Data compendium

2010·4 MB·English

by  Centers for Medicare & Medicaid Services (U.S.). Office of Research, Development, and Information

2010
•
Data
Compendium

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Centers for Medicare Medicaid Services
.V 2010
DATA
COMPENDIUM
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U.S. Department of Health and Human Services
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Centers for Medicare Medicaid Services
Office of Research, Development, and Information
Baltimore, Maryland

2010 DATA COMPENDIUM
LIST OF TABLES
BUDGET:
Table 1.1-CMS Disbursements, Fiscal Years 2009-2011
Table 1.2 - Program Benefit Payments, Selected Fiscal Years
Table 1.3- Program Benefit Payments Per Enrollee, Selected Fiscal Years
Table 1.4- Benefit Outlays by Program, Selected Fiscal Years
EXPENDITURES:
Table II.1-CMS Benefit Payments by Major Program Service Categories, Fiscal Year 2009
Table 11.2 - Medicare Trust Fund Projections, Fiscal Years 2007-2010
Table 11.3 - Medicare Benefit Payments byType of Benefit, Fiscal Years 2007-2009
Table 11.4- Medicaid Payments by Basis of Eligibility, Selected Fiscal Years
Table 11.5- Medicaid Payments byType ofService and Basis of Eligibility, Fiscal Year 2007
Table 11.6- Medicaid Medical Assistance Payments byType ofService, Fiscal Years 2006-2008
Table 11.7- National Health Care byType of Expenditure, CalendarYear 2008
Table 11.8-CMS Benefit Payments by Major Personal Health Expenditure Service Categories,
CalendarYear 2008
Table 11.9- National Health Expenditures: Public and Private Funding, Selected Calendar Years
Table 11.10- National Health Expenditures Source ofFunds, Selected CalendarYears
Table 11.11 - Personal Health Care Payment Source, Selected CalendarYears
Table 11.12 -Consumer Price Index, All Urban Consumers, Selected Components
ADMINISTRATIVE/OPERATING:
Table lll.l - Medicare Operations ofthe HI Trust Fund Report, Selected Fiscal Years
Table III.2 - Medicare Operationsofthe SMI Trust Fund, Selected Fiscal Years
Table III.3 - Medicare SMI Part BTrust Fund Income, Selected Fiscal Years
Table 111.4- Medicare Ratio ofPart B Benefit Paymentsto Premium Income, Selected Fiscal Years
Table III.5- Medicare Administrative Expenses, Selected Fiscal Years
Table III.6- Medicare Contractors
Table III.7 - Medicare Redeterminations
Table III.8- Medicare Physician/SupplierClaims Charge Reductions, Selected Fiscal Years 1985-2010
Table III.9- Medicare Charge Determination Data for Physician/Supplier Claims, Selected
Fiscal Years 1975-2010
Table 111.10- Medicaid Administrative Expenses, Fiscal Years 2006-2009
POPULATIONS:
Table IV.l - Medicare Enrollees, Selected Years
Table IV.2 - Medicare HI and/orSMI Enrollment Demographics, 2009
Table IV.3 - Medicare HI and/orSMI Enrollment End Stage Renal Disease Demographics, 2009
Table IV.4- Medicare HI Enrollment Demographics, Selected Years
Table IV.5- Medicare Aged Hospital Insurance Enrollment Demographics, Selected Years
Table IV.6- Medicare State Buy-Ins forSMI, 2000-2009
Table IV.7- Medicare Part D Enrollment byAge Group, 2010
Table IV.8- Medicaid Enrollment and Beneficiaries, Selected Fiscal Years
Table IV.9 - Medicaid Eligibles Demographics, Selected Fiscal Years
Table IV.10- Life Expectancy at Birth and at Age 65 by Race and Sex: United States,
Selected CalendarYears
Table IV.ll - Period Life Expectancyat Age 65, Historical and Projected Intermediate Alternative
UTILIZATION:
Table V.l - Medicare Short-Stay Hospital Utilization, Selected Fiscal Years
Table V.2 - Medicare Short-Stay Hospital Days per Person by Days ofCare, CalendarYear 2009
Table V.3 - Medicare Short-Stay Hospital Discharges by Length ofStay, CalendarYear2009
Table V.4- Medicare Short-Stay Hospital DRGs Ranked by Discharges, Fiscal Year 2009
Table V.5 - Medicare Ranking forAll Short-Stay Hospitals, Fiscal Year 2009
Table V.6a, Table V.6b, and Table V.6c- Medicare Leading Part B Procedure Codes Ranked byAllowed
Charges, CalendarYear 2009
Table V.7 - Leading Medicare Physician and Supplier BETOS, Classifications Based on Allowed Charges,
CalendarYears 2009
Table V.8- Medicare Persons Served byType ofCoverage, Selected CalendarYears
Table V.9- Medicare Persons Served byType ofService, Calendaryear 2009
Table V.10- Medicare Use ofSelected Types of Long-Term Care, Calendar Years 1982-2009
Table V.ll - Medicare End Stage Renal Disease (ESRD) byTreatment Modality
Table V.12 - Medicare End Stage Renal Disease (ESRD) Point Prevalence, byTreatment Modality and
Demographics, 2006
Table V.13 - Home Health Agency, Medicare National Summary
Table V.14- Hospice, Medicare National Summary
Table V.15 -Skilled Nursing Facilities, Medicare National Summary
Table V.16-Outpatient, Medicare National Summary
Table V.17 - Medicaid Eligibles byType ofService, Fiscal Years 2003-2007
Table V.18 - National Community Hospital Utilization, 1973-2008
PROVIDERS/SUPPLIERS:
Table VI.1 - Medicare Hospital and SNF/NF/ICF Facility Counts, November 2010
Table VI.2- Medicare Inpatient Hospitals, Selected Years
Table VI.3 -Other Medicare Providers and Suppliers, Selected Years
Table VI.4-Selected Medicare Facilities byType ofControl, 2009
Table VI.5 - Medicare PIP Facilities, Selected Years
Table VI.6- Medicare Participating Physician Program
Table VI.7 - Medicare Assigned Claims, Selected Fiscal Years
Table VI.8- Participation Rates as Percentage of Physicians, by Specialty, Selected Periods
Table VI.9 - Medicare Advantage, Cost, PACE, Demo, and Prescription Drug Contract Report, 2009
STATE:
Table VII.1 - Net Reported Medical Assistance Payments, Fiscal Year 2009
Table VII.2 - Mean Medicaid Outlays by Basis of Eligibility, 2007
Table VII.3 - Medicare Enrollment by State, 2009
Table VI1.4- Medicare Enrollment as a Percent of Resident Population by State, 2009
Table VII.5 - Medicare Part D Enrollment by State, 2010
Table VII.6- Medicare PDP and MA-PA Enrollment byState, 2010
Table VII.7 - Medicare Part D and Retiree Drug Subsidy Enrollment byState, 2010
Table VII.8a and Table Vll.8b - Medicare Part D Enrollment by Organization Type, Arrayed by State, 2010
Table VII.9 - Medicaid Eligibles by State, Fiscal Year 2007
Table VII.10- Medicare State Buy-Insfor Part A and Part B, July 2010
Table VII.11 - Medicare Persons Served by State, CalendarYear 2009
Table VII.12 - National Community Hospital Care by State, 2008 Annual Survey
Table VII.13a and Table VII.13b- Medicare Skilled Nursing Facility Utilization by State,
Calendar Year 2009
Table VII.14a and Table VII.14b- Medicare Home Health Agency Utilization, Calendar Year2009
Table VII.15a and Table VII.15b- Medicare Hospice Utilization, CalendarYear 2009
Table VII.16- Medicare Inpatient Hospitals by State, 2009
Table VII.17 - Medicare Skilled Nursing Facilities and Certified Beds by State, 2009
Table VII.18 - Nursing Facilities Certified for Medicaid Only and Other Medicaid Long-Term Care
Facilities by State, 2009
Table VII.19 -Community Hospitals by State, 2008 Annual Survey
Table VII.20- Medicare Part B Participating Physicians and Other Practitioners by State, Selected Years
Table VII.21 - Physician Assignment Rates as a Percent ofAllowed Charges by State, Fiscal Year 2010
FINANCING:
Table VIII.1 - Financing ofMedicaid Programs, Fiscal Year 2011
Table VIII.2 - Medicare Cost Sharing and Premium Amounts for Hospital Insurance
Table VIII.3 - Medicare Cost Sharing and Premium AmountsforSupplementary Medical Insurance
Table VIII.4- Medicare Annual Maximum Taxable Earnings and HI Contribution Rates,
CalendarYears 1966-2010
Table VIII.5-Title XIX Federal Medical Assistance Percentages, Fiscal Years 2008-2011
1 1
Table 1.1
CMS Disbursements, Fiscal Years 2009 -2011
2009Actual 2010Estimate CurrentLaw201 Proposed Law201
CMS BudgetOutlays(Dollarsin millions)
Medicare Benefits $4yD,y\o J>oz4,^:o1 f3f>c0rOoO,4a-17d0.
TransitionalAssistance & PartDdrug benefits (non-add) 52,962 58,822 68,458 $68,458
MedicarePartBTransferto Medicaid 1 449 530 155 $155
Quality ImprovementOrganizations OOl 358 340 $340
HealthCare FraudandAbuseControl (HCFAC)2 1,083 1,706 1,829 $1,829
OtherMedicareAdministrativeExpenses 3 2,148 2,386 2,487 $2,487
CMS Program Management4 3,099 3,665 3,607 $3607
Medicaid Benefits 240,575 262,405 250,225 $271,826
Qotlodltco adinlHu ILUourd1qlI nAUHlimIIiInMioclflraatLIiUnIn1//TIrIdalilnllinliny 11nU,"0*}+45QJ 1? ins O1L-.-JUO
StateChildren's Health Insurance Program (SCHIP) 7,547 8,903 10,285 $10,285
CLIA/OtherUserFees 317 170 $170
Innovation 3 262 $262
StateGrantsand Demonstrations 498 980 1,052 $1,052
Total Outlays (gross, unadjusted) $763,024 $817,615 $836,192 $857,793
Offsetting Collections, Non-Federal (userfees) -120 -317 -170 -170
TotalOutlays (gross, reduced byuserfees) $762,904 $817,298 $836,022 $857,623
Medicare Premiums -64,540 -65,650 -70,417 -70,395
Medicare Refunds, and Misc. FederalOffsetting Collections -9,336 -9,406 -9,706 -9,706
Total Outlays NetofMedicare Premiums and
Offsetting Collections $689,028 $742,242 $755,899 $777,522
1 Medicaretransferto MedicaidforMedicare Part B premiumassistance.
2Includes HCFACoutlays byCMS and otheragencies.
3Medicare-relatedexpensesofotheragencies, e.g., Social SecurityAdministration.
4 Reflectsdisbursementsfromthetrustfundstofinance program managementactivities, including userfeeactivities.
5 Includes notonlyMedicaid medicalassistancepayments(MAP)butalsoTitleXIXoutlaysfortheVaccinesforChildren
Program (FY2009-$3,382.9million; FY2010-$3,870.1 million; FY2011 -$3,826.8million). Theestimate is reduced bythe
Medicaretransferto Medicaid of$449.4million in FY2009, $530.0million in FY2010, and $155.0 million in FY2011.
NOTES: Fiscal yeardata. Totalsdo notnecessarilyequalthesum ofrounded components.
SOURCES: FY2011 Mid-Session Review; FY2009actual reconcileddata. CMS/OFM December2010,
Table 1.2
Program Benefit Payments
Selected Fiscal Years
Total Medicare1 Medicaid2 CHIPJ
Annual Annual Annual Annual
Percent Percent Percent Percent
riscai Tear Amount Change Amount Change Amount Change Amount Change
Amount in billions
Historical
1980 $57.9 $33.9 - $24.0 —
1985 108.8 12.6 69.5 14.1 39.3 10.4
1990 175.9 15.6 107.2 13.8 68.7 18.4
1991 204.4 16.2 113.9 6.3 90.5 31.7
1992 245.1 19.9 129.2 13.4 115.9 28.1
1993 268.7 9.6 142.9 10.6 ' 125.8 8.5
1994 296.9 10.5 159.3 11.5 137.6 9.4
1995 328.9 10.8 176.9 11.0 152.0 10.5
1996 344.3 4.7 191.1 8.0 153.2 0.8
1997 367.8 6.8 207.1 8.4 160.7 4.9
1998 379.7 3.2 210.1 1.4 169.4 5.5 $0.2
1999 390.5 2.8 208.3 -0.9 180.8 6.7 1.3 655.2
2000 413.8 6.0 214.9 3.2 196.1 8.4 2.8 108.6
2001 457.8 10.6 236.6 10.1 217.4 10.9 3.8 37.2
2002 505.4 10.4 252.3 6.7 247.7 13.9 5.4 41.4
2003 539.4 6.7 272.7 8.1 260.6 5.2 6.1 13.4
2004 585.3 8.5 295.5 8.4 283.2 8.7 6.6 8.4
2005 642.8 9.8 333.4 12.8 302.1 6.7 7.3 10.1
2006 682.4 6.2 375.2 12.5 299.3 -0.9 7.9 8.6
2007 759.5 11.3 434.6 15.8 316.1 5.6 8.8 11.0
2008 800.7 5.4 454.3 4.5 336.4 6.4 10.0 13.6
2009 870.4 8.7 497.4 9.5 362.4 7.7 10.6 6.0
Budget
Currentlaw
2010 (est) 924.0 6.2 524.8 5.5 386.7 6.7 12.5 17.9
2011 (est.) 977.8 5.8 553.6 5.5 409.9 6.0 14.3 14.4
1 Includes catastrophic benefitsfor PartA in FY 1990. Includes Part Btransferto Medicaid. IncludesTransitional
Assistance for FY2004through FY2006. Includes Part D prescription drug benefits beginning in FY2006.
Excludes Quality Improvement Organization expenditures.
2Total computable benefit payments (Federal and Statecombined). Historical dataforFYs 1980-1994
reflecttotal computable medical assistance payments reported bythe States on line 11 ofthe HCFA-64
and predecessorforms. Historical data forFYs 1995-2009 include line 11 total computable medical
assistance payments and outlaysfortheVaccinesforChildren Program, butdo not includetotal
computableTitleXIXexpendituresforthe Children's Health Insurance Program. Budgetdata for
FY201 and FY2011 reflectcurrent lawestimates oftotal adjusted computable medical assistance payments
and outlays forthe Vaccines forChildren Program.
3 Total computable benefits (Federal and Statecombined). Historical datafor FYs 1998-2000 includetotal computable
Children's Health Insurance Program (CHIP) expenditures underboth TitleXIXand TitleXXI, as reported bythe
Statesforthose years.
NOTE: Percent changes based on unrounded numbers.
SOURCES: FY2011 Mid-Session Review; FY2009 actual reconciled data. CMS/OFM December2010