Medicare Fee For Service Expenditure Data

**Overview**
This data package includes datasets that provide the necessary data to evaluate the Medicare Advantage system of fee-for-service payments to hospitals and practices based on the geographical location. The datasets contain data about the adjustments indices used by Centers for Medicare and Medicaid Services (CMS) at county and state level and about the repriced reimbursements based on indices, at county and state level for aged, disabled and beneficiaries with End-Stage Renal Disease (ESRD).

**Description**
This data package contains the Geographic adjustments are intended to ensure that the Medicare Program does not overpay hospitals and practitioners in certain areas and underpay in other because of geographic difference in price for resources such as clinical and administrative staff salaries and benefits, office or hospital space (rent), malpractice insurance (premiums), and other resources that are part of the cost of providing care. The historical claims data are used to rebase the Medicare Advantage (MA) Fee-For-Service (FFS) capitation Ratebook for the next years. The historical claims data is rebased to reflect the most current wage and cost indices. The datasets containing adjusted or repriced Medicare expenditure for aged, disabled and individuals with end-stage renal disease (ESRD) reflect the annual impact of the repricing of FFS claims, at county level.

The datasets containing data about the geographic adjustment indices cover the following:
- Inpatient Prospective Payment System (IPPS) wage and provider indices
- Geographic Practice Cost Indices (GPCI)
- Home Health Agency (HHA) wage indices
- Skilled Nursing Facilities (SNF) wage indices

The datasets containing the repriced claims-based reimbursement data, are for the following services offered to each, Aged and Disabled beneficiaries:
- Medicare Part A and B covered services,
- Durable Medical Equipment (DME) and Durable Medical Equipment Non-Competitive Bidding Area (DME Non-CBA) related services,
- Home Health Agency (HHA) services,
- Hospice services covered by Medicare Part A and B,
- Inpatient services,
- Outpatient services,
- Physician services,
- Services for people in Puerto Rico,
- Skilled Nursing Facility (SNF) services,
- Uncompensated Care services, and combined to both, Aged and Disabled beneficiaries, the services offered by Accountable Care Organizations (ACO).

One dataset contains the repriced claims-based reimbursement data for the services offered to beneficiaries with End-Stage Renal Disease (ESRD).

**Benefits**
- Useful to medicare advantage interested parties and public health specialists or the specialized public. the fields descriptions along with the dataset description are useful for the user to quickly understand the data and the dataset.

**License Information**
The use of John Snow Labs datasets is free for personal and research purposes. For commercial use please subscribe to the [Data Library](https://www.johnsnowlabs.com/marketplace/) on John Snow Labs website. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.

**Included Datasets**
- [Geographic Indices HHA Wage Index](https://www.johnsnowlabs.com/marketplace/geographic-indices-hha-wage-index)
- The dataset has information on the Medicare payment adjustments of geographic indices of Home Health Agency wage index for calendar years 2016-2022. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.
- [Geographic Indices IPPS Provider Index](https://www.johnsnowlabs.com/marketplace/geographic-indices-ipps-provider-index)
- The dataset has information on the Medicare payment adjustments of geographic indices for Inpatient Prospective Payment System (IPPS) by provider number for the fiscal years 2016-2022. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.
- [Geographic Indices IPPS Wage Index](https://www.johnsnowlabs.com/marketplace/geographic-indices-ipps-wage-index)
- The dataset has information on the Medicare payment adjustments of geographic indices for Inpatient Prospective Payment System (IPPS) wage index for the fiscal years 2014-2020. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.
- [Geographic Indices Physician GPCI](https://www.johnsnowlabs.com/marketplace/geographic-indices-physician-gpci)
- The dataset has information on the Medicare payment adjustments of Geographic Practice Cost Indices (GPCI) for calendar years 2015-2021. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.
- [Geographic Indices SNF Wage Index](https://www.johnsnowlabs.com/marketplace/geographic-indices-snf-wage-index)
- The dataset has information on the Medicare payment adjustments of Geographic Indices Skilled Nursing Facility (SNF) Wage index for the fiscal years 2010-2020. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.
- [Repricing FFS Claims ACO Combined Data Aged Disabled PartsA PartB](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aco-combined-data-aged-disabled-partsa-partb)
- The dataset includes the Accountable Care Organizations (ACOs) combined data for aged and disabled beneficiaries reimbursement for part A and part B by state and county of residence for the years 2012-2016.
- [Repricing FFS Claims Aged Disabled Acute Inpatient Hospital Services](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-acute-inpatient-hospital-services)
- The dataset includes the data for aged and disabled, Medicare Part A, beneficiaries reimbursement for acute inpatient hospital services by state and county of residence. The data included cover the years 2016 to 2020.
- [Repricing FFS Claims Aged Disabled Cost Contracts For PartA And PartB](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-cost-contracts-for-parta-and-partb)
- The dataset includes aged and disabled beneficiaries’ reimbursement data for cost contracts for part A and part B by state and county for years 2016-2020. It also contains Medicare Fee-For-Service (FFS) data for each county by aged and disabled beneficiaries including total Medicare FFS reimbursement data for Parts A and B, reimbursement for direct graduate education (DGME) and indirect medical education (IME) expenditures and disproportionate share hospital (DSH) expenditures for Part A.
- [Repricing FFS Claims Aged Disabled Home Health Agency PartA And PartB](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-home-health-agency-parta-and-partb)
- The dataset includes the data for aged and disabled, Medicare Part A and Part B, beneficiaries reimbursement for Home Health Agency (HHA) by state and county of residence. The data included cover the years 2016 to 2020.
- [Repricing FFS Claims Aged Disabled Hospice PartA And PartB](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-hospice-parta-and-partb)
- The dataset includes the data for aged and disabled, Medicare Part A and Part B, beneficiaries reimbursement for the hospice by state and county of residence. The data included cover the years 2016 to 2022.
- [Repricing FFS Claims Aged Disabled Outpatient Healthcare Services](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-outpatient-healthcare-services)
- The dataset includes the data for aged and disabled, Medicare Part B, beneficiaries reimbursement for outpatient healthcare services by state and county of residence. The data included cover the years 2016 to 2020.
- [Repricing FFS Claims Aged Disabled Physician Fee Schedule](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-physician-fee-schedule)
- The dataset includes the data for aged and disabled, Medicare Part B, beneficiaries reimbursement for physician fee schedule (PFS) by state and county of residence. The data included cover the years 2016 to 2020.
- [Repricing FFS Claims Aged Disabled Puerto Rico PartA And PartB](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-disabled-puerto-rico-parta-and-partb)
- The dataset includes the data for aged and disabled, Medicare Part A and Part B, beneficiaries reimbursement for Puerto Rico by county of residence. The data included cover the year 2022.
- [Repricing FFS Claims Aged Durable Medical Equipment Non-CBA](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-durable-medical-equipment-non-cba)
- The dataset includes the data for aged and disabled, Medicare Part B, beneficiaries reimbursement for Durable Medical Equipment Non-Competitive Bidding Area (Non-CBA) by state and county of residence. The data included cover the years 2016-2020.
- [Repricing FFS Claims Aged Durable Medical Equipment](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-durable-medical-equipment)
- The dataset includes the data for aged and disabled, Medicare Part B, beneficiaries reimbursement for Durable Medical Equipment by state and county of residence. The data included cover the years 2016-2020.
- [Repricing FFS Claims Aged Skilled Nursing Facility Reimbursement](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-skilled-nursing-facility-reimbursement)
- The dataset includes data for Aged beneficiaries of Skilled Nursing Facility Reimbursement by state and county of residence. Medicare fee-for-service data for each county broken down by aged, disabled, and end-stage renal disease (ESRD) beneficiaries.
- [Repricing FFS Claims Aged Uncompensated Care Reimbursement Data](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged-uncompensated-care-reimbursement-data)
- The dataset includes data for Aged beneficiaries repricing adjustments to the 2014-2018 uncompensated care reimbursement by state and county of residence. Medicare Fee-For-Service (FFS) data for each county broken down by aged, disabled, and and end-stage renal disease (ESRD) beneficiaries.
- [Repricing FFS Claims Aged](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-aged)
- The dataset includes data for Aged beneficiaries for part A and part B by state and county of residence. Medicare fee-for-service data for each county broken down by aged, disabled, and end-stage renal disease (ESRD) beneficiaries.
- [Repricing FFS Claims Dialysis PartA PartB](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-dialysis-parta-partb)
- The dataset includes data for End-Stage Renal Disease (ESRD) beneficiaries or Dialysis for Part A Part B by state and county of residence. Medicare fee-for-service (FFS) data for each county broken down by aged, disabled, and ESRD beneficiaries.
- [Repricing FFS Claims Disabled Skilled Nursing Facility Data](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-disabled-skilled-nursing-facility-data)
- The dataset includes data for Disabled beneficiaries Skilled Nursing Facility Reimbursement by state and county of residence. Medicare Fee-For-Service (FFS) data for each county broken down by aged, disabled, and end-stage renal disease (ESRD) beneficiaries.
- [Repricing FFS Claims Disabled Uncompensated Care Reimbursement Data](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-disabled-uncompensated-care-reimbursement-data)
- The dataset includes data for Disabled beneficiaries repricing adjustments to the 2010-2014 uncompensated care reimbursement by state and county of residence. Medicare Fee-For-Service (FFS) data for each county broken down by aged, disabled, and end-stage renal disease (ESRD) beneficiaries.
- [Repricing FFS Claims Disabled](https://www.johnsnowlabs.com/marketplace/repricing-ffs-claims-disabled)
- The dataset includes data for disabled beneficiaries for part A and part B by state and county of residence. Medicare Fee-For-Service (FFS) data for each county broken down by aged, disabled, and end-stage renal disease (ESRD) beneficiaries.

**Data Engineering Overview**
**We deliver high-quality data**
- Each dataset goes through 3 levels of quality review
- 2 Manual reviews are done by domain experts
- Then, an automated set of 60+ validations enforces every datum matches metadata & defined constraints
- Data is normalized into one unified type system
- All dates, unites, codes, currencies look the same
- All null values are normalized to the same value
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- Data and Metadata
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- Metadata is provided in the open Frictionless Data standard, and its every field is normalized & validated
- Data Updates
- Data updates support replace-on-update: outdated foreign keys are deprecated, not deleted

**Our data is curated and enriched by domain experts**

Each dataset is manually curated by our team of doctors, pharmacists, public health & medical billing experts:
- Field names, descriptions, and normalized values are chosen by people who actually understand their meaning
- Healthcare & life science experts add categories, search keywords, descriptions and more to each dataset
- Both manual and automated data enrichment supported for clinical codes, providers, drugs, and geo-locations
- The data is always kept up to date – even when the source requires manual effort to get updates
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