Medicare Geographic Variation

New Data on Geographic Variation

The Centers for Medicare & Medicaid Services (CMS) has developed data that enables researchers and policymakers to evaluate geographic variation in the utilization and quality of health care services for the Medicare fee-for-service population.  We have aggregated this data into a Geographic Variation Public Use File that has demographic, spending, utilization, and quality indicators at the state level (including the District of Columbia, Puerto Rico, and the Virgin Islands), and at the hospital referral region (HRR) level.  All of this information is also available in the HHS Health Indicators Warehouse, an online tool that gives the public access to high-quality, community-level health data from agencies and offices across the Department of Health and Human Services.

The Geographic Variation Public Use File has twelve separate files – six files with state-level data and six files with HRR-level data.  Within each group of six files, there are three “Table” files (one with data for beneficiaries under the age of 65, a second with data for beneficiaries that are 65 or older, and a third with data for all beneficiaries regardless of age) that present indicators for all states or HRRs and can easily be exported from Excel to another data analysis program for additional analysis, and three corresponding “Report” files that allow users to compare a specific state or HRR to national Medicare benchmarks.  Each file has a brief Methods section outlining the sample population and methodology that we used to calculate these indicators and a Documentation section which explains the individual indicators in more detail.  Finally, there is also a Methodological Overview paper and a Technical Supplement on Standardization that provides additional information on the methodology we used to standardize claim payment amounts.  

In January 2013, CMS updated the Geographic Variation Public Use File data files that were originally posted in July 2011 and updated in July 2012.  The January 2013 update includes an additional year of data (2011) and incorporates several revisions to the CMS methodology.  Those revisions are described in detail in the Methodological Overview paper.