Others titles
- Medicare Home Healthcare
- Medicare Services Reimburesement Measures
- Medicare Doctors
- Medicare Reimbursements Data
- HRR Level Medicare Spending Claims
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
Medicare Spending Claims Based by Price Age Sex and Race HRR Level
![Medicare Spending Claims Based by Price Age Sex and Race HRR Level](https://www.johnsnowlabs.com/wp-content/uploads/2018/09/normal/Medicare-Claims-and-Utilization.png)
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 healthcare 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.
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Description
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 healthcare 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. 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.
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.
About this Dataset
Data Info
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 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 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Year | The year in which data is recorded. | date | - |
HRR_Number | Hospital Referral Region Identification Number. | integer | level : Nominal |
HRR_Name | Name 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. | string | required : 1 |
State_Abbreviation | Two-letter state abbreviation in the mailing address of the hospital. This includes information on hospitals in: | string | required : 1 |
Medicare_Enrollees | Number of medicare benificiaries in the year 2014. | integer | level : Ratio |
Medicare_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed per enrollee from years 2014 to 2016 adjusted by age, sex and race. | number | level : Ratio |
Medicare_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed per enrollee from years 2014 to 2016 adjusted by price, age, sex and race. | number | level : Ratio |
Hosp_Skilled_Nursing_Fac_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed to Hospital skilled nursing facility. | number | level : Ratio |
Hosp_Skilled_Nursing_Fac_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to Hospital skilled nursing facility. | number | level : Ratio |
Physician_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed to phsician by age sex and race adjusted. | number | level : Ratio |
Physician_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to phsician by price, age, sex and race adjusted. | number | level : Ratio |
Outpatient_Facility_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed to medicare outpatient facility. | number | level : Ratio |
Outpatient_Facility_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to medicare outpatient facility. | number | level : Ratio |
Home_Health_Agency_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed to home health agency. | number | level : Ratio |
Home_Health_Agency_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to home health agency. | number | level : Ratio |
Hospice_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed to hospice facility. | integer | level : Ratio |
Hospice_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to home health agency. | integer | level : Ratio |
Durable_Med_Equip_Reimb_Per_Enrollee_Age_Sex_Race_Adj | The amount of money reimbursed to Durable Medical Equipment facility. | integer | level : Ratio |
Durable_Med_Equip_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to Durable Medical Equipment facility. | integer | level : Ratio |
Data Preview
Year | HRR Number | HRR Name | State Abbreviation | Medicare Enrollees | Medicare Reimb Per Enrollee Age Sex Race Adj | Medicare Reimb Per Enrollee Price Age Sex Race Adj | Hosp Skilled Nursing Fac Reimb Per Enrollee Age Sex Race Adj | Hosp Skilled Nursing Fac Reimb Per Enrollee Price Age Sex Race Adj | Physician Reimb Per Enrollee Age Sex Race Adj | Physician Reimb Per Enrollee Price Age Sex Race Adj | Outpatient Facility Reimb Per Enrollee Age Sex Race Adj | Outpatient Facility Reimb Per Enrollee Price Age Sex Race Adj | Home Health Agency Reimb Per Enrollee Age Sex Race Adj | Home Health Agency Reimb Per Enrollee Price Age Sex Race Adj | Hospice Reimb Per Enrollee Age Sex Race Adj | Hospice Reimb Per Enrollee Price Age Sex Race Adj | Durable Med Equip Reimb Per Enrollee Age Sex Race Adj | Durable Med Equip Reimb Per Enrollee Price Age Sex Race Adj |
2014 | 1 | Birmingham | AL | 229203 | 8786.0 | 10075.0 | 3556.0 | 4379.0 | 2549.0 | 2695.0 | 1343.0 | 1504.0 | 560.0 | 636.0 | 571 | 671 | 227 | 218 |
2014 | 2 | Dothan | AL | 48788 | 8666.0 | 10129.0 | 3387.0 | 4328.0 | 2574.0 | 2729.0 | 1337.0 | 1533.0 | 551.0 | 638.0 | 615 | 728 | 230 | 209 |
2014 | 5 | Huntsville | AL | 72825 | 8783.0 | 9928.0 | 3389.0 | 4164.0 | 2868.0 | 3008.0 | 1325.0 | 1448.0 | 494.0 | 555.0 | 483 | 558 | 230 | 211 |
2014 | 6 | Mobile | AL | 76308 | 8439.0 | 9860.0 | 3275.0 | 4217.0 | 2557.0 | 2702.0 | 1279.0 | 1462.0 | 561.0 | 645.0 | 543 | 638 | 245 | 224 |
2014 | 7 | Montgomery | AL | 43958 | 8239.0 | 9530.0 | 3237.0 | 3992.0 | 2291.0 | 2453.0 | 1605.0 | 1831.0 | 435.0 | 503.0 | 454 | 546 | 230 | 211 |
2014 | 9 | Tuscaloosa | AL | 28946 | 8917.0 | 9914.0 | 3763.0 | 4424.0 | 2444.0 | 2598.0 | 1446.0 | 1565.0 | 631.0 | 691.0 | 424 | 443 | 214 | 192 |
2014 | 10 | Anchorage | AK | 56634 | 8703.0 | 6971.0 | 4102.0 | 3076.0 | 2334.0 | 1971.0 | 1660.0 | 1389.0 | 209.0 | 176.0 | 185 | 172 | 118 | 108 |
2014 | 11 | Mesa | AZ | 83658 | 9864.0 | 9849.0 | 3921.0 | 3980.0 | 3581.0 | 3588.0 | 1167.0 | 1121.0 | 406.0 | 389.0 | 596 | 565 | 182 | 194 |
2014 | 12 | Phoenix | AZ | 264301 | 9231.0 | 9011.0 | 3787.0 | 3646.0 | 3187.0 | 3191.0 | 1217.0 | 1170.0 | 313.0 | 299.0 | 541 | 517 | 187 | 185 |
2014 | 14 | Sun City | AZ | 44440 | 9163.0 | 9234.0 | 3220.0 | 3403.0 | 3731.0 | 3711.0 | 1263.0 | 1209.0 | 325.0 | 311.0 | 433 | 401 | 165 | 179 |