412Hawaii855777464.007183.003338.003037.002113.002116.001440.001466.00137.00140.003473409390
201512Hawaii891697718.397189.893384.282965.212216.722214.181506.891416.65151.00143.423683599390
201612Hawaii893058139.507591.723601.963185.262295.572291.591626.041521.75161.00152.003843708581
20142Alaska566348703.006971.004102.003076.002334.001971.001660.001389.00209.00176.00185172118108
201416Iowa3755037938.008355.003471.003684.001853.001943.001966.002066.00216.00226.00256273192179
201446Utah1577638484.008717.003462.003583.002148.002189.001449.001464.00638.00643.00545598257260
20152Alaska596488848.837133.654075.913091.002485.552085.731681.281421.45206.00176.52186172123109
201516Iowa3814648161.908572.373528.873712.781939.522021.432043.442169.53214.00226.31256276199186
201546Utah1642198624.558903.263403.433567.302238.462266.321537.591568.83619.00630.44561606278283