Others titles
- Medicare Home Healthcare
- Medicare Suffix
- Medicare Doctors
- Medicare Reimbursements Data
- HSA Level Medicare Spending Claims
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
Medicare Spending Claims Based by Price Age Sex and Race HSA Level
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 healthcare 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.
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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 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. 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.
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, 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 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Year | The year in which data is recorded. | date | - |
HSA_Number | Hospital Service Area Identification Number. | integer | level : Nominal |
HSA_Name | Name 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. | string | - |
State_Abbreviation | Two-letter state abbreviation in the mailing address of the hospital. This includes information on hospitals in: | string | - |
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 2014-2016 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 2014-2016 adjusted by price, age, sex and race. | number | level : Ratio |
Hospital_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. | number | level : Ratio |
Physician_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to phsician. | 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. | number | level : Ratio |
Hospice_Reimb_Per_Enrollee_Price_Age_Sex_Race_Adj | The amount of money reimbursed to home health agency. | number | 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 | HSA Number | HSA Name | State Abbreviation | Medicare Enrollees | Medicare Reimb Per Enrollee Age Sex Race Adj | Medicare Reimb Per Enrollee Price Age Sex Race Adj | Hospital 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 | 1001 | Alabaster | AL | 7617 | 9293.0 | 10419.0 | 3751.0 | 4514.0 | 2958.0 | 3077.0 | 1154.0 | 1254.0 | 667.0 | 728.0 | 602.0 | 686.0 | 196 | 213 |
2014 | 1002 | Alexander City | AL | 3070 | 9092.0 | 10639.0 | 3079.0 | 3897.0 | 2520.0 | 2710.0 | 2061.0 | 2425.0 | 597.0 | 707.0 | 519.0 | 606.0 | 324 | 295 |
2014 | 1003 | Andalusia | AL | 4059 | 8963.0 | 10547.0 | 3501.0 | 4514.0 | 2590.0 | 2734.0 | 1387.0 | 1598.0 | 791.0 | 943.0 | 474.0 | 562.0 | 233 | 217 |
2014 | 1004 | Anniston | AL | 13082 | 8914.0 | 10544.0 | 3629.0 | 4736.0 | 2639.0 | 2822.0 | 1289.0 | 1468.0 | 601.0 | 675.0 | 570.0 | 686.0 | 213 | 195 |
2014 | 1006 | Ashland | AL | 1712 | 8531.0 | 9860.0 | 3503.0 | 4338.0 | 2485.0 | 2607.0 | 1490.0 | 1718.0 | 526.0 | 624.0 | 358.0 | 430.0 | 170 | 152 |
2014 | 1007 | Athens | AL | 7456 | 9116.0 | 10181.0 | 3490.0 | 4229.0 | 2834.0 | 2970.0 | 1489.0 | 1593.0 | 625.0 | 685.0 | 426.0 | 484.0 | 249 | 232 |
2014 | 1008 | Atmore | AL | 2102 | 9975.0 | 11742.0 | 4200.0 | 5394.0 | 2462.0 | 2522.0 | 1718.0 | 1981.0 | 949.0 | 1125.0 | 397.0 | 465.0 | 227 | 203 |
2014 | 1010 | Bessemer | AL | 7137 | 9023.0 | 10114.0 | 3701.0 | 4416.0 | 2681.0 | 2827.0 | 1476.0 | 1594.0 | 468.0 | 506.0 | 500.0 | 572.0 | 215 | 223 |
2014 | 1011 | Birmingham | AL | 63721 | 8541.0 | 9594.0 | 3473.0 | 4158.0 | 2726.0 | 2872.0 | 1265.0 | 1372.0 | 428.0 | 464.0 | 464.0 | 533.0 | 197 | 207 |
2014 | 1012 | Boaz | AL | 7694 | 9591.0 | 11180.0 | 3882.0 | 4889.0 | 2302.0 | 2453.0 | 1787.0 | 2087.0 | 843.0 | 961.0 | 584.0 | 645.0 | 245 | 223 |