Context

In the United States, Medicare is a single-payer, national social insurance program administered by the U.S. federal government since 1966. It provides health insurance for Americans aged 65 and older who have worked and paid into the system through the payroll tax. Source: https://en.wikipedia.org/wiki/Medicare_(United_States)

Content

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 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.

Fork this kernel to get started.

Acknowledgements

https://bigquery.cloud.google.com/dataset/bigquery-public-data:medicare

https://cloud.google.com/bigquery/public-data/medicare

Dataset Source: Center for Medicare and Medicaid Services. This dataset is publicly available for anyone to use under the following terms provided by the Dataset Source - http://www.data.gov/privacy-policy#data_policy — and is provided "AS IS" without any warranty, express or implied, from Google. Google disclaims all liability for any damages, direct or indirect, resulting from the use of the dataset.

Banner Photo by @rawpixel from Unplash.

Inspiration

What is the total number of medications prescribed in each state?

What is the most prescribed medication in each state?

What is the average cost for inpatient and outpatient treatment in each city and state?

Which are the most common inpatient diagnostic conditions in the United States?

Which cities have the most number of cases for each diagnostic condition?

What are the average payments for these conditions in these cities and how do they compare to the national average?

The Medicare Current Beneficiary Survey (MCBS) - Survey File Microdata Public Use File (PUF) dataset provides information on topics such as Medicare beneficiaries' access to care, health status, other information regarding beneficiaries’ knowledge of, attitudes toward, and satisfaction with their health care, as well as demographic data and information on all types of health insurance coverage.Resources for Using and Understanding the DataThis dataset is based on information from the MCBS and administrative data. The MCBS is a continuous, multi-purpose longitudinal survey covering a representative national sample of the Medicare population, including the population of beneficiaries aged 65 and over and beneficiaries aged 64 and below with certain disabling conditions. The MCBS collects this information in three data collection periods, or rounds, per year. Disclosure protections have been applied to the file, including de-identification and other methods. As a result, the MCBS Survey File Microdata file does not require a Data Use Agreement (DUA). In contrast, the MCBS Limited Data Set (LDS) releases contain beneficiary-level protected health information (PHI) and therefore require a DUA. The MCBS - Survey File Microdata file is not intended to replace the more detailed LDS files but, rather, it makes available a general-use publicly-available alternative that provides the highest degree of protection to the Medicare beneficiaries’ PHI. The main benefits of using the MCBS - Survey File Microdata file are:Increased data access for researchers of the MCBS through a free file download that is consistent with other U.S. Department of Health and Human Services (HHS) public-use survey files.Enhanced potential for policy-relevant analyses, by attracting new researchers and policymakers. Accessing the MCBS LDS can be a significant deterrent due to the associated costs and time but the MCBS - Survey File Microdata file mitigates these barriers to encourage broader utilization. A link to the more detailed MCBS LDS files is provided in the Resources section on this page. MCBS LDS data are also presented in the MCBS Chartbook linked in the Visualization section on this page.

The Insurance Coverage of Noninstitutionalized Medicare Beneficiaries dataset includes data about Medicare insurance coverage beneficiaries aged 65 in the United States by age, gender, race, poverty and marital status between 1992 and 2015.

The DocGraph Teaming data set shows how healthcare providers in the United States team together to provide care to Medicare patients. The dataset is a simple graph data structure, using the National Provider Identifier as keys. We have not heard of a larger, publicly available graph data set that uses real identities. This file contains the links to both the data sets (which are many Gigabytes even as zip files) as well as the documentation for the data.Note: On Oct 5 2015, this data set was redacted due to signifigant issues with its content vs documentation. On Dec 15 2015, this data, along with updated documentation, was replaced. http://www.docgraph.com/teamingdatav2/

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

More Datasets

For more datasets, click here.

Featured Notebooks

• 🚨 Your notebook can be here! 🚨!

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.

2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims, Master Beneficiary Summary Files, and many other files. Indicators from this data source have been computed by personnel in CDC's Division for Heart Disease and Stroke Prevention (DHDSP). This is one of the datasets provided by the National Cardiovascular Disease Surveillance System. The system is designed to integrate multiple indicators from many data sources to provide a comprehensive picture of the public health burden of CVDs and associated risk factors in the United States. The data are organized by location (national and state) and indicator. The data can be plotted as trends and stratified by sex and race/ethnicity.

The MBSF mortality denominator can be used to study mortality rates of the elder population in the US. Access to CMS data is restricted. Processed datasets cannot be shared. Contact the authors if you've purchased CMS data through RESDAC and would like to use our data processing pipelines to clean CMS raw data and generate the MBSF mortality denominator. Medicare Overview In the United States, when individuals reach the age of 65, they become eligible for the Medicare federal health insurance program. Medicare also covers individuals under 65 if they have certain disabilities or End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). About CMS The Center for Medicare & Medicaid Services (CMS) is the federal agency responsible for managing the Medicare and Medicaid data. CMS makes predefined datasets available for purchase to researchers after they enter a Data usage agreement through Research Data Assistance Center (ResDAC). Master Beneficiary Summary File (MBSF) A beneficiary-level data from CMS/ResDAC is known as the Master Beneficiary Summary File (MBSF). The raw MBSF data contains basic demographic information of individuals, an indicator of death, and some details on their medicare enrollment. Mortality Denominator We refer to the mortality denominator as the clean subset of MBSF health data that is representative of the older population. The subset consists of the US elder population; notably, individuals under 64 who qualified because of a disability are excluded.

Medicare COVID-19 Hospitalization Trends

  Description

The Medicare COVID-19 Hospitalization Trends dataset contains aggregate information from Medicare Fee-for-Service claims, Medicare Advantage encounter, and Medicare enrollment data. It provides insight around the groups of beneficiaries that were hospitalized at different points during the pandemic.

CMS publicly released the first Preliminary Medicare COVID-19 Snapshot in June 2020 during the early stages of the… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/medicare-covid-19-hospitalization-trends.

The Part D Prescriber Public Use File (PUF) provides information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The Part D Prescriber PUF is based on information from CMSs Chronic Conditions Data Warehouse, which contains Prescription Drug Event records submitted by Medicare Advantage Prescription Drug (MAPD) plans and by stand-alone Prescription Drug Plans (PDP). The dataset identifies providers by their National Provider Identifier (NPI) and the specific prescriptions that were dispensed at their direction, listed by brand name (if applicable) and generic name. For each prescriber and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost. The total drug cost includes the ingredient cost of the medication, dispensing fees, sales tax, and any applicable administration fees and is based on the amount paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers. Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D prescriptions, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physicians entire practice or all of Medicare as it only includes information on beneficiaries enrolled in the Medicare Part D prescription drug program (i.e., approximately two-thirds of all Medicare beneficiaries). In addition, the data are not intended to indicate the quality of care provided. For additional limitations, please review the methodology document.

The Medicare Inpatient Hospitals by Provider and Service dataset provides information on inpatient discharges for Original Medicare Part A beneficiaries by IPPS hospitals. It includes information on the use, payment, and hospital charges for more than 3,000 U.S. hospitals that received IPPS payments. The data are organized by hospital and Medicare Severity Diagnosis Related Group (DRG). Hospitals determine what they will charge for items and services provided to patients, and these charges are the amount the hospital bills for an item or service. The Total Payment Amount includes the DRG amount, claim per diem amount, beneficiary primary payer claim payment amount, beneficiary Part A (Hospital Insurance) coinsurance amount, beneficiary deductible amount, beneficiary blood deductible amount and diagnosis related group outlier amount.

The Medicare Current Beneficiary Survey (MCBS) - Cost Supplement File Microdata Public Use File (PUF) dataset provides information on expenditures and payment sources for all services used by Medicare beneficiaries, including co-payments, deductibles, and non-covered services.

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.

These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data.

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.

We present a synthetic medicare claims dataset linked to environmental exposures and potential confounders. In most environmental health studies relying on claims data, data restrictions exist and the data cannot be shared publicly. Centers for Medicare and Medicaid services (CMS) has generated synthetic publicly available Medicare claims data for 2008-2010. In this dataset, we link the 2010 synthetic Medicare claims data to environmental exposures and potential confounders. We aggregated the Medicare claims synthetic data for 2010 to the county level. Data is compiled for the contiguous United States, which in 2010, included 3109 counties. We merged the Medicare claims synthetic data with air pollution exposure data, more specifically with estimates of 𝑃𝑀2.5 exposures obtained from Di et al., 2019, 2021, which provided daily and annual estimates of PM2.5 exposure at 1 km×1 km grid cells in the contiguous United States. We use Census Bureau (United States Census Bureau, 2021), the Center for Disease Control (Centers for Disease Control and Prevention (CDC), 2021), and GridMET (Abatzoglou, 2013) to obtain data on potential confounders. The mortality rate, as the outcome, was computed using the synthetic Medicare data (CMS, 2021). We use the average of surrounding counties to impute missing observations, except in the case of the CDC confounders, where we imputed missing values by generating a normal distribution for each state and randomly imputing from this distribution. The steps for generating the merged dataset are provided at NSAPH Synthetic Data Github Repository (https://github.com/NSAPH/synthetic_data). Analytic inferences based on this synthetic dataset should not be made. The aggregated dataset is composed of 46 columns and 3109 rows.

Medicare Diabetes Prevention Program

  Description

The Medicare Diabetes Prevention Program dataset contains information about suppliers from which eligible Medicare beneficiaries may be furnished associated services. The information in this dataset can include organization name, location, contact information, National Provider Identifier (NPI) among other data points. Location data populates the "Map of MDPP Suppliers furnishing MDPP Services" map.

  Dataset Details… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/medicare-diabetes-prevention-program.

Abstract (en): This data collection is the second in a series of data releases from the Medicare Current Beneficiary Survey (MCBS) relating to beneficiary access to medical care. The MCBS is a continuous, multipurpose survey of a representative sample of the Medicare population, both aged and disabled. Sample persons are interviewed three times a year over several years to form a continuous profile of their health care experience. Interviews are conducted regardless of whether the sample person resides at home or in a long-term care facility, using the questionnaire version appropriate to the setting. The MCBS also collects a variety of information about demographic characteristics (date of birth, sex, race, education, military service, and marital status), health status and functioning, access to care, sources of and satisfaction with care, insurance coverage, financial resources, and family supports. The 1992 interview data were collected during September through December of 1992, the fourth round of data collection. The 1992 data are designed to stand alone for cross-sectional analysis, or they can be used for longitudinal analysis. Weights are provided for both cross-sectional and longitudinal analysis. Medicare beneficiaries. Respondents were sampled from the Medicare enrollment file to be representative of the Medicare population as a whole and by age group: under 45, 45-64, 65-69, 70-74, 75-79, 80-84, and 85 and over. Because of interest in their special health care needs, the oldest old (85 and over) and the disabled (64 and under) were oversampled to permit detailed analysis of these subpopulations. The sample was drawn from 107 primary sampling units (PSUs). The 1992 Round 4 data include interviews for 10,388 persons who were interviewed in 1991 and for 1,995 new people added to the survey during the current round. The 1992 supplementary sample included newly enrolled beneficiaries, as well as previously enrolled beneficiaries who were included to improve coverage or to maintain the desired sample size. 2006-01-12 All files were removed from dataset 25 and flagged as study-level files, so that they will accompany all downloads.1997-04-22 Part 7 (Health Status and Functioning Record File) and Part 11 (Health Insurance Record File) have been resupplied by the principal investigator to correct several variables. In addition, the billing records data (Parts 25-30) were withdrawn from distribution by the principal investigator. On March 13, 1997, the HCFA withdrew the billing records data (Parts 25-30) from distribution.

The dataset contains information about the prevalence of chronic conditions among Original Medicare beneficiaries as well as about the spending and co-occurring conditions for those with each condition. The data are available for California and for the rest of the United States, overall and by demographic and geographic groups. Additionally, the data are available for each of 19 California geographic regions overall and by demographic and geographic groups. The data represent Medicare beneficiaries who are in the Original Medicare program. Medicare offers health care coverage for older adults and certain individuals with disabilities. The Original Medicare program is Parts A and B of Medicare, administered by the U.S. Centers for Medicare & Medicaid Services. The analysis excludes enrollees of the Medicare Advantage program, administered by private insurers, because Medicare Advantage data are incomplete.

Hospitals Registered with MedicareThis feature layer, utilizing data from the Centers of Medicare and Medicaid Services (CMS), depicts all hospitals that are currently registered with Medicare in the U.S. Per NIH, "Since the passage of Medicare legislation in 1965, Section 1861 of the Social Security Act has stated that hospitals participating in Medicare must meet certain requirements specified in the act and that the Secretary of the Department of Health, Education and Welfare (HEW) [now the Department of Health and Human Services (DHHS)] may impose additional requirements found necessary to ensure the health and safety of Medicare beneficiaries receiving services in hospitals. On this basis, the Conditions of Participation, a set of regulations setting minimum health and safety standards for hospitals participating in Medicare, were promulgated in 1966 and substantially revised in 1986."Ascension Columbia St Mary's HospitalData currency: 11/26/2024Data modification: This data was created using the geocoding process on the CSV file.Data downloaded from: Hospital General InformationFor more information: HospitalsSupport documentation: Data dictionaryFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters of Medicare and Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

The Denominator File combines Medicare beneficiary entitlement status information from administrative enrollment records with third-party payer information and GHP enrollment information. The Denominator File contains data on all Medicare beneficiaries enrolled and or entitled in a given year. It is an abbreviated version of the Enrollment Data Base (EDB) (selected data elements). It does not contain data on all beneficiaries ever entitled to Medicare. The file contains data only for beneficiaries who were entitled during the year of the data. These data are available annually in May of the current year for the prior year.

Graph and download economic data for Producer Price Index by Commodity: Health Care Services: Medicare Patients: Physician Care (WPU51110102) from Jun 2014 to Jun 2025 about physicians, healthcare, health, services, commodities, PPI, inflation, price index, indexes, price, and USA.

More Medicare beneficiaries are taking advantage of the quality and compassionate care provided through the hospice benefit. As greater numbers of beneficiaries have availed themselves of the benefit, the mix of hospice patients has changed, with relatively fewer cancer patients as a percentage of total patients.