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.

This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage.

DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

Content

The following dataset demonstrates the Medicare-enrolled MDPP suppliers from which eligible Medicare beneficiaries may be furnished MDPP services. If you receive your Medicare coverage via a Medicare Advantage plan, please consult your health plan to identify the specific MDPP suppliers that are available to you with no cost sharing

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by Philipp Mandler on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

Context

The CMS National Plan and Provider Enumeration System (NPPES) was developed as part of the Administrative Simplification provisions in the original HIPAA act. The primary purpose of NPPES was to develop a unique identifier for each physician that billed medicare and medicaid. This identifier is now known as the National Provider Identifier Standard (NPI) which is a required 10 digit number that is unique to an individual provider at the national level.

Once an NPI record is assigned to a healthcare provider, parts of the NPI record that have public relevance, including the provider’s name, speciality, and practice address are published in a searchable website as well as downloadable file of zipped data containing all of the FOIA disclosable health care provider data in NPPES and a separate PDF file of code values which documents and lists the descriptions for all of the codes found in the data file.

Content

The dataset contains the latest NPI downloadable file in an easy to query BigQuery table, npi_raw. In addition, there is a second table, npi_optimized which harnesses the power of Big Query’s next-generation columnar storage format to provide an analytical view of the NPI data containing description fields for the codes based on the mappings in Data Dissemination Public File - Code Values documentation as well as external lookups to the healthcare provider taxonomy codes . While this generates hundreds of columns, BigQuery makes it possible to process all this data effectively and have a convenient single lookup table for all provider information.

Fork this kernel to get started.

Acknowledgements

https://bigquery.cloud.google.com/dataset/bigquery-public-data:nppes?_ga=2.117120578.-577194880.1523455401

https://console.cloud.google.com/marketplace/details/hhs/nppes?filter=category:science-research

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 are the top ten most common types of physicians in Mountain View?

What are the names and phone numbers of dentists in California who studied public health?

Verify the accuracy of SSNs of all individual Medicare providers, owners, managing/directing employees, authorized representatives, ambulance service medical directors, ambulance crew members, technicians, chain organization administrators, Independent Diagnostic Test Facility (IDTF), supervising/directing physicians, and IDTF interpretation service providers. Also included in this Agreement are individual health care providers who apply for a National Provider Identification Number (NPI).

This historic dataset with total enrollment in separate CHIP programs by month and state was created to fulfill reporting requirements under section 1902(tt)(1) of the Social Security Act, which was added by section 5131(b) of subtitle D of title V of division FF of the Consolidated Appropriations Act, 2023 (P.L. 117-328) (CAA, 2023). For each month from April 1, 2023, through June 30, 2024, states were required to submit to CMS (on a timely basis), and CMS was required to make public, certain monthly data, including the total number of beneficiaries who were enrolled in a separate CHIP program. Accordingly, this historic dataset contains separate CHIP enrollment by month and state between April 2023 and June 2024. CMS will continue to publicly report separate CHIP enrollment by month and state (beyond the historic CAA/Unwinding period) in a new dataset, which is available at [link]. Please note that the methods used to count separate CHIP enrollees differ slightly between the two datasets; as a result, data users should exercise caution if comparing separate CHIP enrollment across the two datasets. Sources: T-MSIS Analytic Files (TAF) and state-submitted enrollment totals. The data notes indicate when a state’s monthly total was a state-submitted value, rather than from T-MSIS.TAF data were pulled as follows:April 2023 enrollment - TAF as of August 2023May 2023 enrollment - TAF as of August 2023June 2023 enrollment - TAF as of September 2023July 2023 enrollment - TAF as of October 2023August 2023 enrollment - TAF as of November 2023September 2023 enrollment - TAF as of December 2023October 2023 enrollment - TAF as of January 2024November 2023 enrollment - TAF as of February 2024December 2023 enrollment - TAF as of March 2024January 2024 enrollment - TAF as of April 2024February 2024 enrollment - TAF as of May 2024March 2024 enrollment - TAF as of June 2024April 2024 enrollment – TAF as of July 2024May 2024 enrollment – TAF as of August 2024June 2024 enrollment – TAF as of September 2024 TAF are produced one month after the T-MSIS submission month. For example, TAF as of August 2023 is based on July T-MSIS submissions. Notes: The separate CHIP enrollment in this report is not inclusive of enrollees covered by Medicaid expansion CHIP. Enrollment includes individuals enrolled in separate CHIP at any point during the month but excludes those enrolled in both Medicaid and separate CHIP during the month. See the Data Sources and Metrics Definitions Overview document for a full description of the data sources, metric definitions, and general data limitations.Alaska, District of Columbia, Hawaii, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, South Carolina, Vermont, and Wyoming do not have separate CHIP Programs. Maryland has a separate CHIP program that began in July 2023; April 2023 - June 2023 data for Maryland represents retroactive coverage. This document includes separate CHIP data submitted to CMS by states via T-MSIS or a separate collection form. These data include reporting metrics consistent with section 1902(tt)(1) of the Social Security Act.CHIP: Children's Health Insurance Program Data notes: (a) State-submitted value; data not from T-MSIS(b1) May 2023 enrollment pulled from TAF as of September 2023(b2) Data was restated using TAF as of October 2023(b3) Data was restated using TAF as of April 2024(b4) Data was restated using TAF as of July 2024(b5) Data was restated using TAF as of August 2024(c) Enrollment counts include postpartum women with coverage funded via a Health Services Initiative

The Medicare Current Beneficiary Survey (MCBS) is a comprehensive, longitudinal survey of Medicare beneficiaries conducted by the Centers for Medicare & Medicaid Services (CMS) in partnership with NORC at the University of Chicago. It contains detailed information on beneficiaries’ demographics, health status, healthcare utilization, and outcomes, including social and medical risk factors. The datasets can be linked with Medicare enrollment data and claims, and provide information to evaluate effectiveness of health care policy and policy interventions. This dataset is restricted-use due to the inclusion of sensitive and identifiable health information. As such, the data files themselves cannot be shared via this Dataverse entry. Students, post-docs, and researchers conducting NSAPH-related research in collaboration with PIs at Harvard or affiliated institutions may gain access to the data, provided have submitted a project initiation form, are listed on an approved IRB protocol, and have completed all required data security trainings. No data files are included in this entry, and the data has not been processed in any way. This entry serves as a reference to the original raw data received from CMS and includes only supporting materials such as a README file, and other relevant documentation, codebooks and tutorials from the CMS website to assist authorized users in understanding the structure and content of the MCBS restricted-use files. The README includes: Structure and content of the MCBS data files References to supporting documentation

The datasets include the monthly count of individuals who are enrolled in Medicare Savings Programs (MSP), by aid code and county. The counts reflect the total number of eligible individuals enrolled during the month. MSP help individuals with limited income and resources pay for some of the out-of-pocket costs for Medicare, including Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. There are four Medicare Savings Programs: Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Working Disabled Individual (QWDI). Individuals who are eligible for QMB, SLMB, and QI also automatically qualify for the Low Income Subsidy (or “Extra Help”) program, which helps lower the cost of prescription drugs. Counties and aid codes with zero individuals enrolled during a reporting period are not included in the dataset.

2014-2019. This dataset is a de-identified summary table of vision and eye health data indicators from Medicare claims, stratified by all available combinations of age group, race/ethnicity, gender, and state. Medicare claims for VEHSS includes beneficiaries who were fully enrolled in Medicare Part B Fee-for-Service (FFS) for the duration of the year. Medicare claims provide a convenience sample that includes approximately 30 million individuals annually, which represents nearly 89% of the US population aged 65 and older and 3.3% of the US population younger than 65, including persons disabled due to blindness. Medicare data for VEHSS include Service Utilization and Medical Diagnoses indicators. Data were suppressed for de-identification to ensure protection of patient privacy. Data will be updated as it becomes available. Detailed information on VEHSS Medicare analyses can be found on the VEHSS Medicare webpage (cdc.gov/visionhealth/vehss/data/claims/medicare.html). Information on available Medicare claims data can be found on the ResDac website (www.resdac.org). The VEHSS Medicare dataset was last updated May 2023.

Context

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarize counts of enrollees who are dually-eligible for both Medicare and Medicaid program, including those in Medicare Savings Programs. “Duals” represent 20 percent of all Medicare beneficiaries, yet they account for 34 percent of all spending by the program, according to the Commonwealth Fund . As a representation of this high-needs, high-cost population, these data offer a view of regions ripe for more intensive care coordination that can address complex social and clinical needs. In addition to the high cost savings opportunity to deliver upstream clinical interventions, this population represents the county-by-county volume of patients who are eligible for both state level (Medicaid) and federal level (Medicare) reimbursements and potential funding streams to address unmet social needs across various programs, waivers, and other projects. The dataset includes eligibility type and enrollment by quarter, at both the state and county level. These data represent monthly snapshots submitted by states to the CMS, which are inherently lower than ever-enrolled counts (which include persons enrolled at any time during a calendar year.) For more information on dually eligible beneficiaries

Querying BigQuery tables

You can use the BigQuery Python client library to query tables in this dataset in Kernels. Note that methods available in Kernels are limited to querying data. Tables are at bigquery-public-data.sdoh_cms_dual_eligible_enrollment.

Sample Query

In what counties in Michigan has the number of dual-eligible individuals increased the most from 2015 to 2018? Find the counties in Michigan which have experienced the largest increase of dual enrollment households

duals_Jan_2015 AS ( SELECT Public_Total AS duals_2015, County_Name, FIPS FROM bigquery-public-data.sdoh_cms_dual_eligible_enrollment.dual_eligible_enrollment_by_county_and_program WHERE State_Abbr = "MI" AND Date = '2015-12-01' ),

duals_increase AS ( SELECT d18.FIPS, d18.County_Name, d15.duals_2015, d18.duals_2018, (d18.duals_2018 - d15.duals_2015) AS total_duals_diff FROM duals_Jan_2018 d18 JOIN duals_Jan_2015 d15 ON d18.FIPS = d15.FIPS )

SELECT * FROM duals_increase WHERE total_duals_diff IS NOT NULL ORDER BY total_duals_diff DESC

Medicare is a federal health insurance program for those aged 65 and older, certain people under 65 with disabilities, and people of any age with end-stage renal disease in the United States (US). Medicare covers about 96% of all US citizens aged 65 and older. These data have been used to describe patterns of morbidity and mortality and burden of disease, compare the effectiveness of pharmacologic therapies, examine the cost of care, evaluate the effects of provider practices on the delivery of care, and explore the effects of important policy changes on physician practices and patient outcomes. In 2014, 16% of Medicare beneficiaries were under the age of 65 years, 46% were between 65 and 74 years, 25% between 75 and 84 years, and 12% over the age of 85 years. Fifty-five percent of beneficiaries were female, 76% were white, 10% black, 9% Hispanic, and 5% Asian or other/unknown race.

This dataset tracks the updates made on the dataset "Eligible Individuals Enrolled in Medicare Savings Programs (MSP)" as a repository for previous versions of the data and metadata.

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees. The “Total dually eligible individuals” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including enrollees receiving full Medicaid benefits or Medicaid cost sharing. "--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.

NCHS has linked data from various surveys with 1999-2013 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.

Total Medicaid Enrollees - VIII Group Break Out Report Reported on the CMS-64 The enrollment information is a state-reported count of unduplicated individuals enrolled in the state’s Medicaid program at any time during each month in the quarterly reporting period. The enrollment data identifies the total number of Medicaid enrollees and, for states that have expanded Medicaid, provides specific counts for the number of individuals enrolled in the new adult eligibility group, also referred to as the “VIII Group”. The VIII Group is only applicable for states that have expanded their Medicaid programs by adopting the VIII Group. This data includes state-by-state data for this population as well as a count of individuals whom the state has determined are newly eligible for Medicaid. All 50 states, the District of Columbia and the US territories are represented in these data. Notes: 1. “VIII GROUP” is also known as the “New Adult Group.” 2. The VIII Group is only applicable for states that have expanded their Medicaid programs by adopting the VIII Group. VIII Group enrollment information for the states that have not expanded their Medicaid program is noted as “N/A.”

Content

The Affordable Care Act created the new Pre-Existing Condition Insurance Plan (PCIP) program to make health insurance available to Americans denied coverage by private insurance companies because of a pre-existing condition. Coverage for people living with such conditions as diabetes, asthma, cancer, and HIV/AIDS has often been priced out of the reach of most Americans who buy their own insurance, and this has resulted in a lack of coverage for millions. The temporary program covers a broad range of health benefits and is designed as a bridge for people with pre-existing conditions who cannot obtain health insurance coverage in today’s private insurance market. To learn more, visit PCIP.gov or HealthCare.gov.

Note: * Massachusetts and Vermont are guarantee issue states that have already implemented many of the broader market reforms included in the Affordable Care Act that take effect in 2014. Existing commercial plans offering guaranteed coverage at premiums comparable to PCIP are already available in both states.

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by Lily Banse on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and March 31, 2025. The data were used to generate the Medicare Telehealth Trends Report.

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: 9/22/2021Data modification: this data was created using the geocoding process on the CSV file.Data downloaded from: Hospital General InformationFor more information: HospitalsFor feedback, please contact: ArcGIScomNationalMaps@esri.comThumbnail image courtesy of Tim EvansonCenters 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."

One record summarizes the number of days an individual was enrolled in a given calendar year. Commercial health data contains benefit information for enrollees and their dependents, for as long as the enrollee is an active employee.

This dataset includes total enrollment in separate CHIP (S-CHIP) programs by month and state from April 2023 forward.

Sources: T-MSIS Analytic Files (TAF) and state-submitted enrollment totals. The data notes indicate when a state’s monthly total was a state-submitted value, rather than from T-MSIS.
Methods: Enrollment includes individuals enrolled in S-CHIP at any point during the coverage month, excluding those enrolled in dental-only coverage. The S-CHIP enrollment in this report also excludes enrollees covered by Medicaid expansion CHIP, a program in which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act. If an individual is enrolled in both Medicaid or Medicaid-expansion CHIP and S-CHIP in a given month, TAF picks the program in which they were last enrolled.
Unless S-CHIP enrollment counts are replaced with a state-submitted value, each state's monthly S-CHIP enrollment is equal to the number of unique people in TAF with a CHIP_CODE = 3 (S-CHIP) and ELGBLTY_GRP_CD not equal to ‘66’ (Children Eligible for Dental Only Supplemental Coverage). More information about TAF is available at https://www.medicaid.gov/medicaid/data-systems/macbis/medicaid-chip-research-files/transformed-medicaid-statistical-information-system-t-msis-analytic-files-taf/index.html.

Note: A historic dataset with S-CHIP enrollment by month and state from April 2023 to June 2024 is also available at: https://data.medicaid.gov/dataset/d30cfc7c-4b32-4df1-b2bf-e0a850befd77. This historic dataset was created to fulfill reporting requirements under section 1902(tt)(1) of the Social Security Act, which was added by section 5131(b) of subtitle D of title V of division FF of the Consolidated Appropriations Act, 2023 (P.L. 117-328) (CAA, 2023). Please note that the methods used to count S-CHIP enrollees differ slightly between the two datasets; as a result, data users should exercise caution if comparing S-CHIP enrollment across the two datasets.
State notes: Alaska, District of Columbia, Hawaii, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, South Carolina, Vermont, and Wyoming do not have S-CHIP programs.
Maryland has an S-CHIP program for the from conception to end of pregnancy group that began in July 2023; April 2023 - June 2023 data for Maryland represents retroactive coverage.
Oregon moved all its S-CHIP enrollees, other than those in the from conception to the end of pregnancy group, to a Medicaid-expansion CHIP program effective January 1, 2024.
CHIP: Children's Health Insurance Program