Demos
Others titles
- Medicare Hospital Service Area HRR and HSA Spending
- Medicare Reimbursements Data
- Hospital Service Area
- Medicare Reimbursement
Keywords
- Medicare CMHS Based Spending
- Medicare Spending HSA Level
- Medicare Spending
- Continuous Medicare History Sample
- Health Insurance Claim
Medicare Spending CMHS Based by Age Sex and Race HSA Level
This dataset includes the Hospital Service Area (HSA) level Medicare spending CMHS based data by 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. 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. The Continuous Medicare History Sample file was used to analyze trends in the spending concentration over thirty years.
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.
About this Dataset
Data Info
| Date Created | 2007 |
|---|---|
| Last Modified | 2014 |
| Version | 2014 |
| Update Frequency |
Never |
| Temporal Coverage |
N/A |
| 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 CMHS Based Spending, Medicare Spending HSA Level, Medicare Spending, Continuous Medicare History Sample, Health Insurance Claim |
| Other Titles | Medicare Hospital Service Area HRR and HSA Spending, Medicare Reimbursements Data, Hospital Service Area, Medicare Reimbursement |
Data Fields
| Name | Description | Type | Constraints |
|---|---|---|---|
| HSA_Number | Hospital Service Area Identification Number. | integer | level : Nominalrequired : 1 |
| HSA_Label | 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 | required : 1 |
| Medicare_Enrollees_CMHS_Five_Percent_Sample_2007 | Number 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 on the Health Insurance Claim (HIC) number | integer | level : Ratio |
| Total_Medicare_Reimb_Part_A_And_B_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 both Part A and B claims. | integer | level : Ratio |
| Total_Part_A_Medicare_Reimb_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part A claims. | integer | level : Ratio |
| Total_Part_B_Medicare_Reimb_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims. | integer | level : Ratio |
| Medicare_Reimb_For_Inpatient_Short_Stays_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Inpatient Short Stays. | integer | level : Ratio |
| Medicare_Reimb_For_Inpatient_Long_Stays_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Inpatient long Stays. | integer | level : Ratio |
| Medicare_Reimb_For_Outpatient_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Outpatient Services. | integer | level : Ratio |
| Part_B_Medicare_Reimb_For_Prof_And_Lab_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims for Professional and Laboratory services. | integer | level : Ratio |
| Part_B_Medicare_Reimb_For_Med_And_Surgi_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims for Medical and Surgical services. | integer | level : Ratio |
| Part_B_Medicare_Reimb_For_Medical_Care_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims for Medical Care. | integer | level : Ratio |
| Part_B_Medicare_Reimb_For_Surgical_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims for Surgical Services. | integer | level : Ratio |
| Part_B_Medicare_Reimb_For_Diag_Lab_And_Xray_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims for Diagnostic Laboratory and X-ray Services. | integer | level : Ratio |
| Part_B_Medicare_Reimb_For_Durable_Medical_Equipment_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Part B claims for Durable Medical Equipment. | integer | level : Ratio |
| Medicare_Reimb_For_Home_Health_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Home Health Services. | integer | level : Ratio |
| Medicare_Reimb_For_Hospice_Services_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Hospice Services. | integer | level : Ratio |
| Medicare_Reimb_For_Skilled_Nursing_Facs_Per_Enrollee_2007 | Total amount reimbursed per enrollee for year 2007 Skilled Nursing Facilities. | integer | level : Ratio |
Data Preview
| HSA Number | HSA Label | Medicare Enrollees CMHS Five Percent Sample 2007 | Total Medicare Reimb Part A And B Per Enrollee 2007 | Total Part A Medicare Reimb Per Enrollee 2007 | Total Part B Medicare Reimb Per Enrollee 2007 | Medicare Reimb For Inpatient Short Stays Per Enrollee 2007 | Medicare Reimb For Inpatient Long Stays Per Enrollee 2007 | Medicare Reimb For Outpatient Services Per Enrollee 2007 | Part B Medicare Reimb For Prof And Lab Services Per Enrollee 2007 | Part B Medicare Reimb For Med And Surgi Services Per Enrollee 2007 | Part B Medicare Reimb For Medical Care Per Enrollee 2007 | Part B Medicare Reimb For Surgical Services Per Enrollee 2007 | Part B Medicare Reimb For Diag Lab And Xray Services Per Enrollee 2007 | Part B Medicare Reimb For Durable Medical Equipment Per Enrollee 2007 | Medicare Reimb For Home Health Services Per Enrollee 2007 | Medicare Reimb For Hospice Services Per Enrollee 2007 | Medicare Reimb For Skilled Nursing Facs Per Enrollee 2007 |
| 1001 | AL-Alabaster | 340 | 9039 | 4896.0 | 4142 | 2859.0 | 938 | 2158 | 1527 | 1061 | 465 | 630 | 283.0 | 618.0 | |||
| 1002 | AL-Alexander City | 152 | 10381 | 5455.0 | 4937 | 3030.0 | 1349 | 2496 | 1827 | 1388 | 436 | 669 | 436.0 | ||||
| 1003 | AL-Andalusia | 220 | 7541 | 4390.0 | 3153 | 2528.0 | 521 | 1728 | 1169 | 741 | 428 | 560 | 242.0 | ||||
| 1004 | AL-Anniston | 621 | 8105 | 4485.0 | 3623 | 3046.0 | 901 | 1873 | 1382 | 952 | 431 | 490 | 289.0 | 557.0 | 404.0 | ||
| 1006 | AL-Ashland | 118 | 8255 | 5052.0 | 3215 | 848 | 1462 | 1071 | 699 | 373 | 391 | 252.0 | |||||
| 1007 | AL-Athens | 356 | 8067 | 4385.0 | 3682 | 3183.0 | 662 | 1871 | 1429 | 1037 | 392 | 443 | 289.0 | 825.0 | |||
| 1008 | AL-Atmore | 91 | 7335 | 3290 | 661 | 1580 | 1201 | 837 | 365 | 380 | |||||||
| 1010 | AL-Bessemer | 371 | 8624 | 5274.0 | 3363 | 3202.0 | 795 | 1964 | 1525 | 1071 | 455 | 439 | 158.0 | 326.0 | |||
| 1011 | AL-Birmingham | 3053 | 7941 | 4334.0 | 3607 | 2494.0 | 523.0 | 856 | 1988 | 1438 | 1033 | 405 | 551 | 211.0 | 415.0 | 528.0 | 595.0 |
| 1012 | AL-Boaz | 399 | 9197 | 4808.0 | 4382 | 3397.0 | 1398 | 1882 | 1306 | 944 | 362 | 575 | 312.0 | 705.0 |