Centers for Medicare and Medicaid Services

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Details Medicare fee-for-service beneficiaries, Medicare costs, Medicare inpatient service utilization, Medicare outpatient service utilization, Medicare FQHC/RHC service utilization, HCC risk scores, Medicare beneficiary demographics, Medicaid eligibility, chronic health conditions of Medicare beneficiaries (alcohol abuse, Alzheimer’s disease, arthritis, asthma, atrial fibrillation, autism spectrum disorder, cancer, COPD, chronic kidney disease, depression, diabetes, drug/substance abuse heart failure, hepatitis (chronic viral B & C), high cholesterol, high blood pressure, HIV/AIDS, coronary artery disease, osteoporosis, schizophrenia, and stroke)
Topics Medicare, Medicaid, chronic health conditions
Source Centers for Medicare and Medicaid Services
Years Available 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023
Geographies county, state
Public Edition or Subscriber-only Public Edition
Download Available yes
For more information http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Geographic-Variation/index
Last updated on PolicyMap August 2025

Description:

The Centers for Medicare and Medicaid Services’ Chronic Conditions Data Warehouse contains claims information for persons enrolled in the Medicare fee-for-service (FFS) program. Only information for beneficiaries enrolled in both Part A and Part B is included; information for beneficiaries who have died during the study year is included. Non-FFS Medicare beneficiaries are those with partial Part A and/or Part B coverage and people and who were enrolled in Parts A and B Medicare and Medicare Advantage plan.
Medicare Part A (hospital insurance) and Part B (medical insurance) cover individuals ages 65 and over who are receiving Social Security, people who have received disability benefits for at least two years, people who have amyotrophic lateral sclerosis (Lou Gehrig’s disease) and receive disability benefits, and people who have end-stage renal disease (permanent kidney failure) and receive maintenance dialysis or a kidney transplant. Individuals with Medicare Advantage (Part C) and Medicare Prescription Drug Plan (Part D) coverage are not represented in the data.

Chronic health condition data is based on CMS administrative enrollment and claims data for Medicare fee-for-service beneficiaries. A Medicare beneficiary is considered to have a chronic condition if there is a CMS claim indicating that the beneficiary received a service or treatment for that specific condition. Beneficiaries may have more than one of the chronic conditions listed.

In March 2022, the CMS Chronic Conditions Warehouse released an updated algorithm for their Chronic Condition indicators. Due to this algorithm update, some Chronic Conditions indicators may experience significant changes to prevalence rates (i.e., percentages). This update applies to 2021 data and forward. For more information, please visit CMS Mapping Medicare Disparities Tool Technical Documentation.
Please note that Alcohol Use Disorder and Drug Use Disorder conditions are available for years 2007-2018, and 2021 due to CMS’s data availability.

CMS demographics, spending, and service utilization data available on PolicyMap comes from CMS’s Fee-for-Service Geographic Variation Public Use File (FFS GV PUF). This public use file is based primarily on information from CMS’s Chronic Conditions Data Warehouse.

In May 2024, CMS released 2022 data for the FFS GV PUF and updated historic data for years 2014-2021. This is due to CMS using different classification systems to define physician services between the 2014-2022 and 2007-2013 data years. For more information on methodology changes, please visit the FFS GV PUF Technical Documentation May 2024 Update.

All dollar amounts in this data set are standardized by CMS to adjust for factors that result in different payment rates for the same service, including local variations in wages and payments Medicare makes to hospitals to advance program goals (including training doctors). The standardized values represent what Medicare would have paid in the absence of those adjustments. Because the state of Maryland is exempt from reporting special payments to Medicare, costs in Maryland were standardized using different factors than the nationwide model.

Available Data Layers & Indicators
Indicator Name Geographies Measurement Type Time Frame Coverage
Percent of Medicare fee-for-service inpatient hospital readmissions Nation, State, County Percent Annually from 2007 to 2023
Standardized per capita Medicare Costs Nation, State, County Average dollars Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are male Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are African American Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are non-Hispanic White Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are female Nation, State, County Percent Annually from 2007 to 2023
Estimated percent of all people who are Medicare fee-for-service beneficiaries Nation, State, County Percent Annually from 2007 to 2023
Average age of Medicare fee-for-service beneficiaries Nation, State, County Average Annually from 2007 to 2023
Hospital Inpatient covered admissions per 1,000 Medicare fee-for-service beneficiaries Nation, State, County Rate Annually from 2007 to 2023
Rate per 1,000 beneficiaries of inpatient or hospital outpatient emergency department visits among Medicare fee-for-service beneficiaries Nation, State, County Rate Annually from 2007 to 2023
Hospital Outpatient visits per 1,000 Medicare fee-for-service beneficiaries Nation, State, County Rate Annually from 2007 to 2023
FQHC and/or RHC services visits per 1,000 Medicare fee-for-service beneficiaries Nation, State, County Rate Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries eligible for Medicaid Nation, State, County Percent Annually from 2007 to 2023
Average risk score among Medicare fee-for-service beneficiaries Nation, State, County Average Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are Hispanic Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with diabetes Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with stroke Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with asthma Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with chronic kidney disease Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with heart failure Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with schizophrenia or other psychotic disorder Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with coronary artery disease Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with high blood pressure Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with high cholesterol Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with arthritis Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with Alzheimer's disease or dementia Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with depression Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with chronic obstructive pulmonary disease Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with osteoporosis Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with atrial fibrillation Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with autism spectrum disorders Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with cancer Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with hepatitis (chronic viral B & C) Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with HIV/AIDS Nation, State, County Percent Annually from 2007 to 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with alcohol abuse Nation, State, County Percent 2021, 2022, 2023
Percent of Medicare fee-for-service beneficiaries who are diagnosed with drug or substance abuse Nation, State, County Percent 2021, 2022, 2023
Percent of Medicare fee-for-service beneficiaries who are other race/ethnicity or whose race/ethnicity is unknown Nation, State, County Percent Annually from 2007 to 2023
Home Health visits per 1,000 Medicare fee-for-service beneficiaries Nation, State, County Rate Annually from 2007 to 2023