NCHS has linked data from various surveys with Medicare program enrollment and health care utilization and expenditure data from the Centers for Medicare & Medicaid Services (CMS). Linkage of the NCHS survey participants with the CMS Medicare data provides the opportunity to study changes in health status, health care utilization and costs, and prescription drug use among Medicare enrollees. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

Abstract

This is a Medicare dataset released by the Center for Medicare and Medicaid Services (CMS) and accessed via BigQuery. All data is from 2014.

Documentation

For more information regarding the CMS data, click here.

From BigQuery:

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, physicians, and other suppliers. The dataset includes the following data - common inpatient and outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions.

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.

Methodology

None

Usage

This dataset page includes some of the tables from the Medicare Data in PHS's possession. Other Medicare tables are included on other dataset pages on the PHS Data Portal. Depending upon your research question and your DUA with CMS, you may only need tables from a subset of the Medicare dataset pages, or you may need tables from all of them.

The location of each of the Medicare tables (i.e. a chart of which tables are included in each Medicare dataset page) is shown here.

Before Manuscript Submission

All manuscripts (and other items you'd like to publish) must be submitted to

support@stanfordphs.freshdesk.com for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

Documentation

CMS has created a set of analytical files that contain data from the Medicare Shared Saving Program. There are two separate files in this data set:

• The Shared Savings Program Beneficiary-Level Research Identifiable File (RIF)
• The Shared Savings Program Provider-Level RIF

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Section 2

Metadata access is required to view this section.

The CMS Program Statistics - Medicare Advantage & Other Health Plan Enrollment tables provide data on characteristics of the population covered by Medicare Advantage & other health plans.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR ENROLL AB 15. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend
MDCR ENROLL AB 16. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend
MDCR ENROLL AB 17. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics
MDCR ENROLL AB 18. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics
MDCR ENROLL AB 19. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence
MDCR ENROLL AB 20. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

The CMS Program Statistics – Medicare Advantage, Physician, Non-Physician Practitioner and Supplier tables provide utilization data for physician, non-physician practitioners, and suppliers, by Medicare Advantage beneficiaries.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR PHYSSUPP MA 1. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR PHYSSUPP MA 2. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR PHYSSUPP MA 3. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Area of Residence
MDCR PHYSSUPP MA 4. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Place of Service
MDCR PHYSSUPP MA 5. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Restructured BETOS Classification System

The CMS Program Statistics – Medicare Advantage, Outpatient Facility tables provide utilization data for outpatient facilities, by Medicare Advantage beneficiaries.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR OUTPATIENT MA 1. Medicare Outpatient Facilities: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR OUTPATIENT MA 2. Medicare Outpatient Facilities: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR OUTPATIENT MA 3. Medicare Outpatient Facilities: Utilization for Medicare Advantage Beneficiaries, by Area of Residence

The CMS Program Statistics - Medicare Newly Enrolled tables provide data on characteristics of the newly enrolled Medicare population.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR ENROLL AB 21. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Enrollees, Yearly Trend
MDCR ENROLL AB 22. Medicare Newly Enrolled Beneficiaries: Total Enrollees by Month of Enrollment, Yearly Trend
MDCR ENROLL AB 23. Medicare Newly Enrolled Beneficiaries: Total Enrollees, by Demographic Characteristics
MDCR ENROLL AB 24. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Enrollees, by Area of Residence
MDCR ENROLL AB 25. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Original Medicare Enrollees
MDCR ENROLL AB 26. Medicare Newly Enrolled Beneficiaries: Original Medicare Enrollees by Month of Enrollment, Yearly Trend
MDCR ENROLL AB 27. Medicare Newly Enrolled Beneficiaries: Original Medicare Enrollees, by Demographic Characteristics
MDCR ENROLL AB 28. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Original Medicare Enrollees, by Area of Residence
MDCR ENROLL AB 29. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Medicare Advantage and Other Health Plan Enrollees, Yearly Trend
MDCR ENROLL AB 30. Medicare Newly Enrolled Beneficiaries: Medicare Advantage and Other Health Plan Enrollees, by Month of Enrollment, Yearly Trend
MDCR ENROLL AB 31. Medicare Newly Enrolled Beneficiaries: Medicare Advantage and Other Health Plan Enrollees, by Demographic Characteristics
MDCR ENROLL AB 32. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Medicare Advantage and Other Health Plan Enrollees, by Area of Residence

The Medicare Home Health Agency tables provide use and payment data for home health agencies. The tables include use and expenditure data from home health Part A (Hospital Insurance) and Part B (Medical Insurance) claims.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR HHA 1. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR HHA 2. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR HHA 3. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Area of Residence
MDCR HHA 4. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, Type of Agency and Type of Service Visit
MDCR HHA 5. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, by Type of Control and Type of Service Visit
MDCR HHA 6. Medicare Home Health Agencies: Persons with Utilization, Total Service Visits, and Program Payments for Original Medicare Beneficiaries, by Number of Service Visits and Number of Episodes

The CMS Program Statistics - Medicare Hospice tables provide use and payment data for hospice.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR HOSPICE 1. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR HOSPICE 2. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR HOSPICE 3. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Area of Residence
MDCR HOSPICE 4. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Control and Type of Service Visit
MDCR HOSPICE 5. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Level of Care and Site of Service
MDCR HOSPICE 6. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Number of Service Visits

This blog post was posted by Niall Brennan on June 4, 2012.

The CMS Program Statistics - Medicare Providers summary tables provide data on institutional (i.e., hospitals, skilled nursing facilities, home health agencies, hospices, etc.) and non-institutional (i.e., physicians, nonphysicians, specialists, and suppliers) providers.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR PROVIDERS 1. Medicare Providers: Number of Medicare Certified Institutional Providers, Yearly Trend
MDCR PROVIDERS 2. Medicare Providers: Number of Medicare Certified Inpatient Hospital and Skilled Nursing Facility Beds and Beds Per 1,000 Enrollees, Yearly Trend
MDCR PROVIDERS 3. Medicare Providers: Number of Medicare Certified Facilities, by Type of Control, Yearly Trend
MDCR PROVIDERS 4. Medicare Providers: Number of Skilled Nursing Facilities and Medicare Certified Hospitals, and Number of Beds, by State, Territories, Possessions and Other Areas
MDCR PROVIDERS 5. Medicare Providers: Number of Medicare Certified Providers, by Type of Provider, by State, Territories, Possessions, and Other Areas
MDCR PROVIDERS 6. Medicare Providers: Number of Medicare Non-Institutional Providers by Specialty, Yearly Trend
MDCR PROVIDERS 7. Medicare Providers: Number of Medicare Non-Institutional Providers, by State, Territories, Possessions, and Other Areas, Yearly Trend

The CMS Program Statistics - Medicare Skilled Nursing Facility tables provide use and payment data for skilled nursing facilities.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR SNF 1. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR SNF 2. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR SNF 3. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Area of Residence
MDCR SNF 4. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement and Covered Days of Care
MDCR SNF 5. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Facility and Bedsize
MDCR SNF 6. Medicare Skilled Nursing Facilities: Distribution of Medicare Covered Skilled Nursing Facility Days, by State of Provider and Major Resource Utilization Groups (RUG)-III (versions 2013-2018 only)

The CMS Program Statistics - Medicare Total Enrollment tables provide data on characteristics of the Medicare-covered populations.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR ENROLL AB 1. Total Medicare Enrollment: Total, Original Medicare, and Medicare Advantage and Other Health Plan Enrollment, Yearly Trend
MDCR ENROLL AB 2. Total Medicare Enrollment: Total, Original Medicare, Medicare Advantage and Other Health Plan Enrollment, and Resident Population, by Area of Residence
MDCR ENROLL AB 3. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend
MDCR ENROLL AB 4. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend
MDCR ENROLL AB 5. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics
MDCR ENROLL AB 6. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics
MDCR ENROLL AB 7. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence
MDCR ENROLL AB 8. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

The CMS Program Statistics - Medicare Advantage, Inpatient Hospital tables provide utilization data for inpatient hospitals, including short-stay hospitals, critical access hospitals, long term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other hospitals, by Medicare Advantage beneficiaries.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR INPT HOSP MA 4. All Medicare Inpatient Hospital Types: Utilization for Medicare Advantage Beneficiaries, by Type of Hospital
MDCR INPT HOSP MA 5. Medicare Short Stay Hospitals: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR INPT HOSP MA 6. Medicare Short Stay Hospitals: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR INPT HOSP MA 7. Medicare Short Stay Hospitals: Utilization for Medicare Advantage Beneficiaries, by Area of Residence

MDCR INPT HOSP MA 1 – MDCR INPT HOSP MA 3 are not available at this time.

The CMS Program Statistics - Medicare-Medicaid Enrollment tables provide data on characteristics of the Medicare-Medicaid enrollee population.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR ENROLL AB 40. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility, Yearly Trend
MDCR ENROLL AB 41. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and by Demographic Characteristics
MDCR ENROLL AB 42. Medicare-Medicaid Enrollment (MME): Total Medicare-Medicaid Enrollees by Type of Eligibility and Area of Residence
MDCR ENROLL AB 43. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility, Yearly Trend
MDCR ENROLL AB 44. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility and by Demographic Characteristics
MDCR ENROLL AB 45. Medicare-Medicaid Enrollment (MME): Original Medicare Enrollees by Type of Eligibility and Area of Residence
MDCR ENROLL AB 46. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility, Yearly Trend
MDCR ENROLL AB 47. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility and by Demographic Characteristics
MDCR ENROLL AB 48. Medicare-Medicaid Enrollment (MME): Medicare Advantage and Other Health Plan Enrollees by Type of Eligibility and Area of Residence

The Centers for Medicare & Medicaid Services (CMS) Special Terms and Conditions (STC) Datasets.

The CMS Program Statistics - Medicare Part D tables provide use and Part D drug costs by type of Part D plan (stand-alone prescription drug plan and Medicare Advantage prescription drug plan).

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

Below is the list of tables:

MDCR UTLZN D 1. Medicare Part D Utilization: Average Annual Prescription Drug Fills by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Generic Dispensing Rate, Yearly Trend
MDCR UTLZN D 2. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend
MDCR UTLZN D 3. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend
MDCR UTLZN D 4. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan and Demographic Characteristics
MDCR UTLZN D 5. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan and Demographic Characteristics
MDCR UTLZN D 6. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan, by Area of Residence
MDCR UTLZN D 7. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan, by Area of Residence
MDCR UTLZN D 8. Medicare Part D Utilization: Number of Part D Utilizers and Average Annual Prescription Drug Fills by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend
MDCR UTLZN D 9. Medicare Part D Utilization: Number of Part D Utilizers and Drug Costs by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend
MDCR UTLZN D 10. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Events (Fills) and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Demographic Characteristics
MDCR UTLZN D 11. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Area of Residence

Abstract

This is a synthetic patient dataset in the OMOP Common Data Model v5.2, originally released by the CMS and accessed via BigQuery. The dataset includes 24 tables and records for 2 million synthetic patients from 2008 to 2010.

Methodology

This dataset takes on the format of the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). As shown in the diagram below, the purpose of the Common Data Model is to convert various distinctly-formatted datasets into a well-known, universal format with a set of standardized vocabularies. See the diagram below from the Observational Health Data Sciences and Informatics (OHDSI) webpage.

https://redivis.com/fileUploads/d1a95a4e-074a-44d1-92e5-9adfd2f4068a%3E" alt="Why-CDM.png">

Such universal data models ultimately enable researchers to streamline the analysis of observational medical data. For more information regarding the OMOP CDM, refer to the OHSDI OMOP site.

Usage

%3Cli%3EFor documentation regarding the source data format from the Center for Medicare and Medicaid Services (CMS), refer to the %3Ca href="https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/SynPUFs/DE_Syn_PUF"%3ECMS Synthetic Public Use File%3C/a%3E.%3C/li%3E

%3Cli%3EFor information regarding the conversion of the CMS data file to the OMOP CDM v5.2, refer to %3Ca href="https://github.com/OHDSI/ETL-CMS"%3Ethis OHDSI GitHub page%3C/a%3E. %3C/li%3E

%3Cli%3EFor information regarding each of the 24 tables in this dataset, including more detailed variable metadata, see %3Ca href="https://github.com/OHDSI/CommonDataModel/wiki"%3Ethe OHDSI CDM GitHub Wiki page%3C/a%3E. All variable labels and descriptions as well as table descriptions come from this Wiki page. Note that this GitHub page includes information primarily regarding the 6.0 version of the CDM and that this dataset works with the 5.2 version. %3C/li%3E

This is the "Provider of Service" extract from the Quality Improvement Evaluation System (QIES) database maintained by the Centers for Medicare & Medicaid Services (CMS). These data include provider number, name, and address and characterize the participating institutional provider (including hospitals, skilled nursing facilities, home health agencies, and other types of facilities). The data are collected through the CMS Regional Offices. The file contains an individual record for each Medicare-approved provider and is updated quarterly.

http://datawarehouse.hrsa.gov/tools/dataportal.aspx

Simulated dataset QCD_Pt_300to470_TuneCP5_13TeV_pythia8 in NANOAODSIM format for 2016 collision data.

See the description of the simulated dataset names in: About CMS simulated dataset names.

These simulated datasets correspond to the collision data collected by the CMS experiment in 2016.