Medicare Spending CMHS Based by Age Sex and Race State Level

$79 / year

This dataset includes the State level Medicare spending claims based data by price, age, sex and race. This dataset includes the county level Medicare spending claims based data by price, age, sex and race.

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

2007

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 Provider Number, Medicare Cost Report, Medicare Hospital, Medicare Spending Data, CHMS Based Reports, Medicare Reports by Sex Age and Race

Other Titles

Medicare Home Healthcare Claims Based Data, Medicare Cost And utilization Aggregated Data

Name Description Type Constraints
State_NumberState Identification Number.integerrequired : 1 level : Ordinal
StateName of USA States.stringrequired : 1
Medicare_Enrollees_CMHS_Five_Percent_SampleNumber of medicare benificiaries 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 on the Health Insurance Claim (HIC) numberintegerrequired : 1 level : Ratio
Total_Medicare_Reimb_Part_A_And_B_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 both Part A and B claims.integerrequired : 1 level : Ratio
Total_Part_A_Medicare_Reimb_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Part A claims.integerrequired : 1 level : Ratio
Total_Part_B_Medicare_Reimb_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Part B claims.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Inpatient_Short_Stays_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Inpatient Short Stays.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Inpatient_Long_Stays_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Inpatient long Stays.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Outpatient_Services_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Outpatient Services.integerrequired : 1 level : Ratio
Part_B_Medicare_Reimb_For_Prof_And_Lab_Services_Per_EnrolleeTotal 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_EnrolleeTotal 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_EnrolleeTotal 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_EnrolleeTotal 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_EnrolleeTotal 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_EnrolleeTotal 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_EnrolleeTotal amount reimbursed per enrollee for year 2007 Home Health Services.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Hospice_Services_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Hospice Services.integerrequired : 1 level : Ratio
Medicare_Reimb_For_Skilled_Nursing_Facs_Per_EnrolleeTotal amount reimbursed per enrollee for year 2007 Skilled Nursing Facilities.integerlevel : Ratio
State_NumberStateMedicare_Enrollees_CMHS_Five_Percent_SampleTotal_Medicare_Reimb_Part_A_And_B_Per_EnrolleeTotal_Part_A_Medicare_Reimb_Per_EnrolleeTotal_Part_B_Medicare_Reimb_Per_EnrolleeMedicare_Reimb_For_Inpatient_Short_Stays_Per_EnrolleeMedicare_Reimb_For_Inpatient_Long_Stays_Per_EnrolleeMedicare_Reimb_For_Outpatient_Services_Per_EnrolleePart_B_Medicare_Reimb_For_Prof_And_Lab_Services_Per_EnrolleePart_B_Medicare_Reimb_For_Med_And_Surgi_Services_Per_EnrolleePart_B_Medicare_Reimb_For_Medical_Care_Per_EnrolleePart_B_Medicare_Reimb_For_Surgical_Services_Per_EnrolleePart_B_Medicare_Reimb_For_Diag_Lab_And_Xray_Services_Per_EnrolleePart_B_Medicare_Reimb_For_Durable_Medical_Equipment_Per_EnrolleeMedicare_Reimb_For_Home_Health_Services_Per_EnrolleeMedicare_Reimb_For_Hospice_Services_Per_EnrolleeMedicare_Reimb_For_Skilled_Nursing_Facs_Per_Enrollee
2Alaska1940803546953355353355813201407108679728932213223248379
12Hawaii434859263190273624051598581436108182725435592122126416
13Idaho6280640333313069187847611401205919596320286245305253598
46Utah72897297372735682187195100115471228827399319319605488673
16Iowa174986686349831902238414127613801076749327303221162230528
20Maine86657259395033092428428135313091024722301286175358154745
53Wyoming288665133547296722225159851252981646333272348169113607
36Ohio5611585304845368430224141057184714331048386414221352256954
47Vermont3828735039843366242662015791109909643266201138468108665
1Alabama235098217454236772826359857191814211029392497237503511630