Health Insurance Plan Payments

**Overview**
This dataset covers Healthcare coverage status of adults in New York state, Health insurance minorities and low English level by census tract, Health insurance single parent and disability by census tracts, Health insurance and socioeconomic status by census tracts, Medicare Part B, Part D drug cost and utilization data, Medicare Part D plan reconciliation contract, Part D plan reconciliation parent organization, Medicare plan payment Part C county & plan level, Medicare plan payment Part D.

**Description**
Health insurance plans Unified Rate Review, Health insurance rate by plan level age tobacco use and location; Information on Medicare FFS claims that underwent Comprehensive Error Rate Testing (CERT) medical review. Estimates of the health care coverage status for the entire population of noninstitutionalized (18+ years old) persons from New York State, broken down by demographic categories and groups. Census tract level and estimated data about the number of uninsured non-institutionalized civilians, the number of persons belonging to minority (from ethnicity point of view, including Hispanic/Latino population) and the number of persons aged 5 and older who speak English less than well. Census tract level estimates for the number of uninsured noninstitutionalized civilians, number of single-parent households with children under 18 and for the number of noninstitutionalized civilians with a disability. Census tract level estimates for the number of uninsured noninstitutionalized civilians, number of persons below the poverty line, unemployed population, number of persons with no high school diploma, which are socioeconomic characteristics with a negative impact on the access to healthcare services.Information on the drug spending and utilization information on Medicare Part B drugs (drugs administered in doctors’ offices and other outpatient settings) and Medicare Part D drugs (drugs patients generally administer themselves).

Results by contract of the audit of the Centers for Medicare & Medicaid Services’ Medicare Part D Prescription Drug Event (PDE) reconciliation process performed by an independent certified public accounting firm. Results by the parent organization of the audit of the Centers for Medicare & Medicaid Services’ Medicare Part D Prescription Drug Event (PDE) reconciliation process performed by an independent certified public accounting firm. Average payment per member per month for Medicare Part C Plans by county, Medicare Part C Plans by plan level, Medicare Part D Plans. The number of people in the U.S. will have an increase in their premium even while qualifying for the Extra Help (Low Income Subsidy) at state and zip code level. Health insurance plans rate filing information on rate increases submitted to the Centers for Medicare & Medicaid Services (CMS). Health Insurance Rate by Plan Level Age Tobacco Use And Location carry plan-level data on individual rates based on an eligible subscriber’s age, tobacco use, and geographic location. Details on variations in insurance plan rates with age ratings, tobacco ratings, geography, family size, small group market ratings. Information on Medicare FFS claims that underwent Comprehensive Error Rate Testing (CERT) medical review.

**Benefits**
- Useful in assessing the impact of these socioeconomic variables on the access to healthcare services and on the population health status. help inform geographical areas for targeted outreach efforts to find and assist individuals who may see an increase in their cost-sharing while qualifying for the low-income subsidy.

**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**
- [Active Third Party Administrators in Iowa](https://www.johnsnowlabs.com/marketplace/active-third-party-administrators-in-iowa)
- This dataset shows the active third-party administrator (TPA) in Iowa. A third-party administrator is an entity that performs insurance and claims related tasks for residents of the state of Iowa.
- [Health Care Coverage Of Adults In New York State](https://www.johnsnowlabs.com/marketplace/health-care-coverage-of-adults-in-new-york-state)
- This dataset contains estimates of the health care coverage status for the entire population of noninstitutionalized (18+ years old) persons from New York State, broken down by and by demographic categories and groups, starting with 2011.
- [Health Insurance Business Rules PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-business-rules-puf)
- This dataset shows the plan-level data on rating business rules, such as allowed relationships (e.g., spouse, dependents) and tobacco use by the Centers for Medicare & Medicaid Services (CMS).
- [Health Insurance Minorities and Low English Level by Tracts 2010-2014](https://www.johnsnowlabs.com/marketplace/health-insurance-minorities-and-low-english-level-by-tracts-2010-2014)
- This dataset contains census tract level and estimated data about the number of uninsured non-institutionalized civilians, the number of persons belonging to minority (from ethnicity point of view, including Hispanic/Latino population) and the number of persons aged 5 and older who speak English less than well. In this dataset could be found all US census tracts and the estimates are made using data collected from 2010 to 2014 by the American Community Survey (ACS).
- [Health Insurance Minorities and Low English Level by Tracts 2014-2018](https://www.johnsnowlabs.com/marketplace/health-insurance-minorities-and-low-english-level-by-tracts-2014-2018)
- This dataset contains census tract level and estimated data about the number of uninsured non-institutionalized civilians, the number of persons belonging to minority (from ethnicity point of view, including Hispanic/Latino population) and the number of persons aged 5 and older who speak English less than well. In this dataset could be found all US census tracts and the estimates are made using data collected from 2014 to 2018 by the American Community Survey (ACS).
- [Health Insurance Plan ID Crosswalk PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-plan-id-crosswalk-puf)
- This dataset shows the plan-level data mapping plans offered in the previous plan year (2019) to plans offered in the current plan year (2022) by the Centers for Medicare & Medicaid Services (CMS).
- [Health Insurance Plan Level Individual Rates PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-plan-level-individual-rates-puf)
- This dataset contains the Rate Public Use File (PUF) that makes up the Marketplace Public Use Files. The Rate-PUF contains plan-level data on individual rates based on an eligible subscriber’s age, tobacco use, and geographic location.
- [Health Insurance Plans Unified Rate Review PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-plans-unified-rate-review-puf)
- The Public Health Service Act (PHSA) and the implementing regulation, establish requirements for health insurance issuers (issuers) offering health insurance coverage for non-grandfathered products in the small group and/or individual markets to submit rate filing information on rate increases to the Centers for Medicare & Medicaid Services (CMS).
- [Health Insurance Provider Network PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-provider-network-puf)
- This dataset shows the issuer-level data identifying provider network URLs by the Centers for Medicare & Medicaid Services (CMS).
- [Health Insurance Service Area PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-service-area-puf)
- This dataset shows the Issuer-level data on geographic service areas including state, county, and zip code by the Centers for Medicare & Medicaid Services (CMS).
- [Health Insurance Single Parent and Disability by Tracts 2010-2014](https://www.johnsnowlabs.com/marketplace/health-insurance-single-parent-and-disability-by-tracts-2010-2014)
- This dataset is focused on offering census tract level estimates for the number of uninsured noninstitutionalized civilians, the number of single-parent households with children under 18 and for the number of noninstitutionalized civilians with a disability. The dataset contains data for all US census tracts; the estimates were made using data collected from 2010 to 2014.
- [Health Insurance Single Parent and Disability by Tracts 2014-2018](https://www.johnsnowlabs.com/marketplace/health-insurance-single-parent-and-disability-by-tracts-2014-2018)
- This dataset is focused on offering census tract level estimates for the number of uninsured noninstitutionalized civilians, the number of single-parent households with children under 18 and for the number of noninstitutionalized civilians with a disability. The dataset contains data for all US census tracts; the estimates were made using data collected from 2014 to 2018.
- [Health Insurance Transparency in Coverage PUF](https://www.johnsnowlabs.com/marketplace/health-insurance-transparency-in-coverage-puf)
- This dataset shows the issuer-level claims, appeals, and active URL data. The PY2022 PUF contains data from PY2021 for issuers participating in the Exchange in PY2020.
- [Health Insurance and Socioeconomic Status by Census Tracts 2010-2014](https://www.johnsnowlabs.com/marketplace/health-insurance-and-socioeconomic-status-by-census-tracts-2010-2014)
- This dataset offers census tract level estimates for the number of uninsured noninstitutionalized civilians, number of persons below poverty line, unemployed population, number of persons with no high school diploma, which are socioeconomic characteristics with a negative impact on the access to healthcare services.
- [Health Insurance and Socioeconomic Status by Census Tracts 2014-2018](https://www.johnsnowlabs.com/marketplace/health-insurance-and-socioeconomic-status-by-census-tracts-2014-2018)
- This dataset offers census tract level estimates for the number of uninsured noninstitutionalized civilians, number of persons below poverty line, unemployed population, number of persons with no high school diploma, which are socioeconomic characteristics with a negative impact on the access to healthcare services.
- [Insurance Producers Licensed in Iowa](https://www.johnsnowlabs.com/marketplace/insurance-producers-licensed-in-iowa)
- This dataset provides a listing of resident and non-resident insurance producers licensed to sell to Iowans.
- [Medicare Comprehensive Error Rate Testing Improper Payment Data](https://www.johnsnowlabs.com/marketplace/medicare-comprehensive-error-rate-testing-improper-payment-data)
- The dataset includes detailed information on Medicare fee-for-service (FFS) claims that underwent Comprehensive Error Rate Testing (CERT) medical review for the years 2011 to 2021 report period. These claims were used to calculate the Medicare fee-for-service improper payment rate.
- [Medicare Part B Drug Cost and Utilization Data 2011-2015](https://www.johnsnowlabs.com/marketplace/medicare-part-b-drug-cost-and-utilization-data-2011-2015)
- The 2015 Medicare Part B Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part B drugs (drugs administered in doctors’ offices and other outpatient settings) and includes annual data for 2011 to 2015.
- [Medicare Part B Drug Cost and Utilization Data 2016-2020](https://www.johnsnowlabs.com/marketplace/medicare-part-b-drug-cost-and-utilization-data-2016-2020)
- The Medicare Part B Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part B drugs (drugs administered in doctors’ offices and other outpatient settings) and includes annual data for 2016 to 2020.
- [Medicare Part B Drug Cost and Utilization Data](https://www.johnsnowlabs.com/marketplace/medicare-part-b-drug-cost-and-utilization-data)
- The 2015 Medicare Part B Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part B drugs (drugs administered in doctors’ offices and other outpatient settings) and includes annual data for 2011 to 2015.
- [Medicare Part C Plan Payment County Level](https://www.johnsnowlabs.com/marketplace/medicare-part-c-plan-payment-county-level)
- This dataset contains information provided by insurance companies regarding average payment per member per month for Medicare Part C Plans by county.
- [Medicare Part C Plan Payment](https://www.johnsnowlabs.com/marketplace/medicare-part-c-plan-payment)
- This dataset contains information provided by insurance companies regarding average payment per member per month for Medicare Part C Plans by plan level.
- [Medicare Part D Drug Cost and Utilization Data 2011-2015](https://www.johnsnowlabs.com/marketplace/medicare-part-d-drug-cost-and-utilization-data-2011-2015)
- The 2015 Medicare Part D Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part D drugs (drugs patients generally administer themselves) and includes annual data for 2011 to 2015.
- [Medicare Part D Drug Cost and Utilization Data 2016-2020](https://www.johnsnowlabs.com/marketplace/medicare-part-d-drug-cost-and-utilization-data-2016-2020)
- The 2020 Medicare Part D Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part D drugs (drugs patients generally administer themselves) and includes annual data for 2016 to 2020.
- [Medicare Part D Drug Cost and Utilization Data](https://www.johnsnowlabs.com/marketplace/medicare-part-d-drug-cost-and-utilization-data)
- The 2015 Medicare Part D Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part D drugs (drugs patients generally administer themselves) and includes annual data for 2011 to 2015.
- [Medicare Part D Plan Payment](https://www.johnsnowlabs.com/marketplace/medicare-part-d-plan-payment)
- This dataset contains information by insurance companies contracts regarding average payment per member per month for Medicare Part D Plans.
- [Medicare Part D Plan Reconciliation Contract](https://www.johnsnowlabs.com/marketplace/medicare-part-d-plan-reconciliation-contract)
- This dataset contains the results by contract of the audit of the Centers for Medicare & Medicaid Services’ Medicare Part D Prescription Drug Event (PDE) reconciliation process performed by an independent certified public accounting firm.
- [Medicare Part D Plan Reconciliation Parent Organization](https://www.johnsnowlabs.com/marketplace/medicare-part-d-plan-reconciliation-parent-organization)
- This dataset contains the results by parent organization of the audit of the Centers for Medicare & Medicaid Services’ Medicare Part D Prescription Drug Event (PDE) reconciliation process performed by an independent certified public accounting firm.
- [Notice List of Beneficiaries Who Chose Premium Plan For 2012](https://www.johnsnowlabs.com/marketplace/notice-list-of-beneficiaries-who-chose-premium-plan-for-2012)
- The dataset reflects the number of people in the U.S. who received the choosers notice sent to those who selected their own plan and will have an increase in their premium even while qualifying for the Extra Help (Low Income Subsidy) in 2012 at the state and zip code level.
- [Qualified Health Plans in Market](https://www.johnsnowlabs.com/marketplace/qualified-health-plans-in-market)
- This dataset shows 2018 individual and family health plans available in the United States where the federal government is operating the Marketplace. States not represented in the dataset runs their own Marketplaces.
- [Quality Dental Plans in Market](https://www.johnsnowlabs.com/marketplace/quality-dental-plans-in-market)
- This dataset shows 2023 individual and family dental plans available in states where the federal government is operating the Marketplace. States not represented in the dataset runs their own Marketplaces.
- [Total Effectuated Enrollment and Financial Assistance by State](https://www.johnsnowlabs.com/marketplace/total-effectuated-enrollment-and-financial-assistance-by-state)
- This dataset shows the total effectuated enrollment and financial assistance yearly from Februay 2016 to February 2021 by the United States.
- [Washington Dental Loss Ratios](https://www.johnsnowlabs.com/marketplace/washington-dental-loss-ratios)
- This dataset serves as a dental insurance summary database for Performance Year (PY) 2015-2016. This dataset is cumulative at the company level as reported to the National Association of Insurance Commissioners (NAIC).

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搜集汇总

背景与挑战

背景概述

该数据集整合了纽约州成年人医保覆盖状态、人口普查区层面的社会人口统计数据和Medicare各部分的支付信息，涵盖药物成本、利用率及计划审计结果等多维度医疗支付数据。数据经过严格的质量审查和标准化处理，适用于医疗政策分析和健康服务研究。