In 2022, just under four in ten Medicaid/CHIP enrollees were White, non-Hispanic. In comparison, roughly three-quarters of Medicare beneficiaries were White. The Affordable Care Act (ACA) Medicaid expansion in 2014, has helped reduce racial disparities in access to healthcare in the United States.

Medicaid eligibility

Medicaid provides health coverage to certain low-income individuals, families, children, pregnant women, the elderly, and persons with disabilities. Each state has its own Medicaid eligibility criteria in accordance with federal guidelines. As a result, Medicaid eligibility and benefits differ widely from state to state. Medicaid expansion provision under the Affordable Care Act (ACA) allows states to provide coverage for low-income adults by expanding eligibility for Medicaid to 138 percent of the federal poverty line (FPL).

Medicaid coverage gap

Uninsured individuals who live in states that have chosen not to expand Medicaid under the Affordable Care Act (ACA) are referred to as being in the Medicaid coverage gap. As of January 2021, 12 states have not adopted the Medicaid expansion provision under the Affordable Care Act (ACA). More than two million uninsured adults fall into this coverage gap, and among them, more than 60 percent are people of color.

This is a peer-reviewed supplementary table for the article 'Healthcare resource utilization, costs and treatment associated with myasthenia gravis exacerbations among patients with myasthenia gravis in the USA: a retrospective analysis of claims data' published in the Journal of Comparative Effectiveness Research.Supplementary Table 1: MG treatment definitionsAim: There are limited data on the clinical and economic burden of exacerbations in patients with myasthenia gravis (MG). We assessed patient clinical characteristics, treatments and healthcare resource utilization (HCRU) associated with MG exacerbation. Patients & methods: This was a retrospective analysis of adult patients with MG identified by commercial, Medicare or Medicaid insurance claims from the IBM MarketScan database. Eligible patients had two or more MG diagnosis codes, without evidence of exacerbation or crisis in the baseline period (12 months prior to index [first eligible MG diagnosis]). Clinical characteristics were evaluated at baseline and 12 weeks before each exacerbation. Number of exacerbations, MG treatments and HCRU costs associated with exacerbation were described during a 2-year follow-up period. Results: Among 9352 prevalent MG patients, 34.4% (n = 3218) experienced ≥1 exacerbation after index: commercial, 53.0% (n = 1706); Medicare, 39.4% (n = 1269); and Medicaid, 7.6% (n = 243). During follow-up, the mean (standard deviation) number of exacerbations per commercial and Medicare patient was 3.7 (7.0) and 2.7 (4.1), respectively. At least two exacerbations were experienced by approximately half of commercial and Medicare patients with ≥1 exacerbation. Mean total MGrelated healthcare costs per exacerbation ranged from $26,078 to $51,120, and from $19,903 to $49,967 for commercial and Medicare patients, respectively. AChEI use decreased in patients with multiple exacerbations, while intravenous immunoglobulin use increased with multiple exacerbations. Conclusion: Despite utilization of current treatments for MG,MG exacerbations are associated with a high clinical and economic burden in both commercial and Medicare patients. Additional treatment options and improved disease management may help to reduce exacerbations and disease burden.

This data package contains free-standing Home Health Agencies Medicare cost reports by fiscal year, released annually by the Centers for Medicare and Medicaid Services (CMS). The datasets contain the highest level of Medicare cost report status.

Medicaid Fraud Control Units (MFCU or Unit) investigate and prosecute Medicaid fraud as well as patient abuse and neglect in health care facilities. OIG certifies, and annually recertifies, each MFCU. OIG collects information about MFCU operations and assesses whether they comply with statutes, regulations, and OIG policy. OIG also analyzes MFCU performance based on 12 published performance standards and recommends program improvements where appropriate.

This dataset includes Medicaid Managed Care, Commercial HMO, and Commercial PPO performance data from the Quality Assurance Reporting Requirements (QARR) by member demographic characteristics. QARR is largely based on measures of quality developed and published by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®). Plans are required to submit quality performance data each year. Demographic information analyzed in this report includes members’ sex, age, race/ethnicity, Medicaid aid category, cash assistance status, behavioral health conditions including serious mental illness (SMI) and substance use disorder (SUD), payer status, and region of residence. Measuring the quality of care, and the ability to measure disparities in care is an important first step to a better understanding of the underlying factors that drive differences in care among certain populations within Medicaid Managed Care, Commercial HMO, and Commercial PPO. These data are published annually for Medicaid Managed Care in the Health Care Disparities in New York State Report and on the NYSDOH web site: https://www.health.ny.gov/health_care/managed_care/reports/

This data package contains the data package includes all datasets released by the Centers for Medicare and Medicaid Services (CMS) that belong to the category of Ratebooks & Supporting Data for Medicare Advantage Plan costs estimation. The data contained are related to the two components of the capitated payment (rates and risk scores) and to the county and regional statutory benchmark.

In the fiscal year of 2025, the budget for the Department of Health and Human Services is expected to be about 1.83 trillion U.S. dollars. In comparison, the Small Business Administration is expected to have a budget of 1.46 billion U.S. dollars.

United States Federal Government

The federal government in the United States is comprised of three branches of the government: the legislative, executive, and judicial branches. The executive branch is the office of the President of the United States, the legislative branch is the United States Congress, and the judicial branch is the United States Supreme Court.The U.S. cabinet belongs to the executive branch of the government, which belongs to the president and vice president.

U.S. Department of Health and Human Services

The U.S. Department of Health and Human Services is the department of the federal government that provides health services to Americans. The Secretary of the department is Xavier Becerra, who was appointed by current president Joe Biden. Some of the Operating Divisions in this department include the Food and Drug Administration, the Center for Disease Control and Prevention, and the National Institutes of Health. The outlays for the Department of Health and Human Services have been steadily increasing since 2000. The agency that had the highest amount of spending in this department in 2020 was the Centers of Medicare and Medicaid Services.

The CMS Office of Enterprise Data and Analytics has developed CMS Program Statistics, which includes detailed summary statistics on national health care, Medicare populations, utilization, and expenditures, as well as counts for Medicare-certified institutional and non-institutional providers. CMS Program Statistics is organized into sections which can be downloaded and viewed separately. Tables and maps will be posted as they become finalized. CMS Program Statistics is replacing the Medicare and Medicaid Statistical Supplement, which was published annually in electronic form from 2001-2013.

This dataset provides information related to returning citizens released from a Department of Corrections facility and enrolled in Medicaid during the time period 01/2019 to 03/2022. It contains total number of paid Medicaid claims, cost, and median cost by recipient county. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

This dataset provides information related to returning citizens released from a Department of Corrections facility and enrolled in Medicaid during the time period 01/2019 to 03/2022 and diagnosed with with opioid dependence, alcohol dependence, nicotine dependence, hypertension, anxiety disorder, depression or Type II diabetes. It contains total number of paid Medicaid claims, cost, and median cost by recipient county. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

After May 3, 2024, this dataset and webpage will no longer be updated because hospitals are no longer required to report data on COVID-19 hospital admissions, and hospital capacity and occupancy data, to HHS through CDC’s National Healthcare Safety Network. Data voluntarily reported to NHSN after May 1, 2024, will be available starting May 10, 2024, at COVID Data Tracker Hospitalizations.

The following dataset provides facility-level data for hospital utilization aggregated on a weekly basis (Sunday to Saturday). These are derived from reports with facility-level granularity across two main sources: (1) HHS TeleTracking, and (2) reporting provided directly to HHS Protect by state/territorial health departments on behalf of their healthcare facilities.

The hospital population includes all hospitals registered with Centers for Medicare & Medicaid Services (CMS) as of June 1, 2020. It includes non-CMS hospitals that have reported since July 15, 2020. It does not include psychiatric, rehabilitation, Indian Health Service (IHS) facilities, U.S. Department of Veterans Affairs (VA) facilities, Defense Health Agency (DHA) facilities, and religious non-medical facilities.

For a given entry, the term “collection_week” signifies the start of the period that is aggregated. For example, a “collection_week” of 2020-11-15 means the average/sum/coverage of the elements captured from that given facility starting and including Sunday, November 15, 2020, and ending and including reports for Saturday, November 21, 2020.

Reported elements include an append of either “_coverage”, “_sum”, or “_avg”.

• A “_coverage” append denotes how many times the facility reported that element during that collection week.
• A “_sum” append denotes the sum of the reports provided for that facility for that element during that collection week.
• A “_avg” append is the average of the reports provided for that facility for that element during that collection week.

The file will be updated weekly. No statistical analysis is applied to impute non-response. For averages, calculations are based on the number of values collected for a given hospital in that collection week. Suppression is applied to the file for sums and averages less than four (4). In these cases, the field will be replaced with “-999,999”.

A story page was created to display both corrected and raw datasets and can be accessed at this link: https://healthdata.gov/stories/s/nhgk-5gpv

This data is preliminary and subject to change as more data become available. Data is available starting on July 31, 2020.

Sometimes, reports for a given facility will be provided to both HHS TeleTracking and HHS Protect. When this occurs, to ensure that there are not duplicate reports, deduplication is applied according to prioritization rules within HHS Protect.

For influenza fields listed in the file, the current HHS guidance marks these fields as optional. As a result, coverage of these elements are varied.

For recent updates to the dataset, scroll to the bottom of the dataset description.

On May 3, 2021, the following fields have been added to this data set.

• hhs_ids
• previous_day_admission_adult_covid_confirmed_7_day_coverage
• previous_day_admission_pediatric_covid_confirmed_7_day_coverage
• previous_day_admission_adult_covid_suspected_7_day_coverage
• previous_day_admission_pediatric_covid_suspected_7_day_coverage
• previous_week_personnel_covid_vaccinated_doses_administered_7_day_sum
• total_personnel_covid_vaccinated_doses_none_7_day_sum
• total_personnel_covid_vaccinated_doses_one_7_day_sum
• total_personnel_covid_vaccinated_doses_all_7_day_sum
• previous_week_patients_covid_vaccinated_doses_one_7_day_sum
• previous_week_patients_covid_vaccinated_doses_all_7_day_sum

On May 8, 2021, this data set has been converted to a corrected data set. The corrections applied to this data set are to smooth out data anomalies caused by keyed in data errors. To help determine which records have had corrections made to it. An additional Boolean field called is_corrected has been added.

On May 13, 2021 Changed vaccination fields from sum to max or min fields. This reflects the maximum or minimum number reported for that metric in a given week.

On June 7, 2021 Changed vaccination fields from max or min fields to Wednesday reported only. This reflects that the number reported for that metric is only reported on Wednesdays in a given week.

On September 20, 2021, the following has been updated: The use of analytic dataset as a source.

On January 19, 2022, the following fields have been added to this dataset:

• inpatient_beds_used_covid_7_day_avg
• inpatient_beds_used_covid_7_day_sum
• inpatient_beds_used_covid_7_day_coverage

On April 28, 2022, the following pediatric fields have been added to this dataset:

• all_pediatric_inpatient_bed_occupied_7_day_avg
• all_pediatric_inpatient_bed_occupied_7_day_coverage
• all_pediatric_inpatient_bed_occupied_7_day_sum
• all_pediatric_inpatient_beds_7_day_avg
• all_pediatric_inpatient_beds_7_day_coverage
• all_pediatric_inpatient_beds_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_0_4_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_12_17_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_5_11_7_day_sum
• previous_day_admission_pediatric_covid_confirmed_unknown_7_day_sum
• staffed_icu_pediatric_patients_confirmed_covid_7_day_avg
• staffed_icu_pediatric_patients_confirmed_covid_7_day_coverage
• staffed_icu_pediatric_patients_confirmed_covid_7_day_sum
• staffed_pediatric_icu_bed_occupancy_7_day_avg
• staffed_pediatric_icu_bed_occupancy_7_day_coverage
• staffed_pediatric_icu_bed_occupancy_7_day_sum
• total_staffed_pediatric_icu_beds_7_day_avg
• total_staffed_pediatric_icu_beds_7_day_coverage
• total_staffed_pediatric_icu_beds_7_day_sum

On October 24, 2022, the data includes more analytical calculations in efforts to provide a cleaner dataset. For a raw version of this dataset, please follow this link: https://healthdata.gov/Hospital/COVID-19-Reported-Patient-Impact-and-Hospital-Capa/uqq2-txqb

Due to changes in reporting requirements, after June 19, 2023, a collection week is defined as starting on a Sunday and ending on the next Saturday.

The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) contain the universe of emergency department visits in participating States. The data are translated into a uniform format to facilitate multi-State comparisons and analyses. The SEDD consist of data from hospital-based emergency department visits that do not result in an admission. The SEDD include all patients, regardless of the expected payer including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels. The SEDD contain clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and facilities (as required by data sources). Data elements include but are not limited to: diagnoses, procedures, admission and discharge status, patient demographics (e.g., sex, age, race), total charges, length of stay, and expected payment source, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. In addition to the core set of uniform data elements common to all SEDD, some include State-specific data elements. The SEDD exclude data elements that could directly or indirectly identify individuals. For some States, hospital and county identifiers are included that permit linkage to the American Hospital Association Annual Survey File and the Bureau of Health Professions' Area Resource File except in States that do not allow the release of hospital identifiers. Restricted access data files are available with a data use agreement and brief online security training.

The Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample (NEDS) is the largest all-payer emergency department (ED) database in the United States. yielding national estimates of hospital-owned ED visits. Unweighted, it contains data from over 30 million ED visits each year. Weighted, it estimates roughly 145 million ED visits nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. Sampled from the HCUP State Inpatient Databases (SID) and State Emergency Department Databases (SEDD), the HCUP NEDS can be used to create national and regional estimates of ED care. The SID contain information on patients initially seen in the ED and subsequently admitted to the same hospital. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decision making at the national, State, and community levels. The NEDS contain information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 85% of patients, regardless of expected payer, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as ‘no charge’. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.Restricted access data files are available with a data use agreement and brief online security training.

The dataset contains information about the prevalence of chronic conditions among Original Medicare beneficiaries as well as about the spending and co-occurring conditions for those with each condition. The data are available for California and for the rest of the United States, overall and by demographic and geographic groups. Additionally, the data are available for each of 19 California geographic regions overall and by demographic and geographic groups. The data represent Medicare beneficiaries who are in the Original Medicare program. Medicare offers health care coverage for older adults and certain individuals with disabilities. The Original Medicare program is Parts A and B of Medicare, administered by the U.S. Centers for Medicare & Medicaid Services. The analysis excludes enrollees of the Medicare Advantage program, administered by private insurers, because Medicare Advantage data are incomplete.

In 2023, the total value of direct premiums written by private health insurance companies amounted to approximately 1.2 trillion U.S. dollars. This is more than double the 459.27 billion U.S. dollars recorded ten years prior in 2013, and over 200 billion U.S. dollars higher than the value recorded in 2022. Note these totals include direct premiums written under the Medicare and Medicaid programs, both of which are (largely) public funded.

The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health professionals, administrators, policymakers, and clinicians in their decision-making regarding this critical source of care. The NEDS can be weighted to produce national estimates. The NEDS is the largest all-payer ED database in the United States. It was constructed using records from both the HCUP State Emergency Department Databases (SEDD) and the State Inpatient Databases (SID), both also described in healthdata.gov. The SEDD capture information on ED visits that do not result in an admission (i.e., treat-and-release visits and transfers to another hospital). The SID contain information on patients initially seen in the emergency room and then admitted to the same hospital. The NEDS contains 25-30 million (unweighted) records for ED visits for over 950 hospitals and approximates a 20-percent stratified sample of U.S. hospital-based EDs. The NEDS contains information about geographic characteristics, hospital characteristics, patient characteristics, and the nature of visits (e.g., common reasons for ED visits, including injuries). The NEDS contains clinical and resource use information included in a typical discharge abstract, with safeguards to protect the privacy of individual patients, physicians, and hospitals (as required by data sources). It includes ED charge information for over 75% of patients, regardless of payer, including patients covered by Medicaid, private insurance, and the uninsured. The NEDS excludes data elements that could directly or indirectly identify individuals, hospitals, or states.

In January 2013, the Urban Institute launched the Health Reform Monitoring Survey (HRMS), a survey of the nonelderly population, to explore the value of cutting-edge, Internet-based survey methods to monitor the Affordable Care Act (ACA) before data from federal government surveys are available. Topics covered by the 16th round of the survey (third quarter 2018) include self-reported health status, health insurance coverage, access to and use of health care, out-of-pocket health care costs, health care affordability, work experience, awareness of Medicaid work requirements, experiences with health care and social service providers, and health plan choice. Additional information collected by the survey includes age, gender, sexual orientation, marital status, education, race, Hispanic origin, United States citizenship, housing type, home ownership, internet access, income, employment status, and employer size.