Medicare Links to Additional Resources

Centers for Medicare & Medicaid Services (CMS)

National Health Expenditure Data. Data includes historical and projected spending measures on annual health spending in the U.S. by type of service delivered (hospital care, physician services, nursing home care, etc.) and source of funding for those services (private health insurance, Medicare, Medicaid, out-of-pocket spending, etc.).

CMS Statistics. Summary information about health expenditures and the Medicare and Medicaid programs.

CMS Data Compendium. Contains historic, current, and projected data on Medicare enrollment and Medicaid recipients, expenditures, and utilization. Also includes data pertaining to budget, administrative and operating costs, individual income, financing, and health care providers and suppliers are also included.

Medicare and Medicaid Statistical Supplement.  The Medicare and Medicaid Statistical Supplement contains approximately 300 pages of statistical information about Medicare, Medicaid, and other Centers for Medicare & Medicaid Services (CMS) programs.  The Supplement includes charts and tables showing health expenditures for the entire U.S. population, characteristics of the covered populations, use of services, and expenditures under these programs.

Medicare Trustees Reports. Detailed, lengthy document, containing a substantial amount of data on the past and estimated future financial operations of the Medicare Hospital Insurance and Supplementary Medical Insurance Trust Funds.

Medicare Enrollment. This site contains various Medicare enrollment tables.  It includes national and state enrollment trends, state enrollment by aged, disabled and all, as well as county level enrollment.

Medicare Current Beneficiary Survey (MCBS). MCBS is a continuous, multipurpose survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries.  MCBS, which is sponsored by CMS, is the only comprehensive source of information on the health status, health care use and expenditures, health insurance coverage, and socioeconomic and demographic characteristics of the entire spectrum of Medicare beneficiaries.

Fee-for-Service Statistics Utilization statistics for Medicare Parts A and B. Tables for Medicare utilization for Part A and Medicare utilization for Part B are included.  Information included for hospitals, home health agencies, hospice, skilled nursing facilities, physician and other Part B services.

Prospective Payment Systems. A Prospective Payment System (PPS) is a method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount.  CMS uses separate PPSs for reimbursement to acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.  Links to information about each specific PPS.

Fee Schedules. Listing of fee maximums used to reimburse a physician and/or other providers on a fee-for-service basis.  MS develops fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.  Links to information about each specific fee schedule.

Physician Fee ScheduleContains information on payments under the physician fee schedule and related information concerning the development of the payment amounts.

Medicare Advantage and Medicare Part D Contract and Enrollment DataThe Medicare Advantage (MA) / Part D Contract and Enrollment Data section is a centralized repository for publicly available data on contracts and plans, enrollment numbers, service area data, and contact information for MA, Prescription Drug Plan (PDP), cost, PACE, and demonstration organizations.  Data is broken down by state, county and contract.  Also provides annual Medicare Health Plan Employer Data and Information Set (HEDIS) performance measures.

Medicare Advantage Rates and StatisticsContains information on MA payment methodology, rate calculation data, benchmarks, risk adjustment, and fee-for-service expenditure data by county.

Medicare Prescription Drug BenefitIncludes links to data on drug plan availability, premium information, Part D enrollment, and coverage gap spending.

Congressional Budget Office (CBO)

April 2014 Medicare Baseline

Collection of CBO Medicare related publications including reports and cost-estimates (scores) on recent legislation

2014 Long-Term Budget Outlook including forecasts of Medicare spending and its relationship to total federal spending and GDP

Medicare Payment Advisory Commission (MedPAC)

Data Book: Health Care Spending and the Medicare Program, June 2014

June 2014 Report to Congress, Medicare and the Health Care Delivery System

March 2014 Report to Congress, Medicare Payment Policy

Non-Government Sources

Kaiser Family Foundation State Health Facts: Medicare Data

Kaiser Family Foundation Health and Prescription Drug Plan Tracker

This page was prepared on September 3, 2014 for the 2014 version of the House Ways and Means Committee Green Book.