This statistic shows the percentage breakdown in the Hospital Insurance (HI) Medicare benefit payments from 2015 to 2023. In 2023, only about seven percent of such payments were for skilled nursing facilities.

The Centers for Medicare and Medicaid Services (CMS) offers several different Chart Series with data on beneficiary health status, spending, operations, and quality of care.
CMS Facts and Figures includes charts on agency programs and operations. Health Care System Facts and Figures includes charts on the entire U.S. health care system. Medicare Facts and Figures includes charts on the Medicare program. Medicaid Facts and Figures includes charts on the Medicaid program.

The CMS Program Statistics - Medicare Skilled Nursing Facility tables provide use and payment data for skilled nursing facilities. 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 1. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR SNF 2. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR SNF 3. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Area of Residence MDCR SNF 4. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement and Covered Days of Care MDCR SNF 5. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Facility and Bedsize MDCR SNF 6. Medicare Skilled Nursing Facilities: Distribution of Medicare Covered Skilled Nursing Facility Days, by State of Provider and Major Resource Utilization Groups (RUG)-III (versions 2013-2018 only)

In 1970, some 7.5 billion U.S. dollars were spent on the Medicare program in the United States. Fifty plus years later, this figure stood at 1,122.1 billion U.S. dollars. This statistic depicts total Medicare spending from 1970 to 2024. Increasing Medicare coverage Medicare is the federal health insurance program in the U.S. for the elderly and those with disabilities. In the U.S., the share of the population with any type of health insurance has increased to over 90 percent in the past decade. As of 2019, approximately 18 percent of the U.S. population was covered by Medicare in particular. Increasing Medicare costs Medicare costs are forecasted to continue increasing over time, with outlays rising to a predicted 1.78 trillion U.S. dollars by 2031 as the population continues to age. Certain diseases of old age, such as Alzheimer’s disease, are increasing in prevalence in the U.S., which will reflect on healthcare costs for the elderly. In 2021, Alzheimer's disease was estimated to cost Medicare and Medicaid around 239 billion U.S. dollars in care costs; by 2050, this number is projected to climb to 798 billion dollars.

The Medicare Secondary Payer project is an annual process which attempts to identify working Medicare beneficiaries and/or their spouses. The first stage of this process is to extract all of the Medicare beneficiaries from the MBR. Prior to 2015, CSPOTRUN performed this function. Beginning in 2015, CSRETAP accomplishes this. In this process two files are prepared. One file goes to the Internal Revenue Service (IRS) for a tax return search and the other file is used for the Master Earnings File (MEF) search. IRS searches their tax return database and identifies returns that have spouses identified and returns this information to SSA. This file is then run against the MEF to obtain any current employment information for the beneficiary or the spouse. This data is sent to CMS for their process to determine whether Medicare should be the secondary payer for hospital and doctors bills. They determine whether the beneficiary and/or spouse have current health insurance coverage from their employer.

Context

I found this data set online while I was looking for unique data sets. We all know that there are probably inequalities in medicare by city or by state, as there are many flaws in the system. So I thought I would like to explore this data to find where those inequalities rest.

Content

The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments.

Acknowledgements

Here is where I got my data: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient2016.html

Thanks to the US gov't for the info!

Inspiration

What relationships can you find in the data? What inequalities can you find? Can you regress the data?

This statistic depicts total Medicare income from 1970 to 2024. In 1970, the Medicare program generated a total income of some 8.2 billion U.S. dollars. Fifty plus years later, this figure stood at over 1,133 billion U.S. dollars.

Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment According to findings appearing in Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment, published in Volume 2, Issue 4 of the Medicare and Medicaid Research Review, during the initial open enrollment period, although overall knowledge about the Part D program was limited, beneficiaries who knew correct facts about the program, like everyone has plan choices and assistance is available for low income beneficiaries, were more likely to enroll in a plan. Efforts to educate Medicare beneficiaries about the Part D program may improve rates of prescription drug coverage.

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.

California has more Medicaid and CHIP enrollees than any other state in the United States. As of April 2023, approximately 13 million Americans were enrolled in the Medicaid health insurance programs in California, which accounted for approximately 15 percent of the total number of Medicaid enrollees nationwide (94.4 million).

Blow to Medicaid expansion plans California is one of many states that has expanded its Medicaid program under the Affordable Care Act (ACA) to encourage more low-income adults to sign up for health coverage. One of the original aims of the ACA was to limit some of the variations in state Medicaid programs, but the Supreme Court ruled that the expansion should be optional. Governors of the states that did not expand said they were concerned about long-term costs. California is the leading state for Medicaid expenditure, spending approximately 97.8 billion U.S. dollars in FY2020.

Health coverage for children The Children’s Health Insurance Program (CHIP) was created as a complement to Medicaid, expanding the reach of government-funded health coverage to more children in low-income families. As of May 2021, over five million children were enrolled in Medicaid/CHIP programs in California, more than any other state. As of January 2021, the median Medicaid/CHIP eligibility level for children was 255 percent of the federal poverty level.

This dataset provides the number of L447 notices SSA mailed to beneficiaries who SSA found potentially eligible for either a Medicare Savings Programs or Extra Help with Medicare Prescription Drug Plan Costs. The dataset includes data at the zip code level. Zip codes with 10 or less mailed notices are indicated by an asterisk for privacy protection purposes.

Stores Management Information about Medicare Part C & Part D data for premiums and Medicare Part D Prescription Drug Subsidy processing and workload management data.

Subscribers can find out export and import data of 23 countries by HS code or product’s name. This demo is helpful for market analysis.

Cigna Corporation provides insurance and related products and services in the United States. Its Evernorth segment provides a range of coordinated and point solution health services, including pharmacy, benefits management, care delivery and management, and intelligence solutions to health plans, employers, government organizations, and health care providers. The company's Cigna Healthcare segment offers medical, pharmacy, behavioral health, dental, vision, health advocacy programs, and other products and services for insured and self-insured customers; Medicare Advantage, Medicare Supplement, and Medicare Part D plans for seniors, as well as individual health insurance plans to on and off the public exchanges; and health care coverage in its international markets, as well as health care benefits for mobile individuals and employees of multinational organizations. The company also offers permanent insurance contracts sold to corporations to provide coverage on the lives of certain employees for financing employer-paid future benefit obligations. It distributes its products and services through insurance brokers and consultants; directly to employers, unions and other groups, or individuals; and private and public exchanges. The company was founded in 1792 and is headquartered in Bloomfield, Connecticut.

In 2022, nearly 59 percent of Medicaid and CHIP enrollees were aged between 18 and 64 years, while adults aged 65 years accounted for only 17.4 percent of enrollees. Medicaid program is funded jointly by the federal and the state governments, it provided coverage to nearly 19.5 percent of the U.S. population in 2022.

Medicaid vs CHIP

Medicaid and the Children’s Health Insurance Program (CHIP) both provide health insurance coverage for children from low-income families. Children who are not eligible for Medicaid but who would otherwise be unable to obtain insurance through a family plan are covered by CHIP. More than five million children were enrolled in CHIP in the U.S. in 2023.

Medicaid and CHIP funding rate

The Federal Medical Assistance Percentages (FMAPs) are used to calculate the amount of federal matching funds for State Medicare and CHIP programs. To encourage states to expand coverage for uninsured children the federal matching rates for CHIP are generally 15 points higher than the Medicaid rate. However, unlike permanent federal funding for Medicaid, CHIP federal funding is capped and due to expire in FY 2027.

Uses SVES to obtain data from the Prisoner Update Processing System.

Abstract

We had to delete V3 of MarketScan Medicare Supplemental because of some unusual circumstances with the formats of some of the files we were sent (to prevent the duplication of records). V3.1 contains all of the info that was in V3, however V3.1 has 2022 data & a slightly different version of the 2021 data. The data on this page is the version of the 2021 data that was in V3. Our purpose in posting this is to enable researchers who completed analyses on V3 to replicate their work by combining the data here with the data on the main page.

FOR THE MAJORITY OF RESEARCHERS, however, we strongly recommend using V3.1, and ignoring this page, as it will be irrelevant for most research going forward. (Rule of thumb: If you are unsure whether you need the data on this page, then you probably don't need it.)

Usage

To recreate V3 of the data, use the data for 2020 and earlier that is on the main MarketScan Medicare Supplemental page, and combine it with the data on this page. That will give you the exact same data that was in V3.

The data documentation on the main MarketScan Medicare Supplemental page also applies to the data on this page.

How is the data on this page different from the 2021 data on the main MarketScan Medicare Supplemental page?

Metadata access is required to view this section.

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).

Contains Title II and Medicare Data. Specifically data relating to Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D.

Annual report providing earnings and employment data by state and county for persons covered under the Social Security and Medicare programs. Report for 2000.