The Medicare Geographic Variation by National, State & County dataset provides information on the geographic differences in the use and quality of health care services for the Original Medicare population. This dataset contains demographic, spending, use, and quality indicators at the state level (including the District of Columbia, Puerto Rico, and the Virgin Islands) and the county level.

Spending is standardized to remove geographic differences in payment rates for individual services as a source of variation. In general, total standardized per capita costs are less than actual per capita costs because the extra payments Medicare made to hospitals were removed, such as payments for medical education (both direct and indirect) and payments to hospitals that serve a disproportionate share of low-income patients. Standardization does not adjust for differences in beneficiaries’ health status.

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

The All CMS Data Feeds dataset is an expansive resource offering access to 119 unique report feeds, providing in-depth insights into various aspects of the U.S. healthcare system including nursing facility owners and accountable care organization participants contact data. With over 25.8 billion rows of data meticulously collected since 2007, this dataset is invaluable for healthcare professionals, analysts, researchers, and businesses seeking to understand and analyze healthcare trends, performance metrics, and demographic shifts over time. The dataset is updated monthly, ensuring that users always have access to the most current and relevant data available.

Dataset Overview:

118 Report Feeds: - The dataset includes a wide array of report feeds, each providing unique insights into different dimensions of healthcare. These topics range from Medicare and Medicaid service metrics, patient demographics, provider information, financial data, and much more. The breadth of information ensures that users can find relevant data for nearly any healthcare-related analysis. - As CMS releases new report feeds, they are automatically added to this dataset, keeping it current and expanding its utility for users.

25.8 Billion Rows of Data:

• With over 25.8 billion rows of data, this dataset provides a comprehensive view of the U.S. healthcare system. This extensive volume of data allows for granular analysis, enabling users to uncover insights that might be missed in smaller datasets. The data is also meticulously cleaned and aligned, ensuring accuracy and ease of use.

Historical Data Since 2007: - The dataset spans from 2007 to the present, offering a rich historical perspective that is essential for tracking long-term trends and changes in healthcare delivery, policy impacts, and patient outcomes. This historical data is particularly valuable for conducting longitudinal studies and evaluating the effects of various healthcare interventions over time.

Monthly Updates:

• To ensure that users have access to the most current information, the dataset is updated monthly. These updates include new reports as well as revisions to existing data, making the dataset a continuously evolving resource that stays relevant and accurate.

Data Sourced from CMS:

• The data in this dataset is sourced directly from the Centers for Medicare & Medicaid Services (CMS). After collection, the data is meticulously cleaned and its attributes are aligned, ensuring consistency, accuracy, and ease of use for any application. Furthermore, any new updates or releases from CMS are automatically integrated into the dataset, keeping it comprehensive and current.

Use Cases:

Market Analysis:

• The dataset is ideal for market analysts who need to understand the dynamics of the healthcare industry. The extensive historical data allows for detailed segmentation and analysis, helping users identify trends, market shifts, and growth opportunities. The comprehensive nature of the data enables users to perform in-depth analyses of specific market segments, making it a valuable tool for strategic decision-making.

Healthcare Research:

• Researchers will find the All CMS Data Feeds dataset to be a robust foundation for academic and commercial research. The historical data, combined with the breadth of coverage across various healthcare metrics, supports rigorous, in-depth analysis. Researchers can explore the effects of healthcare policies, study patient outcomes, analyze provider performance, and more, all within a single, comprehensive dataset.

Performance Tracking:

• Healthcare providers and organizations can use the dataset to track performance metrics over time. By comparing data across different periods, organizations can identify areas for improvement, monitor the effectiveness of initiatives, and ensure compliance with regulatory standards. The dataset provides the detailed, reliable data needed to track and analyze key performance indicators.

Compliance and Regulatory Reporting:

• The dataset is also an essential tool for compliance officers and those involved in regulatory reporting. With detailed data on provider performance, patient outcomes, and healthcare utilization, the dataset helps organizations meet regulatory requirements, prepare for audits, and ensure adherence to best practices. The accuracy and comprehensiveness of the data make it a trusted resource for regulatory compliance.

Data Quality and Reliability:

The All CMS Data Feeds dataset is designed with a strong emphasis on data quality and reliability. Each row of data is meticulously cleaned and aligned, ensuring that it is both accurate and consistent. This attention to detail makes the dataset a trusted resource for high-stakes applications, where data quality is critical.

Integration and Usability:

Ease of Integration:

• The dataset is provided in a CSV format, which is widely compatible with most data analysis too...

The CMS Program Statistics - Medicare Part A & Part B - All Types of Service tables provide use and payment data by type of coverage and type of service. 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 SUMMARY AB 1. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for All Original Medicare Beneficiaries, by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 2. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Aged Original Medicare Beneficiaries, by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 3. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Disabled Original Medicare Beneficiaries by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 4. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Coverage, Demographic Characteristics, and Medicare-Medicaid Enrollment Status MDCR SUMMARY AB 5. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Coverage and by Area of Residence MDCR SUMMARY AB 6. Medicare Part A and Part B Summary: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Amount of Program Payments, Type of Coverage, and Type of Service

This series of files links two large population-based sources providing detailed data about Medicare beneficiaries with cancer. The SEER (Surveillance, Epidemiology, and End Results) program consists of clinical, demographic, and cause of death information collected from tumor registries beginning in January 1, 1973. The Medicare contribution includes all claims for covered health care services from beneficiaries’ time of eligibility until death. Linkage is processed biennially by SEER and Centers for Medicare and Medicaid Services (CMS) staff. 95% of individuals age 65 and older are included in the SEER files. Due to privacy concerns, access to this database requires an application, SEER-Medicare Data Use Agreement (DUA), and documentation of institutional review board approval. Additionally, the National Cancer Institute’s information technology contractor assesses a processing fee the amount of which is dependent upon the type and number of files requested.

The Medicare Physician & Other Practitioners by Provider dataset provides information on use, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI). Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The Medicare Home Health Agency tables provide use and payment data for home health agencies. The tables include use and expenditure data from home health Part A (Hospital Insurance) and Part B (Medical Insurance) claims. 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 HHA 1. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR HHA 2. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR HHA 3. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Area of Residence MDCR HHA 4. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, Type of Agency and Type of Service Visit MDCR HHA 5. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, by Type of Control and Type of Service Visit MDCR HHA 6. Medicare Home Health Agencies: Persons with Utilization, Total Service Visits, and Program Payments for Original Medicare Beneficiaries, by Number of Service Visits and Number of Episodes

The Medicare Geographic Variation by National, State & County dataset provides information on the geographic differences in the use and quality of health care services for the Original Medicare population. This dataset contains demographic, spending, use, and quality indicators at the state level (including the District of Columbia, Puerto Rico, and the Virgin Islands) and the county level. Spending is standardized to remove geographic differences in payment rates for individual services as a source of variation. In general, total standardized per capita costs are less than actual per capita costs because the extra payments Medicare made to hospitals were removed, such as payments for medical education (both direct and indirect) and payments to hospitals that serve a disproportionate share of low-income patients. Standardization does not adjust for differences in beneficiaries’ health status.

The CMS Program Statistics - Medicare Part D tables provide use and Part D drug costs by type of Part D plan (stand-alone prescription drug plan and Medicare Advantage prescription drug plan). 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 UTLZN D 1. Medicare Part D Utilization: Average Annual Prescription Drug Fills by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Generic Dispensing Rate, Yearly Trend MDCR UTLZN D 2. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 3. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 4. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan and Demographic Characteristics MDCR UTLZN D 5. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan and Demographic Characteristics MDCR UTLZN D 6. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan, by Area of Residence MDCR UTLZN D 7. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan, by Area of Residence MDCR UTLZN D 8. Medicare Part D Utilization: Number of Part D Utilizers and Average Annual Prescription Drug Fills by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 9. Medicare Part D Utilization: Number of Part D Utilizers and Drug Costs by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 10. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Events (Fills) and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Demographic Characteristics MDCR UTLZN D 11. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Area of Residence

The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF contains information on utilization, payment (Medicare payment and standard payment), submitted charges, primary diagnoses, sites of service, and hospice beneficiary demographics organized by CMS Certification Number 6-digit provider identification number, and state. This PUF is based on information from CMSs Chronic Conditions Data Warehouse (CCW) data files. The data in the Hospice PUF covers calendar year 2014 and contains 100 percent final-action i.e., all claim adjustments have been resolved, hospice claims for the Medicare population including beneficiaries enrolled in a Medicare Advantage plan.
Although the Hospice PUF has a wealth of payment and utilization information about hospice services, the data set also has a number of limitations. The information presented in this file does not indicate the quality of care provided by individual hospice providers. The file only contains cost and utilization information. Additionally, the data are not risk adjusted and thus do not account for differences in patient populations. For additional limitations, please review the methodology document available below.

This dataset contains State data for Medicare beneficiaries of ages 18-65 years old. The dataset includes state and county level data that covers demographic, cost utilization and quality data for all ages. The Geographic Variation Public Use File serve as an evaluation of the utilization and quality of healthcare services according to the geographic area of the population covered by Medicare.

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 Medicare Geographic Variation by Hospital Referral Region dataset provides information for researchers and policymakers to evaluate the geographic differences in the use and quality of health care services for the Original Medicare population. The dataset includes demographic, spending, use, and quality indicators at the hospital referral region (HRR) level. Please note that CMS has decided to discontinue updates to the Fee-for-Service (FFS) Geographic Variation Public Use File by Hospital Referral Region, so the dataset is retired. Data in the FFS Geographic Variation Public Use File by Hospital Referral Region has been divided into two files: 2007-2013 data and 2014-2021 data. This was done to account for changes to the Geographic Variation methodology beginning with data year 2014. The 2007-2013 data is located under data year 2013, and the 2014-2021 data is located under data year 2021.

Analysis of ‘Medicare Geographic Variation - by Hospital Referral Region’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/44d05cca-26e6-4385-bf88-5c96c4d70137 on 11 February 2022.

--- Dataset description provided by original source is as follows ---

The Medicare Geographic Variation by Hospital Referral Region dataset provides information for researchers and policymakers to evaluate the geographic differences in the use and quality of health care services for the Original Medicare population. The dataset includes demographic, spending, use, and quality indicators at the hospital referral region (HRR) level.

--- Original source retains full ownership of the source dataset ---

The Medicare Current Beneficiary Survey (MCBS) - Survey File Microdata Public Use File (PUF) dataset provides information on topics such as Medicare beneficiaries' access to care, health status, other information regarding beneficiaries’ knowledge of, attitudes toward, and satisfaction with their health care, as well as demographic data and information on all types of health insurance coverage.Resources for Using and Understanding the DataThis dataset is based on information from the MCBS and administrative data. The MCBS is a continuous, multi-purpose longitudinal survey covering a representative national sample of the Medicare population, including the population of beneficiaries aged 65 and over and beneficiaries aged 64 and below with certain disabling conditions. The MCBS collects this information in three data collection periods, or rounds, per year. Disclosure protections have been applied to the file, including de-identification and other methods. As a result, the MCBS Survey File Microdata file does not require a Data Use Agreement (DUA). In contrast, the MCBS Limited Data Set (LDS) releases contain beneficiary-level protected health information (PHI) and therefore require a DUA. The MCBS - Survey File Microdata file is not intended to replace the more detailed LDS files but, rather, it makes available a general-use publicly-available alternative that provides the highest degree of protection to the Medicare beneficiaries’ PHI. The main benefits of using the MCBS - Survey File Microdata file are:Increased data access for researchers of the MCBS through a free file download that is consistent with other U.S. Department of Health and Human Services (HHS) public-use survey files.Enhanced potential for policy-relevant analyses, by attracting new researchers and policymakers. Accessing the MCBS LDS can be a significant deterrent due to the associated costs and time but the MCBS - Survey File Microdata file mitigates these barriers to encourage broader utilization. A link to the more detailed MCBS LDS files is provided in the Resources section on this page. MCBS LDS data are also presented in the MCBS Chartbook linked in the Visualization section on this page.

Aggregate demographic information about the eligible population is contained in the population files.

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees by primary language spoken (English, Spanish, and all other languages). Results are shown overall; by state; and by five subpopulation topics: race and ethnicity, age group, scope of Medicaid and CHIP benefits, urban or rural residence, and eligibility category. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, the Northern Mariana Islands, and select states with data quality issues with the primary language variable in TAF are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown overall (where subpopulation topic is "Total enrollees") exclude enrollees younger than age 5 and enrollees in the U.S. Virgin Islands. Results for states with TAF data quality issues in the year have a value of "Unusable data." Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Primary language spoken by the Medicaid and CHIP population in 2020." Enrollees are assigned to a primary language category based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to the comprehensive benefits or limited benefits subpopulation according to the criteria in the "Identifying Beneficiaries with Full-Scope, Comprehensive, and Limited Benefits in the TAF" DQ Atlas brief. Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to an eligibility category subpopulation using their latest reported eligibility group code, CHIP code, and age in the calendar year. Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

The CMS Program Statistics - Medicare Hospice tables provide use and payment data for hospice. 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 HOSPICE 1. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR HOSPICE 2. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR HOSPICE 3. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Area of Residence MDCR HOSPICE 4. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Control and Type of Service Visit MDCR HOSPICE 5. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Level of Care and Site of Service MDCR HOSPICE 6. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Number of Service Visits

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.

The MBSF mortality denominator can be used to study mortality rates of the elder population in the US. Access to CMS data is restricted. Processed datasets cannot be shared. Contact the authors if you've purchased CMS data through RESDAC and would like to use our data processing pipelines to clean CMS raw data and generate the MBSF mortality denominator. Medicare Overview In the United States, when individuals reach the age of 65, they become eligible for the Medicare federal health insurance program. Medicare also covers individuals under 65 if they have certain disabilities or End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). About CMS The Center for Medicare & Medicaid Services (CMS) is the federal agency responsible for managing the Medicare and Medicaid data. CMS makes predefined datasets available for purchase to researchers after they enter a Data usage agreement through Research Data Assistance Center (ResDAC). Master Beneficiary Summary File (MBSF) A beneficiary-level data from CMS/ResDAC is known as the Master Beneficiary Summary File (MBSF). The raw MBSF data contains basic demographic information of individuals, an indicator of death, and some details on their medicare enrollment. Mortality Denominator We refer to the mortality denominator as the clean subset of MBSF health data that is representative of the older population. The subset consists of the US elder population; notably, individuals under 64 who qualified because of a disability are excluded.