In 2023, the average weighted Medicare Advantage (MA) monthly premium in the U.S. was 18 U.S. dollars, it includes premiums for Part C (medical and hospital care) and for Part D (drug benefit). The monthly premium has decreased by nearly 51 percent since 2016. Over half of MA plans have no premiums. It should be noted that all Medicare beneficiaries (whether in a traditional or MA plan) must also pay the Part B premium, which costs 170.10 U.S. dollars per month in 2022. This statistic depicts the average weighted Medicare Advantage monthly premiums from 2010 to 2023 (in U.S. dollars).

The included document uses GIS to investigate and compare Medicare and Medicaid provider infrastructure in Massachusetts. Provider addresses were geocoded and then compared to the geospatial locations of each insurance programs' eligible patient populations (percent of population of each census tract over 65 for Medicare and percent population for each census tract below the Federal Poverty Line for Medicaid). Massachusetts (MA) was picked for the comparison because Medicaid provider data, unlike Medicare provider data, is only available on cms.gov's website going back to 2011 and 2010, before the ACA was implemented in most states. However, MA had enacted "An Act Providing Access to Affordable, Quality, Accountable Health Care" in 2006, which had similar provisions to the subsequent ACA. The included maps used direct comparisons, buffers, and kernel density. Provider addresses obtained from: CMS' MAX Provider Characteristics and Provider of Services Current Files.

In 2023, over 5.1 million people were enrolled in Dual Special Needs Plans (D-SNPs) in the United States, to enroll in D-SNPs beneficiaries must be dually eligible for Medicare and Medicaid. Medicare Advantage plans offer extra benefits beyond the coverage of traditional Medicare. Special Needs Plans (SNPs) are Medicare Advantage plans for people with limited income or certain chronic conditions or diseases.

This data package shows the Co-Morbidity Among Chronic Conditions, Inpatient Admission ER Visit Zip Code and Value-Based Insurance Design Model by the Centers for Medicare and Medicaid Services (CMS).

In 2004, 5.3 million Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans, by 2023, this has reached 31 million. MA penetration within total Medicare has also increased. Medicare Advantage is the private plan alternative to traditional Medicare and often provides prescription benefits to the beneficiary. This statistic depicts the Medicare Advantage (MA) enrollment in the United States from 2004 to 2023.

The CMS Program Statistics - Medicare Advantage, Inpatient Hospital tables provide utilization data for inpatient hospitals, including short-stay hospitals, critical access hospitals, long term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other hospitals, by Medicare Advantage beneficiaries.

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

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

Below is the list of tables:

MDCR INPT HOSP MA 4. All Medicare Inpatient Hospital Types: Utilization for Medicare Advantage Beneficiaries, by Type of Hospital
MDCR INPT HOSP MA 5. Medicare Short Stay Hospitals: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR INPT HOSP MA 6. Medicare Short Stay Hospitals: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR INPT HOSP MA 7. Medicare Short Stay Hospitals: Utilization for Medicare Advantage Beneficiaries, by Area of Residence

MDCR INPT HOSP MA 1 – MDCR INPT HOSP MA 3 are not available at this time.

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using State-based Marketplaces (SBMs) that use their own eligibility and enrollment platforms Source: State-based Marketplace (SBM) operational data submitted to CMS. Each monthly reporting period occurs during the first through last day of the reported month. SBMs report relevant Marketplace activity from April 2023 (when unwinding-related renewals were initiated in most SBMs) through the end of a state’s Medicaid unwinding renewal period and processing timeline, which will vary by SBM. Some SBMs did not receive unwinding-related applications during reporting period months in April or May 2023 due to renewal processing timelines. SBMs that are no longer reporting Marketplace activity due to the completion of a state’s Medicaid unwinding renewal period are marked as NA. Some SBMs may revise data from a prior month and thus this data may not align with that previously reported. For April, Idaho’s reporting period was from February 1, 2023 to April 30, 2023. Notes: This table represents consumers whose Medicaid/CHIP coverage was denied or terminated following renewal and 1) whose applications were processed by an SBM through an integrated Medicaid, CHIP, and Marketplace eligibility system or 2) whose applications/information was sent by a state Medicaid or CHIP agency to an SBM through an account transfer process. Consumers who submitted applications to an SBM that can be matched to a Medicaid/CHIP record are also included. See the "Data Sources and Metrics Definition Overview" at http://www.medicaid.gov for a full description of the differences between the SBM operating systems and resulting data metrics, measure definitions, and general data limitations. As of the September 2023 report, this table was updated to differentiate between SBMs with an integrated Medicaid, CHIP, and Marketplace eligibility system and those with an account transfer process to better represent the percentage of QHP selections in relation to applicable consumers received and processed by the relevant SBM. State-specific variations are: - Maine’s data and Nevada’s April and May 2023 data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process. - Connecticut, Massachusetts, and Washington also report applications with consumers determined ineligible for Medicaid/CHIP due to procedural reasons. - Minnesota and New York report on eligibility and enrollment for their Basic Health Programs (BHP). Effective April 1, 2024, New York transitioned its BHP to a program operated under a section 1332 waiver, which expands eligibility to individuals with incomes up to 250% of FPL. As of the March 2024 data, New York reports on consumers with expanded eligibility and enrollment under the section 1332 waiver program in the BHP data. - Idaho’s April data on consumers eligible for a QHP with financial assistance do not depict a direct correlation to consumers with a QHP selection. - Virginia transitioned from using the HealthCare.gov platform in Plan Year 2023 to an SBM using its own eligibility and enrollment platform in Plan Year 2024. Virginia's data are reported in the HealthCare.gov and HeathCare.gov Transitions Marketplace Medicaid Unwinding Reports through the end of 2024 and is available in SBM reports as of the April 2024 report. Virginia's SBM data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process, and as a result are not directly comparable to their data in the HealthCare.gov data reports. - Only SBMs with an automatic plan assignment process have and report automatic QHP selections. These SBMs make automatic plan assignments into a QHP for a subset of individuals and provide a notification of options regarding active selection of an alternative plan and/or, if appli

The CMS Program Statistics – Medicare Advantage, Outpatient Facility tables provide utilization data for outpatient facilities, by Medicare Advantage beneficiaries. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR OUTPATIENT MA 1. Medicare Outpatient Facilities: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend MDCR OUTPATIENT MA 2. Medicare Outpatient Facilities: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR OUTPATIENT MA 3. Medicare Outpatient Facilities: Utilization for Medicare Advantage Beneficiaries, by Area of Residence

18,0 (%) в 2021. Medicare: Includes those covered by Medicare, Medicare Advantage, and those who have Medicare and another type of non-Medicaid coverage where Medicare is the primary payer. Excludes those with Medicare Part A coverage only.

By 2023, 51 percent of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. MA penetration rate has steadily increased throughout the years. Medicare Advantage is the private plan alternative to traditional Medicare and often provides prescription benefits to the beneficiary. This statistic shows the Medicare Advantage penetration into total Medicare in the United States from 2000 to 2023.

The CMS Program Statistics - Medicare Advantage, Skilled Nursing Facility tables provide utilization data for skilled nursing facilities, by Medicare Advantage beneficiaries.

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

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

Below is the list of tables:

MDCR SNF MA 1. Medicare Skilled Nursing Facilities: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR SNF MA 2. Medicare Skilled Nursing Facilities: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR SNF MA 3. Medicare Skilled Nursing Facilities: Utilization for Medicare Advantage Beneficiaries, by Area of Residence

A central question in the debate over privatized Medicare is whether increased government payments to private Medicare Advantage (MA) plans generate lower premiums for consumers or higher profits for producers. Using difference-in-differences variation brought about by a sharp legislative change, we find that MA insurers pass through 45 percent of increased payments in lower premiums and an additional 9 percent in more generous benefits. We show that advantageous selection into MA cannot explain this incomplete pass-through. Instead, our evidence suggests that market power is important, with premium pass-through rates of 13 percent in the least competitive markets and 74 percent in the most competitive.

In 2024, nearly all individual Medicare Advantage (MA) plans will offer fitness and vision benefits. This is often the reason why beneficiaries choose MA plans rather than Traditional Medicare in the U.S. This statistic shows the percentage of individual Medicare Advantage (MA) plans with extra benefits in the U.S. in 2024, by benefit.

In 2022, 69 percent of Latino Medicare beneficiaries were enrolled in Medicare Advantage in the United States, the highest share among all ethnic groups. This statistic depicts the share of Medicare beneficiaries enrolled in Medicare Advantage (MA) by ethnicity in the United States in 2022.

Introduction: The prevalence of chronic kidney disease (CKD) in Medicare beneficiaries has quadrupled in the past 2 decades, but little is known about risk factors affecting the progression of CKD. This study aims to understand the progression in Medicare Advantage enrollees and whether it differs by provider recognition of CKD, race and ethnicity, or geographic location. In a large cohort of Medicare Advantage (MA) enrollees, we examined whether CKD progression, up to 5 years after study entry, differed by demographic and clinical factors and identified additional risk factors of CKD progression. Methods: In a cohort of 1,002,388 MA enrollees with CKD stages 1–4 based on 2013–2018 labs, progression was estimated using a mixed-effects model that adjusted for demographics, geographic location, comorbidity, urine albumin-to-creatinine ratio, clinical recognition via diagnosed CKD, and time-fixed effects. Race and ethnicity, geographic location, and clinical recognition of CKD were interacted with time in 3 separate regression models. Results: Mean (median) follow-up was 3.1 (3.0) years. Black and Hispanic MA enrollees had greater kidney function at study entry than other beneficiaries, but their kidney function declined faster. MA enrollees with clinically recognized CKD had estimated glomerular filtration rate levels that were 18.6 units (95% confidence interval [CI]: 18.5–18.7) lower than levels of unrecognized patients, but kidney function declined more slowly in enrollees with clinical recognition. There were no differences in CKD progression by geography. After removal of the race coefficient from the eGFR equation in a sensitivity analysis, kidney function was much lower in all years among Black MA enrollees, but patterns of progression remained the same. Discussion/Conclusions: These results suggest that patients with clinically recognized CKD and racial and ethnic minorities merit closer surveillance and management to reduce their risk of faster progression.

23,1 (%) in 2021. Medicaid: Includes those covered by Medicaid, the Children’s Health Insurance Program (CHIP), and those who have both Medicaid and another type of coverage, such as dual eligibles who are also covered by Medicare.

In 2004, Medicare implemented a risk-adjustment system that pays Medicare Advantage (MA) plans based on diagnoses reported for their enrollees, giving the plans an incentive to identify more diagnoses. As reported in the article, Measuring Coding Intensity in the Medicare Advantage Program, published in Volume 4, Issue 2 of Medicare and Medicaid Research Review, each year since 2004 the average MA risk score increased faster than the average fee-for-service (FFS) score. This relative increase in scores largely reflects changes in diagnostic coding, not real increases in the morbidity of MA enrollees, as survey-based data shows no trend in MA risk scores relative to FFS scores. Increases in risk scores vary widely by MA contract, with some contracts coding very similarly to traditional Medicare and others more intensively than the MA average.

In 2023, over 5.7million people were enrolled in special needs plans (SNPs) in the United States, the highest number of enrollments in the provided time interval. Medicare Advantage plans offer extra benefits beyond the coverage of traditional Medicare. Special Needs Plans (SNPs) are Medicare Advantage (MA) plans for people with limited income or certain chronic conditions or diseases.

Note: After November 1, 2024, this dataset will no longer be updated due to a transition in NHSN Hospital Respiratory Data reporting that occurred on Friday, November 1, 2024. For more information on NHSN Hospital Respiratory Data reporting, please visit https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html.

Due to a recent update in voluntary NHSN Hospital Respiratory Data reporting that occurred on Wednesday, October 9, 2024, reporting levels and other data displayed on this page may fluctuate week-over-week beginning Friday, October 18, 2024. For more information on NHSN Hospital Respiratory Data reporting, please visit https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html. Find more information about the updated CMS requirements: https://www.federalregister.gov/documents/2024/08/28/2024-17021/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient. 

This dataset represents weekly respiratory virus-related hospitalization data and metrics aggregated to national and state/territory levels reported during two periods: 1) data for collection dates from August 1, 2020 to April 30, 2024, represent data reported by hospitals during a mandated reporting period as specified by the HHS Secretary; and 2) data for collection dates beginning May 1, 2024, represent data reported voluntarily by hospitals to CDC’s National Healthcare Safety Network (NHSN). NHSN monitors national and local trends in healthcare system stress and capacity for up to approximately 6,000 hospitals in the United States. Data reported represent aggregated counts and include metrics capturing information specific to COVID-19- and influenza-related hospitalizations, hospital occupancy, and hospital capacity. Find more information about reporting to NHSN at: https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html.

Source: COVID-19 hospitalization data reported to CDC’s National Healthcare Safety Network (NHSN).

• Data source description (updated October 18, 2024): As of October 9, 2024, Hospital Respiratory Data (HRD; formerly Respiratory Pathogen, Hospital Capacity, and Supply data or ‘COVID-19 hospital data’) are reported to HHS through CDC’s National Healthcare Safety Network based on updated requirements from the Centers for Medicare and Medicaid Services (CMS). These data are voluntarily reported to NHSN as of May 1, 2024 until November 1, 2024, at which time CMS will require acute care and critical access hospitals to electronically report information via NHSN about COVID-19, Influenza, and RSV, hospital bed census and capacity, and limited patient demographic information, including age. Data for collection dates prior to May 1, 2024, represent data reported during a previously mandated reporting period as specified by the HHS Secretary. Data for collection dates May 1, 2024, and onwards represent data reported voluntarily to NHSN; as such, data included represents reporting hospitals only for a given week and might not be complete or representative of all hospitals. NHSN monitors national and local trends in healthcare system stress and capacity for approximately 6,000 hospitals in the United States. Data reported by hospitals to NHSN represent aggregated counts and include metrics capturing information specific to hospital capacity, occupancy, hospitalizations, and admissions. Find more information about reporting to NHSN: https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html. Find more information about the updated CMS requirements: https://www.federalregister.gov/documents/2024/08/28/2024-17021/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient. 
• Data quality: While CDC reviews reported data for completeness and errors and corrects those found, some reporting errors might still exist within the data. CDC and partners work with reporters to correct these errors and update the data in subsequent weeks. Data since December 1, 2020, have had error correction methodology applied; data prior to this date may have anomalies that are not yet resolved. Data prior to August 1, 2020, are unavailable.
• Metrics and inclusion criteria: Many hospital subtypes, including acute care and critical access hospitals, are included in the metric calculations included in this dataset. Psychiatric, rehabilitation, and religious non-medical hospital types, as well as Veterans Administration, Defense Health Agency, and Indian Health Service hospitals, are excluded from calculations. For a given metric calculation, hospitals that reported those data at least one day during a given week are included.
• Find full details on NHSN Hospital Respiratory Data (HRD) reporting guidance, including additional information on bed type definitions at https://www.cdc.gov/nhsn/psc/hospital-respiratory-reporting.html.

Notes: May 10, 2024: Due to missing hospital data for the April 28, 2024 through May 4, 2024 reporting period, data for Commonwealth of the Northern Mariana Islands (CNMI) are not available for this period in the Weekly NHSN Hospitalization Metrics report released on May 10, 2024.

May 17, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), Minnesota (MN), and Guam (GU) for the May 5,2024 through May 11, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on May 1, 2024.

May 24, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), and Minnesota (MN) for the May 12, 2024 through May 18, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on May 24, 2024.

May 31, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Virgin Islands (VI), Massachusetts (MA), and Minnesota (MN) for the May 19, 2024 through May 25, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on May 31, 2024.

June 7, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Virgin Islands (VI), Massachusetts (MA), Guam (GU), and Minnesota (MN) for the May 26, 2024 through June 1, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on June 7, 2024.

June 14, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), and Minnesota (MN) for the June 2, 2024 through June 8, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on June 14, 2024.

June 21, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), West Virginia (WV), Massachusetts (MA), American Samoa (AS), Guam (GU), Virgin Islands (VI), and Minnesota (MN) for the June 9, 2024 through June 15, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on June 21, 2024.

June 28, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the June 16, 2024 through June 22, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on June 28, 2024.

July 5, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), West Virginia (WV), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the June 23, 2024 through June 29, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on July 5, 2024.

July 12, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), West Virginia (WV), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the June 30, 2024 through July 6, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on July 12, 2024.

July 19, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the July 7, 2024 through July 13, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on July 19, 2024.

July 26, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the July 13, 2024 through July 20, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on July 26, 2024.

August 2, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), West Virginia (WV), and Minnesota (MN) for the July 21, 2024 through July 27, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on August 2, 2024.

August 9, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), Guam (GU), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the July 28, 2024 through August 3, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on August 9, 2024.

August 16, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the August 4, 2024 through August 10, 2024 reporting period are not available for the Weekly NHSN Hospitalization Metrics report released on August 16, 2024.

August 23, 2024: Data for Commonwealth of the Northern Mariana Islands (CNMI), Massachusetts (MA), American Samoa (AS), Virgin Islands (VI), and Minnesota (MN) for the August 11, 2024 through August 17, 2024 reporting period are not available for the Weekly

This section provides information about Acute Hospital Payments and Rates, and Hospital Remittance Advices and Claims Denials.