Medicare Data and More

General sites:

• https://data.cms.gov/provider-data/
• https://www.medicare.gov/care-compare/
• https://www.medicare.gov/procedure-price-lookup/ National averages
  
• https://www.medicare.gov/medicare-and-you) Medicare Handbook
  

 1. Hospital data

Financial data are on a separate page

Medicare has a summary page for each year since 2013, and links to a "home page" for hospital data each year since 2012 (called IPPS Rule) at the bottom of the main CMS readmission page (and the bottom of the left navigation menu, which is often the only link for the coming year).

• From that home page follow the links for Tables (discussed below and on Payments page).
• There is also a link for Data Files which include the

1. Impact File (names of hospitals, size, categories),
2. Standardizing File (cost factors),
3. Wage Index File
4. Readmissions Supplemental File or Readmissions PUF (numbers of readmissions, PUF=Public Use File)

Item 4, the Readmissions file, is the source of "Number" and "Readmit Rate" for each of the 5 medical categories in our "Combined list" of all hospitals (methods). The file also shows the number of patients set aside from the data for various reasons (transfers, deaths, etc.), and the total DRG weights of readmitted patients (reflecting their costs).

Item 1, the Impact file, is the source of the price and wage adjustments in our Combined List.

Files of death rates and other quality measures for hospital and other patients. These ignore deaths of people who have been in hospice any time in the past year. (methods)

Medicare has data each year, called tables, on:

• item 1, table 1, Hospital payment bases
• item 3, table 5, Disease payment weights (DRG)
• item 5, table 6, Codes for comorbidities worsening the diseases
• item 6, table 7, Number of patients, by disease

Hospital bills for 100 most common diagnoses, each year from 2011 on.

Medicare gives away software to calculate readmission risk. It focuses attention on the frailest patients who are most likely to be readmitted in spite of better care, so are natural targets to promote hospice, comfort care and DNR, even if their condition is treatable.

Data on hospitals' use of Electronic Health Records are on a separate Medicare page.

2. Nursing Home data are on another page

3. Patient and beneficiary data

Medicare has counts for each year since 1985, more detailed in the most recent years.
File of interviews and spending for representative sample of 13,000 Medicare patients living in the community, 2013-2017 (free, 50 megabytes/year)
Medicare Advantage Plans (Part C) encounters with patients.
File of 15,000,000 hospitalized Medicare patients ($3,700 per year, on DVD)
Other data

National Center for Health Statistics has surveys of people and institutions

4. Doctor and treatment data
Medicare has counts and costs for the procedures and tests billed by each doctor and other provider in 2012.

Data on doctors' use of Electronic Health Records are on a separate Medicare page.

5. Drug Use and Costs are on another page.

6. Medical Equipment

Medicare lists doctors who prescribe medical equipment and supplies, by type of equipment, showing numbers and costs, but the file is not organized by provider, so you cannot compare prices at different providers. The goal seems to be to press doctors to prescribe less, rather than help patients or doctors find the best or popular providers.

7. Other sources

Topics are also covered in the MedPAC, Data Book. June 2013

The Agency for Healthcare Research and Quality has data on costs and disease.

Medicare shows, by state or county, number of beneficiaries, as well as users and providers of ambulances, labs, home health, skilled nursing facilities, and hospices.