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.

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.

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?

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

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.

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.

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.”

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

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

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.

The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and September 30, 2024. The data were used to generate the Medicare Telehealth Trends Report.

Data from: https://data.medicare.gov/Hospital-Compare/Payment-and-value-of-care-Hospital/c7us-v4mf More information coming soon!

Context

There's a story behind every dataset and here's your opportunity to share yours.

Content

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.

Acknowledgements

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.

Inspiration

Your data will be in front of the world's largest data science community. What questions do you want to see answered?

The Share of Medicaid Enrollees in any Managed Care and in Comprehensive Managed CaAre profiles state-level enrollment statistics (numbers and percentages) of total Medicaid enrollees in any type of managed care as well as those enrolled specifically in comprehensive managed care programs. The report provides managed care enrollment by state with all 50 states, the District of Columbia and the US territories are represented in these data.

1. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program.

2. 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.

3. The “Total Medicaid Enrollment in Any Type of Managed Care” column represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, PCCMs, and PCCM entities.

4. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), as well as PACE programs. It excludes beneficiaries who are enrolled in a Financial Alignment Initiative Medicare-Medicaid Plan as their only form of managed care.

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."

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

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.

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).

Evaluating Health Home Care Quality

CMS Core Set and Health Home SPA Measures

By Health Data New York [source]

About this dataset

This dataset provides comprehensive measures to evaluate the quality of medical services provided to Medicaid beneficiaries by Health Homes, including the Centers for Medicare & Medicaid Services (CMS) Core Set and Health Home State Plan Amendment (SPA). This allows us to gain insight into how well these health homes are performing in terms of delivering high-quality care. Our data sources include the Medicaid Data Mart, QARR Member Level Files, and New York State Delivery System Inform Incentive Program (DSRIP) Data Warehouse. With this data set you can explore essential indicators such as rates for indicators within scope of Core Set Measures, sub domains, domains and measure descriptions; age categories used; denominators of each measure; level of significance for each indicator; and more! By understanding more about Health Home Quality Measures from this resource you can help make informed decisions about evidence based health practices while also promoting better patient outcomes

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For more datasets, click here.

Featured Notebooks

• 🚨 Your notebook can be here! 🚨!

How to use the dataset

This dataset contains measures that evaluate the quality of care delivered by Health Homes for the Centers for Medicare & Medicaid Services (CMS). With this dataset, you can get an overview of how a health home is performing in terms of quality. You can use this data to compare different health homes and their respective service offerings.

The data used to create this dataset was collected from Medicaid Data Mart, QARR Member Level Files, and New York State Delivery System Incentive Program (DSRIP) Data Warehouse sources.

In order to use this dataset effectively, you should start by looking at the columns provided. These include: Measurement Year; Health Home Name; Domain; Sub Domain; Measure Description; Age Category; Denominator; Rate; Level of Significance; Indicator. Each column provides valuable insight into how a particular health home is performing in various measurements of healthcare quality.

When examining this data, it is important to remember that many variables are included in any given measure and that changes may have occurred over time due to varying factors such as population or financial resources available for healthcare delivery. Furthermore, changes in policy may also affect performance over time so it is important to take these things into account when evaluating the performance of any given health home from one year to the next or when comparing different health homes on a specific measure or set of indicators over time

Research Ideas

• Using this dataset, state governments can evaluate the effectiveness of their health home programs by comparing the performance across different domains and subdomains.
• Healthcare providers and organizations can use this data to identify areas for improvement in quality of care provided by health homes and strategies to reduce disparities between individuals receiving care from health homes.
• Researchers can use this dataset to analyze how variations in cultural context, geography, demographics or other factors impact delivery of quality health home services across different locations

Acknowledgements

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

License

See the dataset description for more information.

Columns

File: health-home-quality-measures-beginning-2013-1.csv | Column name | Description | |:--------------------------|:----------------------------------------------------| | Measurement Year | The year in which the data was collected. (Integer) | | Health Home Name | The name of the health home. (String) | | Domain | The domain of the measure. (String) | | Sub Domain | The sub domain of the measure. (String) | | Measure Description | A description of the measure. (String) | | Age Category | The age category of the patient. (String) | | Denominator | The denominator of the measure. (Integer) | | Rate | The rate of the measure. (Float) | | Level of Significance | The level of significance of the measure. (String) | | Indicator | The indicator of the measure. (String) |

Acknowledgements

...

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).

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 2023
May 2023 enrollment - TAF as of August 2023
June 2023 enrollment - TAF as of September 2023
July 2023 enrollment - TAF as of October 2023
August 2023 enrollment - TAF as of November 2023
September 2023 enrollment - TAF as of December 2023
October 2023 enrollment - TAF as of January 2024
November 2023 enrollment - TAF as of February 2024
December 2023 enrollment - TAF as of March 2024
January 2024 enrollment - TAF as of April 2024
February 2024 enrollment - TAF as of May 2024
March 2024 enrollment - TAF as of June 2024
April 2024 enrollment – TAF as of July 2024
May 2024 enrollment – TAF as of August 2024
June 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

This dataset contains aggregate Medicaid payments, and counts for eligible recipients and recipients served by month and county in Iowa, starting with month ending 1/31/2011. Eligibility groups are a category of people who meet certain common eligibility requirements. Some Medicaid eligibility groups cover additional services, such as nursing facility care and care received in the home. Others have higher income and resource limits, charge a premium, only pay the Medicare premium or cover only expenses also paid by Medicare, or require the recipient to pay a specific dollar amount of their medical expenses. Eligible Medicaid recipients may be considered medically needy if their medical costs are so high that they use up most of their income. Those considered medically needy are responsible for paying some of their medical expenses. This is called meeting a spend down. Then Medicaid would start to pay for the rest. Think of the spend down like a deductible that people pay as part of a private insurance plan.