In 1970, some 7.5 billion U.S. dollars were spent on the Medicare program in the United States. Fifty plus years later, this figure stood at 1,122.1 billion U.S. dollars. This statistic depicts total Medicare spending from 1970 to 2024. Increasing Medicare coverage Medicare is the federal health insurance program in the U.S. for the elderly and those with disabilities. In the U.S., the share of the population with any type of health insurance has increased to over 90 percent in the past decade. As of 2019, approximately 18 percent of the U.S. population was covered by Medicare in particular. Increasing Medicare costs Medicare costs are forecasted to continue increasing over time, with outlays rising to a predicted 1.78 trillion U.S. dollars by 2031 as the population continues to age. Certain diseases of old age, such as Alzheimer’s disease, are increasing in prevalence in the U.S., which will reflect on healthcare costs for the elderly. In 2021, Alzheimer's disease was estimated to cost Medicare and Medicaid around 239 billion U.S. dollars in care costs; by 2050, this number is projected to climb to 798 billion dollars.

2023 saw the largest expenditures on Medicaid in U.S. history. At that time about 894 billion U.S. dollars were expended on the Medicaid public health insurance program that aims to provide affordable health care options to low income residents and people with disabilities. Medicaid was signed into law in 1965. By 1975 around 13 billion U.S. dollars were spent on the program. Groups covered by Medicaid There are several components of the Medicaid health insurance program. The Children’s Health Insurance Program (CHIP) was started in 1997 to provide health coverage to families and children that could not afford care. As of 2021, children represented the largest distribution of Medicaid enrollees. Despite having the largest proportion of enrollees, those that were enrolled in Medicaid as children had the lowest spending per enrollee. As of 2021, disabled Medicaid enrollees had the highest spending per enrollee. Medicaid expenditures Currently, Medicaid accounts for 19 percent of all health care expenditure in the United States. Expenditures on Medicaid programs vary among the U.S. states and depend heavily on whether Medicaid expansion was accepted after the Affordable Care Act was enacted. California and New York are the top states with the highest Medicaid expenditures. It is projected that Medicaid expenditure will continue to increase at both the state and federal levels.

This data package contains the information of Medicare and Medicaid healthcare spending and healthcare cost and percentages by state.

The statistic represents the total Medicaid spending projections from 2018 to 2029, as a percentage of the gross domestic product. Medicaid spending totaled to 389 billion U.S. dollars in 2018, which was about 1.9 percent of the U.S. GDP.

In 2021, Medicare spent an average of more than 13,139 U.S. dollars per enrollee in New York, while the average for the United States was 11,080 U.S. dollars per enrollee. This statistic depicts the leading ten U.S. states based on Medicare spending per enrollee in 2021.

This dataset includes the county level Medicare spending claims based data by price, age, sex and race. The variables included are: state, number of Medicare enrollees, total Medicare reimbursements per enrollee, hospital and skilled nursing facility reimbursements per enrollee, physician reimbursements per enrollee, outpatient facility reimbursements per enrollee, home health agency reimbursements per enrollee, hospice reimbursements per enrollee, and durable medical equipment per enrollee.

Medicare Spending per Beneficiary

Detailed Hospital Expense Breakdown

By Health [source]

About this dataset

This file allows healthcare executives and analysts to make informed decisions regarding how well continued improvements are being made over time so that they can understand how efficient they are fulfilling treatments while staying within budgetary constraints. Additionally, it’ll also help them map out trends amongst different hospitals and spot anomalies that could indicate areas where decisions should be reassessed as needed

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How to use the dataset

This dataset can provide valuable insights into how Medicare is spending per patient at specific hospitals in the United States. It can be used to gain a better understanding of the types of services covered under Medicare, and to what extent those services are being used. By comparing the average Medicare spending across different hospitals, users can also gain insight into potential disparities in care delivery or availability.

To use this dataset, first identify which hospital you are interested in analyzing. Then locate the row for that hospital in the dataset and review its associated values: value, footnote (optional), and start/end dates (optional). The Value column refers to how much Medicare spends on each particular patient; this is a numerical value represented as a decimal number up to 6 decimal places. The Footnote (optional) provides more information about any special circumstances that may need attention when interpreting the value data points. Finally, if Start Date and End Date fields are present they will specify over what timeframe these values were aggregated over.

Once all relevant data elements have been reviewed successively for all hospitals of interest then comparison analysis among them can be conducted based on Value, Footnote or Start/End dates as necessary to answer specific research questions or formulate conclusions about how Medicare is spending per patient at various hospitals nationwide

Research Ideas

• Developing a cost comparison tool for hospitals that allows patients to compare how much Medicare spends per patient across different hospitals.
• Creating an algorithm to help predict Medicare spending at different facilities over time and build strategies on how best to manage those costs.
• Identifying areas in which a hospital can save money by reducing unnecessary spending in order to reduce overall Medicare expenses

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

License: Dataset copyright by authors - You are free to: - Share - copy and redistribute the material in any medium or format for any purpose, even commercially. - Adapt - remix, transform, and build upon the material for any purpose, even commercially. - You must: - Give appropriate credit - Provide a link to the license, and indicate if changes were made. - ShareAlike - You must distribute your contributions under the same license as the original. - Keep intact - all notices that refer to this license, including copyright notices.

Columns

File: Medicare_hospital_spending_per_patient_Medicare_Spending_per_Beneficiary_Additional_Decimal_Places.csv | Column name | Description | |:---------------|:--------------------------------------------------------------------------------------| | Value | The amount of Medicare spending per patient for a given hospital or region. (Numeric) | | Footnote | Any additional notes or information related to the value. (Text) | | Start_Date | The start date of the period for which the value applies. (Date) | | End_Date | The end date of the period for which the value applies. (Date) |

Acknowledgements

If you use this dataset in your research, please credit the original authors. If you use this dataset in your research, please credit Health.

The Medicare Part D by Drug dataset presents information on spending for drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other healthcare providers. Drugs prescribed in the Medicare Part D program are drugs patients generally administer themselves.The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications.Drug spending metrics for Part D drugs are based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments. The Part D spending metrics do not reflect any manufacturers’ rebates or other price concessions as CMS is prohibited from publicly disclosing such information.

This data package contains Medicare spending statistics for beneficiaries grouped according to their age, gender, race/ethnicity and geographical location. At the same time, it provides data about spendings taking into consideration provider specific coordinates like the Hospital Referral Region (HRR) or Hospital Service Area (HSA). The data package contains as well as spending statistics based on the payment system, like the Outpatient Prospective Payment System.

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.

The Medicaid by Drug dataset presents information on spending for covered outpatient drugs prescribed to beneficiaries enrolled in Medicaid by physicians and other healthcare professionals. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. Units refer to the drug unit in the lowest dispensable amount. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications.Drug spending metrics for Medicaid represent the total amount reimbursed by both Medicaid and non-Medicaid entities to pharmacies for the drug. Medicaid drug spending contains both the Federal and State reimbursement and is inclusive of any applicable dispensing fees. In addition, this total is not reduced or affected by Medicaid rebates paid to the states.

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.

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarizes the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals. The dataset includes the following data - common inpatient and outpatient services from 2012 to 2015.

Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure.

In 2022, Medicare and Medicaid national health expenditures reached 944 billion U.S. dollars and 805 billion U.S. dollars, respectively. The largest expense category for both healthcare care programs was hospital care. Long-term care solutions Medicaid’s second-largest expense category was other health care, which includes programs that provide alternatives to long-term institutional services. The use of home- and community-based services can substantially reduce expenditures for enrollees who would otherwise have to receive care in an institutional setting, such as a nursing home. In recent decades, there has been a significant shift in the distribution of Medicaid’s long-term care services expenditures. Medicaid’s federal-state partnership Medicare is a health insurance program solely funded by the federal government, whereas Medicaid plays an important role in both federal and state budgets. The federal government establishes certain parameters for all states to follow, but states can decide who gets coverage and what gets covered in its version of Medicaid. In 2021, California was the state with the highest Medicaid expenditure.

Also known as Medicare Spending per Beneficiary (MSPB) Spending Breakdowns by Claim Type file. The data displayed here show average spending levels during hospitals’ Medicare Spending per Beneficiary (MSPB) episodes. An MSPB episode includes all Medicare Part A and Part B claims paid during the period from 3 days prior to a hospital admission through 30 days after discharge. These average Medicare payment amounts have been price-standardized to remove the effect of geographic payment differences and add-on payments for indirect medical education (IME) and disproportionate share hospitals (DSH). CMS uses the information on this webpage to calculate a hospital’s MSPB Measure value, which is reported on Hospital Compare. Specifically, the MSPB Measure methodology risk-adjusts the values on this webpage to account for beneficiary age and severity of illness. This data set provides the pre-risk-adjusted values to help the public understand the MSPB Measure and its composition.

Question: What is the association between growth in Medicare expenditures and decreased mortality between January 1, 1999, and June 30, 2014? Findings: In this cross-sectional analysis study of Medicare beneficiaries with acute myocardial infarction, reductions in mortality varied by hospital and were associated with diffusion of cost-effective care, such as early percutaneous coronary interventions, rather than overall spending. Meaning: Increased adoption of cost-effective care at the hospital level could improve patient outcomes and, if accompanied by cuts in cost-ineffective care (whether in the acute care or postacute care setting), may also reduce expenditures. Importance: Many studies have considered the association between Medicare spending and health outcomes at a point in time; few have considered the association between the long-term growth in spending and outcomes. Objective: To assess whether components of growth in Medicare expenditures are associated with mortality rates between January 1, 1999, and June 30, 2014, for beneficiaries hospitalized for acute myocardial infarction. Design, Setting, and Participants: Cross-sectional analysis of a random 20% sample of fee-for-service Medicare beneficiaries from January 1, 1999, through December 31, 2000 (n=72 473) and January 1, 2004, through December 31, 2004 (n=38 248), and 100% sample from January 1, 2008, through December 31, 2008 (n=159 558) and January 1, 2013, through June 30, 2014 (n=209 614) admitted with acute myocardial infarction to 1220 hospitals. Main Outcomes and Measures: Primary exposure measures include the growth of 180-day expenditure components (eg, inpatient, physician, and postacute care) and early percutaneous coronary intervention by hospitals adjusted for price differences and inflation. The primary outcome is the risk-adjusted 180-day case fatality rate. Results: Patients in each of the years 2004, 2008, and 2013-2014 (relative to those in 1999-2000) were qualitatively of equivalent age, less likely to be white or female, and more likely to be diabetic (all P<.001). Adjusted expenditures per patient increased 13.9% from January 1, 1999, through December 31, 2000, and January 1, 2013, through June 30, 2014, but declined 0.5% between 2008 and 2013-2014. Mean (SD) expenditures in the 5.0% of hospitals (n=61) with the most rapid expenditure growth between 1999-2000 and 2013-2014 increased by 44.1% ($12 828 [$2315]); for the 5.0% of hospitals with the slowest expenditure growth (n=61), mean expenditures decreased by 18.7% (−$7384 [$4141]; 95% CI, $8177-$6496). The growth in early percutaneous coronary intervention exhibited a negative association with 180-day case fatality. Spending on cardiac procedures was positively associated with 180-day mortality, while postacute care spending exhibited moderate cost-effectiveness ($455 000 per life saved after 180 days; 95% CI, $323 000-$833 000). Beyond spending on noncardiac procedures, growth in other components of spending was not associated with health improvements. Conclusions and Relevance: Health improvements for patients with acute myocardial infarction varied across hospitals and were associated with the diffusion of cost-effective care, such as early percutaneous coronary intervention and, to a lesser extent, postacute care, rather than overall expenditure growth. Interventions designed to promote hospital adoption of cost-effective care could improve patient outcomes and, if accompanied by cuts in cost-ineffective care (inside and outside of the hospital setting), also reduce expenditures.

In 2021, Medicare spending per beneficiary amounted an average of ****** U.S. dollars, a fairly sharp increase from the previous year. Medicare spending per person has being steadily rising over the provided time interval. Growth in health care spending is influenced by increasing volume and use of services, new technologies, and rising prices. This statistic displays the per capita Medicare spending in the U.S. from 2010 to 2021.

Medicare outlays in the United States reached 3.2 percent of GDP in 2024. This amounted to a total value of 910 billion U.S. dollars. The share of this expenditure was expected to increase to four percent of U.S. GDP by 2035.

The data displayed here describes average spending levels during hospitals’ Medicare Spending per Beneficiary (MSPB) episodes by Medicare claim type. The data presented on Hospital Compare provide price-standardized, non-risk-adjusted values for hospital spending by claim type because risk adjustment is done at the episode level rather than at the service category/claim level. An MSPB episode includes all Medicare Part A and Part B claims paid during the period from 3 days prior to an inpatient hospital admission through 30 days after discharge.

Medicare spending and utilization by population segment.