The CMS Program Statistics - Medicare Total Enrollment tables provide data on characteristics of the Medicare-covered populations. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR ENROLL AB 1. Total Medicare Enrollment: Total, Original Medicare, and Medicare Advantage and Other Health Plan Enrollment, Yearly Trend MDCR ENROLL AB 2. Total Medicare Enrollment: Total, Original Medicare, Medicare Advantage and Other Health Plan Enrollment, and Resident Population, by Area of Residence MDCR ENROLL AB 3. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend MDCR ENROLL AB 4. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend MDCR ENROLL AB 5. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics MDCR ENROLL AB 6. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics MDCR ENROLL AB 7. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence MDCR ENROLL AB 8. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

The CMS Program Statistics - Medicare Advantage & Other Health Plan Enrollment tables provide data on characteristics of the population covered by Medicare Advantage & other health plans. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables:MDCR ENROLL AB 15. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly TrendMDCR ENROLL AB 16. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly TrendMDCR ENROLL AB 17. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Demographic CharacteristicsMDCR ENROLL AB 18. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic CharacteristicsMDCR ENROLL AB 19. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of ResidenceMDCR ENROLL AB 20. Medicare Advantage and Other Health Plan Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of ResidenceResources for using and understanding the dataThe data reported in these enrollment tables are based on information gathered from CMS administrative enrollment data for beneficiaries enrolled in Medicare Advantage and Other Health Plans available from the CMS Chronic Conditions Data Warehouse.

The CMS Program Statistics - Medicare Newly Enrolled tables provide data on characteristics of the newly enrolled Medicare population. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR ENROLL AB 21. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Enrollees, Yearly Trend MDCR ENROLL AB 22. Medicare Newly Enrolled Beneficiaries: Total Enrollees by Month of Enrollment, Yearly Trend MDCR ENROLL AB 23. Medicare Newly Enrolled Beneficiaries: Total Enrollees, by Demographic Characteristics MDCR ENROLL AB 24. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Enrollees, by Area of Residence MDCR ENROLL AB 25. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Original Medicare Enrollees MDCR ENROLL AB 26. Medicare Newly Enrolled Beneficiaries: Original Medicare Enrollees by Month of Enrollment, Yearly Trend MDCR ENROLL AB 27. Medicare Newly Enrolled Beneficiaries: Original Medicare Enrollees, by Demographic Characteristics MDCR ENROLL AB 28. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Original Medicare Enrollees, by Area of Residence MDCR ENROLL AB 29. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Medicare Advantage and Other Health Plan Enrollees, Yearly Trend MDCR ENROLL AB 30. Medicare Newly Enrolled Beneficiaries: Medicare Advantage and Other Health Plan Enrollees, by Month of Enrollment, Yearly Trend MDCR ENROLL AB 31. Medicare Newly Enrolled Beneficiaries: Medicare Advantage and Other Health Plan Enrollees, by Demographic Characteristics MDCR ENROLL AB 32. Medicare Newly Enrolled Beneficiaries: Total, Aged, and Disabled Medicare Advantage and Other Health Plan Enrollees, by Area of Residence

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

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

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

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

Below is the list of tables:

MDCR ENROLL AB 9. Original Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend
MDCR ENROLL AB 10. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend
MDCR ENROLL AB 11. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics
MDCR ENROLL AB 12. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics
MDCR ENROLL AB 13. Original Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence
MDCR ENROLL AB 14. Original Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

The Hospice Enrollments dataset provides enrollment information of all hospices currently enrolled in Medicare in Detroit. This data includes information on the hospice's legal business name, doing business as name, organization type and address.

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

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

Below is the list of tables:

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

The 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

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.

The Hospital Enrollments dataset provides enrollment information of all Hospitals currently enrolled in Medicare. This data includes information on the Hospital's sub-group type, legal business name, doing business as name, organization type and address.

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

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

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

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.

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.

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.

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

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

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

Background Our aim was to compare access to effective care among elderly Medicare patients in a Staff Model and Group Model HMO and in Fee-for-Service (FFS) care. Methods We used a retrospective cohort study design, using claims and automated medical record data to compare achievement on quality indicators for elderly Medicare recipients. Secondary data were collected from 1) HMO data sets and 2) Medicare claims files for the time period 1994–95. All subjects were Medicare enrollees in a defined area of New England: those enrolled in two divisions of a managed care plan with different physician payment arrangements: a staff model, and a group model; and the Medicare FFS population. We abstracted information on indicators covering several domains: preventive, diagnosis-specific, and chronic disease care. Results On the indicators we created and tested, access in the single managed care plan under study was comparable to or better than FFS care in the same geographic region. Percent of Medicare recipients with breast cancer screening was 36 percentage points higher in the staff model versus FFS (95% confidence interval 34–38 percentage points). Follow up after hospitalization for myocardial infarction was 20 percentage points higher in the group model than in FFS (95% confidence interval 14–26 percentage points). Conclusion According to indicators developed for use in both claims and automated medical record data, access to care for elderly Medicare beneficiaries in one large managed care organization was as good as or better than that in FFS care in the same geographic area.

The dataset gives information on Cardiac echocardiogram rates of Medicare beneficiaries at Hospital Referral Regions (HRR) for the year 2012. Hospitalization rates are the counts for the discharges that occurred in a definitive time period (the numerator) for a specific population (the denominator).

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.”