Medicare Spending CMHS Based by Age Sex and Race HRR Level

$79 / year

This dataset includes the Hospital Refferal Region level Medicare spending CMHS based data by age, sex and race. The Continuous Medicare History Sample file was used to analyze trends in the spending concentration over thirty years. 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.

Complexity

Medicare spending is concentrated among a few high-cost beneficiaries who are often targeted by cost-saving interventions. The Continuous Medicare History Sample file was used to analyze trends in the spending concentration over thirty years. Annual expenditures became less concentrated over time, although the year-to-year persistence of person-level high costs remained strong. There was an increase in the prevalence of chronic conditions among high-cost beneficiaries, which supports the rationale for focusing cost-saving interventions on chronic disease management. However, the decrease in concentration may reduce the potential savings from interventions focused on such beneficiaries. Annual spending has become less concentrated over time, with the top 5 percent of spenders accounting for less of the Medicare spending total than in the 1980s. The concentration of Medicare spending among a small number of beneficiaries is well documented. In any given year, the most expensive 5 percent of beneficiaries account for roughly half of fee-for-service (FFS) Medicare costs.1 Aggregated over multiple years, spending becomes less concentrated: During the five-year period 1997–2001, the top 5 percent of beneficiaries accounted for 27.3 percent of Medicare costs.

Nonetheless, many high-cost beneficiaries have persistently high costs from year to year. Similar spending patterns have been found in non-Medicare healthcare markets. The CMHS contains enrollment and claims data for a 5 percent sample of the Medicare population, selected on the basis of the last two digits of the Health Insurance Claim (HIC) number. The file covers the most recent thirty-year period for which data are available. Data on cost and utilization are aggregated by type of service by calendar year. Claim-specific data such as diagnoses and procedures are not contained in the file. Data on managed care enrollment and state buy-in status are included for each year of Medicare entitlement. The CMHS is longitudinal; that is, beneficiaries remain in the file unless a change in their HIC numbers causes them to drop out of the digital sample.

Date Created

2005-11-02

Last Modified

2009-11-25

Version

2009-11-25

Update Frequency

Never

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 CMHS Based Spending, Medicare Spending HRR Level, Medicare Spending, Continuous Medicare History Sample, Health Insurance Claim

Other Titles

Medicare Hospital Service Area HRR and HSA Spending, Medicare Reimbursements Data, Hospital Referral Region, Medicare Reimbursement

Name Description Type Constraints
HRR_NumberHospital Referral Region Identification Number.integerrequired : 1 level : Nominal
HRR_LabelName 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 neurosurgerystringrequired : 1
Medicare_Enrollees_CMHS_Five_Percent_Sample_2007Number of Medicare beneficiaries CMHS based five percent sample in the year 2007. The CMHS contains enrollment and claims data for a 5 percent sample of the Medicare population, selected on the basis of the last two digits of the Health Insurance Claim (HIC) number.integerrequired : 1 level : Ratio
Total_Medicare_Reimb_Part_A_And_B_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 both Part A and B claims.integerrequired : 1 level : Ratio
Total_Part_A_Medicare_Reimb_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part A claims.integerrequired : 1 level : Ratio
Total_Part_B_Medicare_Reimb_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Inpatient_Short_Stays_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Inpatient Short Stays.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Inpatient_Long_Stays_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Inpatient long Stays.integerlevel : Ratio
Medicare_Reimb_For_Outpatient_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Outpatient Services.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Prof_And_Lab_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims for Professional and Laboratory services.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Med_And_Surgi_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims for Medical and Surgical services.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Medical_Care_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims for Medical Care.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Surgical_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims for Surgical Services.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Diag_Lab_And_Xray_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims for Diagnostic Laboratory and X-ray Services.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Durable_Medical_Equipment_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Part B claims for Durable Medical Equipment.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Home_Health_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Home Health Services.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Hospice_Services_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Hospice Services.integerlevel : Ratio
Medicare_Reimb_For_Skilled_Nursing_Facs_Per_Enrollee_2007Total amount reimbursed per enrollee for year 2007 Skilled Nursing Facilities.integerrequired : 1 level : Ratio
HRR_NumberHRR_LabelMedicare_Enrollees_CMHS_Five_Percent_Sample_2007Total_Medicare_Reimb_Part_A_And_B_Per_Enrollee_2007Total_Part_A_Medicare_Reimb_Per_Enrollee_2007Total_Part_B_Medicare_Reimb_Per_Enrollee_2007Medicare_Reimb_For_Inpatient_Short_Stays_Per_Enrollee_2007Medicare_Reimb_For_Inpatient_Long_Stays_Per_Enrollee_2007Medicare_Reimb_For_Outpatient_Services_Per_Enrollee_2007Part_B_Medicare_Reimb_For_Prof_And_Lab_Services_Per_Enrollee_2007Part_B_Medicare_Reimb_For_Med_And_Surgi_Services_Per_Enrollee_2007Part_B_Medicare_Reimb_For_Medical_Care_Per_Enrollee_2007Part_B_Medicare_Reimb_For_Surgical_Services_Per_Enrollee_2007Part_B_Medicare_Reimb_For_Diag_Lab_And_Xray_Services_Per_Enrollee_2007Part_B_Medicare_Reimb_For_Durable_Medical_Equipment_Per_Enrollee_2007Medicare_Reimb_For_Home_Health_Services_Per_Enrollee_2007Medicare_Reimb_For_Hospice_Services_Per_Enrollee_2007Medicare_Reimb_For_Skilled_Nursing_Facs_Per_Enrollee_2007
324ND-Minot8156299306332381979-3481707104790061828114620267693
345OR-Salem69252212380284716349491296992726266305173205-150393
2AL-Dothan2392763743433298242737080016661288905384378255437604714
6AL-Mobile3788805243973656273926298817921336943393456220470568627
11AZ-Mesa30788412456038523031260717232416421182460681216304620465
31CA-Chico1981729938363462281418710921599118183035141828734190570
78CA-Salinas16467485423532483119846176013921012380368176409106611
148GA-Rome1508824846403614280856082317251246873373478310697277763
341OR-Bend965707837073365214753592916691293908384376219396-502344
421UT-Ogden130569313583334421368495915141209855353306310386669561