Medicare Public Use Files

CMS has provided access to data collected through the administration of claims to researchers since 2003 through the PUF (Public Use Files).  These files contain useful information on patients going back to 1999.  These files are offered for free as CSV (spreadsheet) files and offer valuable information on specific healthcare services.

These files are designed for researchers, but for you number crunchers out there, they can provide valuable insight into industry trends and how your own organization compares to your competitors.

For example, the current PUF file on hospice beneficiaries contains data for 2010 for a total of 56,943 beneficiaries.  The file contains eight pieces of information for each one.  These totals come from the data dictionary and code book describing this file.  The totals themselves are very interesting:

Public Use Files
Medicare Public Use Files

 

 

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/BSAPUFS/Downloads/2010_BSA_Hospice_Bene_PUF_DataDic_CB.pdf

Sex

Age category

Still alive at the end of 2010 (16,776 or 29.46%) and deceased at discharge (40,167 or 70.53%)

Diagnosis Category:

Variable Value Formatted Value Frequency Frequency (%)
1 Non-Alzheimer’s Dementia 6,081 10.679
2 Debility, unspecified 6,462 11.348
3 Lung Cancer 4,673 8.206
4 Congestive Heart Failure (CHF) 4,330 7.604
5 Non-infectious Respiratory Disease 3,677 6.457
6 Other 31,720 55.705

Cancer code (70.57% with cancer, 29.43% without cancer)

Total Hospice days:

Variable Value Formatted Value Frequency Frequency (%)
1 1 – 7 days 15,511 27.240
2 8 – 30 days 15,169 26.639
3 31 – 90 days 11,731 20.601
4 91 – 180 days 6,853 12.035
5 181 or more days 7,679 13.485

Hospice Payment Amount

This data contains total payments made by Medicare for the hospice claims of the beneficiary to all hospice providers during their coverage period.  This comes from the Medicare hospice claims file:

Variable Value(1) ($) Frequency Frequency (%)
0 77 0.135
250 2,513 4.413
500 2,768 4.861
750 2,736 4.805
1,000 5,481 9.625
2,000 6,083 10.683
3,000 4,369 7.673
4,000 3,415 5.997
5,000 2,599 4.564
6,000 2,240 3.934
7,000 1,867 3.279
8,000 1,644 2.887
9,000 1,385 2.432
10,000 3,397 5.966
15,000 4,097 7.195
20,000 2,664 4.678
25,000 5,020 8.816
50,000 4,438 7.794
75,000 150 0.263

 

The final piece of data shows the number of other beneficiary records that have exactly the same data as the record for the specific beneficiary (beneficiary count).

Each type of PUF file contains different information that might be interesting to researchers for that particular part of healthcare delivery.  For example, the inpatient PUF contains data related to DRGs, primary diagnosis, days of stay, and payment data.

Here are the categories of PUF files available from CMS through the site:

  • Inpatient
  • DME
  • Hospice
  • Line Items
  • HHA Beneficiary
  • Outpatient Procedures
  • SNF
  • Chronic Conditions
  • Institutional Provider and Beneficiary Summary
  • Prescription Drug Profiles

If you like working with statistics and using them to analyze your healthcare operations, these PUF files are relatively small and easy to manage and are well worth the effort to review.

 

By Kalon Mitchell, President – MEDTranDirect