The purpose of the project is to detect unreported Supplemental Security Income (SSI) recipient admissions to Title XIX institutions. A file containing SSN's of SSI recipients (all eligible individuals and members of eligible couples in current pay) will be matched against the Health Care Financing Administration's (HCFA) Minimum Data Set (MDS) database which contains admission, discharge, re-entry and assessment information about persons in Title XIX facilities for all 50 States and Washington, D.C. This database is updated monthly. The match will produce an output file containing MDS data pertinent to SSI eligibility on matched records. This data will be compared back to the SSR data to generate alerts to the Field Offices for their actions.
https://creativecommons.org/publicdomain/zero/1.0/https://creativecommons.org/publicdomain/zero/1.0/
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.
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.
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.
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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?
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 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
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.
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
The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and June 30, 2024. The data were used to generate the Medicare Telehealth Trends Report.
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.”
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 PCCM, MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services. The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals 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.
The hospital readmission rate PUF presents nation-wide information about inpatient hospital stays that occurred within 30 days of a previous inpatient hospital stay (readmissions) for Medicare fee-for-service beneficiaries. The readmission rate equals the number of inpatient hospital stays classified as readmissions divided by the number of index stays for a given month. Index stays include all inpatient hospital stays except those where the primary diagnosis was cancer treatment or rehabilitation. Readmissions include stays where a beneficiary was admitted as an inpatient within 30 days of the discharge date following a previous index stay, except cases where a stay is considered always planned or potentially planned. Planned readmissions include admissions for organ transplant surgery, maintenance chemotherapy/immunotherapy, and rehabilitation.
This dataset has several limitations. Readmissions rates are unadjusted for age, health status or other factors. In addition, this dataset reports data for some months where claims are not yet final. Data published for the most recent six months is preliminary and subject to change. Final data will be published as they become available, although the difference between preliminary and final readmission rates for a given month is likely to be less than 0.1 percentage point.
Data Source: The primary data source for these data is the CMS Chronic Condition Data Warehouse (CCW), a database with 100% of Medicare enrollment and fee-for-service claims data. For complete information regarding data in the CCW, visit http://ccwdata.org/index.php. Study Population: Medicare fee-for-service beneficiaries with inpatient hospital stays.
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!
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 Justyn Warner on Unsplash
Unsplash Images are distributed under a unique Unsplash License.
This dataset is distributed under NA
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."
All states (including the District of Columbia) provide data to the Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment metrics. These data reflect state-reported information on Medicaid and CHIP eligibility renewals initiated and scheduled for completion during the reporting period. In addition to reporting the outcomes of renewals at the end of each reporting period, states also provide an update on renewals that were reported pending as of the end of a reporting period. For more information on these data, see Sections II and III of the Eligibility Processing Data Report specifications. Notes: Georgia reported data for individuals who continue to be eligible following a change in circumstances and were granted a new 12-month eligibility period during the reporting period, along with data on individuals due for renewal in the month. North Carolina reports renewal outcomes for only initiated renewals scheduled for completion in the report month, and as such, the data do not reflect renewals that should have been completed in the reporting period that the state was unable to initiate by the end of the report month.
This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).
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License information was derived automatically
analyze the basic stand alone medicare claims public use files (bsapufs) with r and monetdb the centers for medicare and medicaid services (cms) took the plunge. the famous medicare 5% sample has been released to the public, free of charge. jfyi - medicare is the u.s. government program that provides health insurance to 50 million elderly and disabled americans. the basic stand alone medicare claims public use files (bsapufs) contain either person- or event-level data on inpatient stays, durable medical equipment purchases, prescription drug fills, hospice users, doctor visits, home health provision , outpatient hospital procedures, skilled nursing facility short-term residents, as well as aggregated statistics for medicare beneficiaries with chronic conditions and medicare beneficiaries living in nursing homes. oh sorry, there's one catch: they only provide sas scripts to analyze everything. cue the villian music. that bored old game of monopoly ends today. the initial release of the 2008 bsapufs was accompanied by some major fanfare in the world of health policy , a big win for government transparency. unfortunately, the final files that cleared the confidentiality hurdles are heavily de-identified and obfuscated. prime examples: none of the files can be linked to any other file. not across years, not across expenditure categories costs are rounded to the nearest fifth or tenth dollar at lower values, nearest thousandth at higher values ages are categorized into five year bands so these files are baldly inferior to the unsquelched, linkable data only available through an expensive formal application process. any researcher with a budget flush enough to afford a sas license (the only statistical software mentioned in the cms official documentation) can probably also cough up the money to buy the identifiable data through resdac (resdac, btw, rocks). soapbox: cms released free public data sets that could only be analyzed with a software package costing thousands of dollars. so even though the actual data sets were free, researchers still needed deep pock ets to buy sas. meanwhile, the unsquelched and therefore superior data sets are also available for many thousands of dollars. researchers with funding would (reasonably) just buy the better data. researchers without any financial resources - the target audience of free, public data - were left out in the cold. no wonder these bsapufs haven't been used much. that ends now. using r, monetdb, and the personal computer you already own (mine cost $700 in 2009), researchers can, for the first time, seriously analyze these medicare public use files without spending another dime. woah. plus hey guess what all you researcher fat-cats with your federal grant streams and your proprietary software licenses: r + monetdb runs one heckuva lot faster than sas. woah^2. dump your sas license water wings and learn how to swim. the scripts below require monetdb . click here for step-by-step instructions of how to install it on windows and click here for speed tests. vroom. since the bsapufs comprise 5% of the medicare population, ya generally need to multiply any counts or sums by twenty. although the individuals represented in these claims are randomly sampled, this data should not be treated like a complex survey sample, meaning that the creation of a survey object is unnecessary. most bsapufs generalize to either the total or fee-for-service medicare population, but each file is different so give the documentation a hard stare before that eureka moment. this new github repository contains three scripts: 2008 - download all csv files.R loop through and download every zip file hosted by cms unzip the contents of each zipped file to the working directory 2008 - import all csv files into monetdb.R create the batch (.bat) file needed to initiate the monet database in the f uture loop through each csv file in the current working directory and import them into the monet database create a well-documented block of code to re-initiate the monetdb server in the future 2008 - replicate cms publications.R initiate the same monetdb server instance, unsing the same well-documented block of code as above replicate nine sets of statistics found in data tables provided by cms < a href="https://github.com/ajdamico/usgsd/tree/master/Basic%20Stand%20Alone%20Medicare%20Claims%20Public%20Use%20Files">click here to view these three scripts for more detail about the basic stand alone medicare claims public use files (bsapufs), visit: the centers for medicare and medicaid's bsapuf homepage a joint academyhealth webinar given by the organizations that partnered to create these files - cms, impaq, norc notes: the replication script has oodles of easily-modified syntax and should be viewed for analysis examples. if you know the name of the data table you want to examine, you can quickly modify these general monetdb analysis examples too. just run sql queries - sas users, that's "proc...
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 PCCM, MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services.
The “Total Medicaid Enrollees” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and dually eligible individuals 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.
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).
Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using HealthCare.gov. As of August 2024, CMS is no longer releasing the “HealthCare.gov” metrics. Historical data between July 2023-July 2024 will remain available. The “HealthCare.gov Transitions” metrics, which are the CAA, 2023 required metrics, will continue to be released.
Sources: HealthCare.gov application and policy data through May 5, 2024, and T-MSIS Analytic Files (TAF) through March 2024 (TAF version 7.1 with T-MSIS enrollment through the end of March 2024). Data include consumers in HealthCare.gov states where the first unwinding renewal cohort is due on or after the end of reporting month (state identification based on HealthCare.gov policy and application data). State data start being reported in the month when the state's first unwinding renewal cohort is due. April data include Arizona, Arkansas, Florida, Indiana, Iowa, Kansas, Nebraska, New Hampshire, Ohio, Oklahoma, South Dakota, Utah, West Virginia, and Wyoming. May data include the previous states and the following new states: Alaska, Delaware, Georgia, Hawaii, Montana, North Dakota, South Carolina, Texas, and Virginia. June data include the previous states and the following new states: Alabama, Illinois, Louisiana, Michigan, Missouri, Mississippi, North Carolina, Tennessee, and Wisconsin. July data include the previous states and Oregon. All HealthCare.gov states are included in this version of the report.
Notes:
On April 5, 2023, the Children’s Bureau issued Information Memorandum 23-04 on the changes to Medicaid eligibility for youth/young adults age 18 and older who transition out of foster care and move to a new state. On the webinar, the Center for Medicare & Medicaid Services (CMS) will provide an overview to the changes made by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and the State Health Official Letter issued by CMS. Following the CMS overview, the Children’s Bureau will provide information on the action steps states can take to collaborate on the implementation.
A critical component of the webinar is to provide information on how the implementation of the SUPPORT Act can be used to address the inequities and health disparities experienced by young people as they transition out of foster care.
Leaders from the Center for Medicare & Medicaid Services (CMS) and the Administration on Children, Youth, and Families (ACYF) presented during the webinar. The webinar was originally recorded on May 11, 2023.
Audio Description Version
Metadata-only record linking to the original dataset. Open original dataset below.
https://creativecommons.org/publicdomain/zero/1.0/https://creativecommons.org/publicdomain/zero/1.0/
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
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!
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.
https://creativecommons.org/publicdomain/zero/1.0/https://creativecommons.org/publicdomain/zero/1.0/
Data from: https://data.medicare.gov/Hospital-Compare/Payment-and-value-of-care-Hospital/c7us-v4mf More information coming soon!
There's a story behind every dataset and here's your opportunity to share yours.
What's inside is more than just rows and columns. Make it easy for others to get started by describing how you acquired the data and what time period it represents, too.
We wouldn't be here without the help of others. If you owe any attributions or thanks, include them here along with any citations of past research.
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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
Nursing Home Compare has detailed information about every Medicare and Medicaid nursing home in the country. A nursing home is a place for people who can’t be cared for at home and need 24-hour nursing care. These are the official datasets used on the Medicare.gov Nursing Home Compare Website provided by the Centers for Medicare & Medicaid Services. These data allow you to compare the quality of care at every Medicare and Medicaid-certified nursing home in the country, including over 15,000 nationwide.
The purpose of the project is to detect unreported Supplemental Security Income (SSI) recipient admissions to Title XIX institutions. A file containing SSN's of SSI recipients (all eligible individuals and members of eligible couples in current pay) will be matched against the Health Care Financing Administration's (HCFA) Minimum Data Set (MDS) database which contains admission, discharge, re-entry and assessment information about persons in Title XIX facilities for all 50 States and Washington, D.C. This database is updated monthly. The match will produce an output file containing MDS data pertinent to SSI eligibility on matched records. This data will be compared back to the SSR data to generate alerts to the Field Offices for their actions.