2004 Medicare Advantage Rate Calculation Data
Applicable to March - December

Three tables of identical layout, one for aged (AGED2004_REVISED.CSV),
one for disabled (DSAB2004_REVISED.CSV), and one for ESRD 
(ESRD2004_REVISED.CSV) enrollees, are included as comma delimited files. 
All fields in these files are separated by commas and text strings
are enclosed in double quotes. These files can be imported into
spreadsheet programs. These tables contain all the data needed to
calculate the 2004 rates for every county. The column headings
are self-explanatory. More clarification follows.

The growth rates in 1998, 1999, 2000, 2001, 2002, 2003, & 2004 are
shown at the beginning of the table. They are used to project the
1997 rates to 2004. Also shown at the beginning of the table are the
2004 national average rates and the factors used to split the 2004
rates into their Part A and Part B components. 

There are three columns labeled under "Medicare Benes in 2001":
Enrollment, Part A Demographic Factor, and Part B Demographic Factor.
The "Enrollment" column shows the number of Medicare beneficiaries,
both fee-for-service and managed care, in each county in 2001, the
latest period available. The other two columns are the average
demographic factors associated with the enrollment. The data in these
three columns are needed to calculate the national average of the
local rates.

Similarly there are three columns labeled under "Risk HMO Benes in
12/02", showing the number of beneficiaries enrolled in risk HMOs
as of December 2002, the latest period available, and their
associated average demographic factors. The data in these three
columns are used in the calculation of the budget neutral adjustment.

Because the 2004 wage indices are not available at the time the rates
were calculated, the 2003 indices are used. Both the wage indices
and the GAFs (geographical area factors) are used to adjust the
national average rate in calculating the blended rates.

The GME/IME carve-out factors represent 100% of the carve-out amount.
To calculate the rates for 2004, use 100% of the factors.

Under the "Rate Category" columns, F means the rate to its immediate
left is the minimum rate, i.e. the floor; M, the minimum increase,
i.e. 2%; and B, the blended rate.

The fourth table (RISK2004_REVISED.CSV) is included as a comma delimited file
which includes the data needed to calculate the rescaling factors.

 
 
