{"main_topic":"health","sub_topic":"cms","topic":"medicare_spending_per_capita","key":"health/cms/medicare_spending_per_capita","version":"1.0.0","year_min":2014,"year_max":2024,"year_gaps":[],"update_frequency":"annual","detail_levels":["counties","states"],"default_detail":"counties","path_template":"health/medicare_spending_per_capita/year={year}/{detail}.parquet","grain":["year","county_fips","tract_geoid","age_bracket","service"],"title":"Medicare Spending per Beneficiary (CMS)","summary":"Original Medicare spending per fee-for-service beneficiary in Georgia and its counties, standardized and actual, by type of service.","description":"How much Original Medicare (fee-for-service) pays for the care of beneficiaries living in Georgia and each of its 159 counties, per beneficiary and in total, for all care and by type of service (hospital inpatient and outpatient, skilled nursing, home health, hospice, physician visits, procedures, tests, imaging, equipment, dialysis and more), from CMS's Medicare Geographic Variation data. The headline is standardized spending per beneficiary, with geographic price differences removed so places compare on the care used: statewide $9,281 in 2014 and $12,393 in 2024 (actual $12,789), and $9,393-$29,853 across counties in 2024. Per Original Medicare beneficiary, not per Medicare enrollee: Medicare Advantage enrollees are not covered. Calendar years 2014-2024; Georgia also by age (under 65, 65 and over).","explorer":true,"search_aliases":{"en":["medicare costs","medicare payments","how much medicare pays","medicare spending per person","health care costs","medical spending","price-adjusted spending","cost per patient","hospital costs","medicare expenditures"],"es":["costos de medicare","pagos de medicare","gasto de medicare","gasto por persona","cuánto paga medicare","gasto médico","costos de salud","costo por paciente","costos hospitalarios","gasto ajustado"]},"source":"Centers for Medicare & Medicaid Services (CMS), Medicare Geographic Variation - by National, State & County, data.cms.gov dataset 6219697b-8f6c-4164-bed4-cd9317c58ebc, 2014-2024 release (2014-2024 Original Medicare Geographic Variation Public Use File.csv)","source_url":"https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-geographic-comparisons/medicare-geographic-variation-by-national-state-county","endpoint":"/api/v1/health/medicare_spending_per_capita","columns":[{"name":"year","type":"integer","role":"year","nullable":false,"label":"Year","short_description":"","description":"Calendar year of service (claims by date of service, January to December), 2014-2024 (CMS's 2014-2024 release).","valid_values":null,"example":2024,"unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"county_fips","type":"string","role":"fk_county","nullable":true,"label":"County FIPS","short_description":"","description":"5-digit county FIPS code of the beneficiaries' residence (CMS BENE_GEO_CD); NULL on the Georgia state row. CMS's GA-UNKNOWN (13000) is left out.","valid_values":null,"example":"13121","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"tract_geoid","type":"string","role":"fk_tract","nullable":true,"label":"Tract GEOID","short_description":"","description":"Always NULL: CMS publishes state and county figures only. Kept for the health domain's standard key shape.","valid_values":null,"example":null,"unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"age_bracket","type":"string","role":"categorical","nullable":false,"label":"Age Bracket","short_description":"'all' = every beneficiary; 'under_65' / '65_plus' (Georgia only).","description":"Beneficiary age group (CMS BENE_AGE_LVL): 'all' (every age), 'under_65' (entitled by disability or end-stage renal disease) and '65_plus'. CMS publishes the two brackets for Georgia only; county rows are 'all'. The brackets partition 'all' (beneficiary counts exactly, dollar amounts within CMS's rounding). Pin 'all' to compare places.","valid_values":["all","under_65","65_plus"],"example":"all","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":true,"metric_component":null},{"name":"service","type":"string","role":"categorical","nullable":false,"label":"Service","short_description":"Type of service ('all' = total Medicare spending).","description":"Type of service Medicare paid for: 'all' (every service, CMS's TOT_MDCR_* totals), 'inpatient' (hospital inpatient stays: acute care hospitals paid under the IPPS, critical access hospitals, inpatient psychiatric facilities and other inpatient Part A services); 'outpatient' (hospital outpatient department services (OPPS hospitals and critical access hospital outpatient departments); outpatient dialysis facilities are their own category); 'ambulatory_surgery_center' (ambulatory surgery center services); 'skilled_nursing_facility' (post-acute skilled nursing facility stays); 'inpatient_rehabilitation_facility' (inpatient rehabilitation facility stays); 'long_term_care_hospital' (long-term care hospital stays); 'home_health' (home health agency services); 'hospice' (hospice care); 'evaluation_and_management' (evaluation and management visits by physicians and other practitioners (office, hospital, nursing facility, emergency department and other E&M services; RBCS)); 'procedures' (procedures billed by physicians and other practitioners, anesthesia included (RBCS)); 'tests' (laboratory and other tests (RBCS)); 'imaging' (imaging: CT, MRI, nuclear medicine, ultrasound, X-ray (RBCS)); 'durable_medical_equipment' (durable medical equipment, supplies, oxygen, orthotics and drugs given through DME (RBCS)); 'outpatient_dialysis_facility' (outpatient dialysis facility services); 'fqhc_and_rural_health_clinic' (federally qualified health center and rural health clinic visits); 'ambulance' (ambulance services); 'treatments' (Part B treatments: chemotherapy, other injections and infusions, radiation oncology, physician dialysis services, and physical, occupational and speech therapy (RBCS)); and 'other_part_b_services' (other Part B services that fit no category above (RBCS 'Other': spinal manipulation, vision, hearing and speech services); CMS publishes only its amounts). The 18 services other than 'all' do not overlap and add up to 'all'; a suppressed service is never filled in as 'all' minus the others.","valid_values":["all","inpatient","outpatient","ambulatory_surgery_center","skilled_nursing_facility","inpatient_rehabilitation_facility","long_term_care_hospital","home_health","hospice","evaluation_and_management","procedures","tests","imaging","durable_medical_equipment","outpatient_dialysis_facility","fqhc_and_rural_health_clinic","ambulance","treatments","other_part_b_services"],"example":"all","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":true,"metric_component":null},{"name":"standardized_payment_per_capita","type":"number","role":"metric","nullable":true,"label":"Standardized Medicare Spending per Beneficiary","short_description":"Original Medicare spending per fee-for-service beneficiary, with geographic price differences removed (dollars).","description":"Medicare payment per beneficiary for the service in the year, in dollars, standardized: CMS removes geographic differences in Medicare's payment rates (local wages and other input prices) and the extra payments teaching and safety-net hospitals receive, so places compare on the care used, not on prices; per Original Medicare beneficiary with Parts A and B, counted for each month entitled (num_om_beneficiaries), not per Medicare enrollee or resident (CMS <SERVICE>_MDCR_STDZD_PYMT_PC; TOT_MDCR_STDZD_PYMT_PC on 'all' rows). Equals standardized_payment_amount / num_om_beneficiaries. For several places pool as SUM(standardized_payment_amount) / SUM(num_om_beneficiaries), never an average. On 'other_part_b_services' rows it is our calculation, CMS's formula applied to the published amount.","valid_values":null,"example":12393.08,"unit":"currency","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS ('*'): fewer than 11 Original Medicare beneficiaries in the place used the service that year, so CMS withholds all of the service's figures for that place and year. Never filled in from the total or other services: a suppressed service is never computed as 'all' minus the other services.","key_metric_grain_contributor":false,"metric_component":null},{"name":"actual_payment_per_capita","type":"number","role":"metric","nullable":true,"label":"Actual Medicare Spending per Beneficiary","short_description":"","description":"Medicare payment per beneficiary, in dollars, actual: what Medicare paid, at the place's own payment rates; per Original Medicare beneficiary with Parts A and B, counted for each month entitled (num_om_beneficiaries), not per Medicare enrollee or resident (CMS <SERVICE>_MDCR_PYMT_PC). Equals actual_payment_amount / num_om_beneficiaries; pool as SUM(actual_payment_amount) / SUM(num_om_beneficiaries). On 'other_part_b_services' rows it is our calculation, CMS's formula applied to the published amount.","valid_values":null,"example":null,"unit":"currency","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS ('*'): fewer than 11 Original Medicare beneficiaries in the place used the service that year, so CMS withholds all of the service's figures for that place and year. Never filled in from the total or other services: a suppressed service is never computed as 'all' minus the other services.","key_metric_grain_contributor":false,"metric_component":null},{"name":"standardized_payment_amount","type":"number","role":"metric","nullable":true,"label":"Standardized Medicare Spending (Total)","short_description":"","description":"Total Medicare payment for the place's Original Medicare beneficiaries' care of this type in the year, in dollars, standardized: CMS removes geographic differences in Medicare's payment rates (local wages and other input prices) and the extra payments teaching and safety-net hospitals receive, so places compare on the care used, not on prices (CMS <SERVICE>_MDCR_STDZD_PYMT_AMT). The services add up to 'all'. Never add it to the actual amount.","valid_values":null,"example":null,"unit":"currency","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS ('*'): fewer than 11 Original Medicare beneficiaries in the place used the service that year, so CMS withholds all of the service's figures for that place and year. Never filled in from the total or other services: a suppressed service is never computed as 'all' minus the other services.","key_metric_grain_contributor":false,"metric_component":null},{"name":"actual_payment_amount","type":"number","role":"metric","nullable":true,"label":"Actual Medicare Spending (Total)","short_description":"","description":"Total Medicare payment for the place's Original Medicare beneficiaries' care of this type in the year, in dollars, actual: what Medicare paid, at the place's own payment rates (CMS <SERVICE>_MDCR_PYMT_AMT). Includes payments CMS routed to accountable care organizations instead of providers (from 2017). The services add up to 'all'.","valid_values":null,"example":null,"unit":"currency","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS ('*'): fewer than 11 Original Medicare beneficiaries in the place used the service that year, so CMS withholds all of the service's figures for that place and year. Never filled in from the total or other services: a suppressed service is never computed as 'all' minus the other services.","key_metric_grain_contributor":false,"metric_component":null},{"name":"pct_of_total_standardized_payment","type":"number","role":"metric","nullable":true,"label":"Share of Standardized Spending","short_description":"","description":"The service's share of the place's total standardized Original Medicare payment, 0-1 (0.30 = 30%; CMS <SERVICE>_MDCR_STDZD_PYMT_PCT, amount / the all-services amount). 1 on 'all' rows. On 'other_part_b_services' rows it is our calculation, CMS's formula applied to the published amount.","valid_values":null,"example":null,"unit":"proportion","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS ('*'): fewer than 11 Original Medicare beneficiaries in the place used the service that year, so CMS withholds all of the service's figures for that place and year. Never filled in from the total or other services: a suppressed service is never computed as 'all' minus the other services.","key_metric_grain_contributor":false,"metric_component":null},{"name":"pct_of_total_actual_payment","type":"number","role":"metric","nullable":true,"label":"Share of Actual Spending","short_description":"","description":"The service's share of the place's total actual Original Medicare payment, 0-1 (CMS <SERVICE>_MDCR_PYMT_PCT). 1 on 'all' rows. On 'other_part_b_services' rows it is our calculation, CMS's formula applied to the published amount.","valid_values":null,"example":null,"unit":"proportion","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS ('*'): fewer than 11 Original Medicare beneficiaries in the place used the service that year, so CMS withholds all of the service's figures for that place and year. Never filled in from the total or other services: a suppressed service is never computed as 'all' minus the other services.","key_metric_grain_contributor":false,"metric_component":null},{"name":"standardized_payment_per_user","type":"number","role":"metric","nullable":true,"label":"Standardized Medicare Spending per User","short_description":"","description":"Medicare payment per Original Medicare (fee-for-service) beneficiary who used the service (not Medicare Advantage enrollees), in dollars, standardized: CMS removes geographic differences in Medicare's payment rates (local wages and other input prices) and the extra payments teaching and safety-net hospitals receive, so places compare on the care used, not on prices (CMS <SERVICE>_MDCR_STDZD_PYMT_PER_USER; FQHC_RHC_MDCR_STDZD_PYMT_PU). The amount divided by the service's users, not by all beneficiaries, so it is always at least the per-capita figure. Users are not in this table: pool as SUM(amount) / SUM(users), never an average. Where no beneficiary used the service CMS publishes 0 per user; those cells are NULL here, since an average over nobody is undefined (the amount and per-capita zeros there are kept).","valid_values":null,"example":null,"unit":"currency","value_min":null,"value_max":null,"null_meaning":"NULL on 'all' and 'other_part_b_services' rows (CMS publishes no per-user figure for them); where CMS suppresses the service (fewer than 11 users; never filled in from other figures); and where no beneficiary used the service (CMS shows 0 per user over zero users, an undefined average).","key_metric_grain_contributor":false,"metric_component":null},{"name":"actual_payment_per_user","type":"number","role":"metric","nullable":true,"label":"Actual Medicare Spending per User","short_description":"","description":"Medicare payment per Original Medicare (fee-for-service) beneficiary who used the service (not Medicare Advantage enrollees), in dollars, actual: what Medicare paid, at the place's own payment rates (CMS <SERVICE>_MDCR_PYMT_PER_USER). Where no beneficiary used the service CMS publishes 0 per user; those cells are NULL here, since an average over nobody is undefined (the amount and per-capita zeros there are kept).","valid_values":null,"example":null,"unit":"currency","value_min":null,"value_max":null,"null_meaning":"NULL on 'all' and 'other_part_b_services' rows (CMS publishes no per-user figure for them); where CMS suppresses the service (fewer than 11 users; never filled in from other figures); and where no beneficiary used the service (CMS shows 0 per user over zero users, an undefined average).","key_metric_grain_contributor":false,"metric_component":null},{"name":"num_om_beneficiaries","type":"integer","role":"metric","nullable":true,"label":"Original Medicare Beneficiaries","short_description":"","description":"Original Medicare (fee-for-service) beneficiaries living in the place: Part A, Part B and Original Medicare for every month they were entitled, new enrollees and people who died during the year included (CMS BENES_OM_CNT). Not every Medicare beneficiary: Medicare Advantage enrollees and people with Part A or B alone are left out. The denominator of every per-capita figure here. The same count repeats on every service row of a place and year: never add it across services.","valid_values":null,"example":716088,"unit":"count","value_min":null,"value_max":null,"null_meaning":"Suppressed by CMS (fewer than 11 beneficiaries). Not seen on any state or county row in the current release.","key_metric_grain_contributor":false,"metric_component":"denominator"}],"key_metric":"standardized_payment_per_capita","numeric_filter_columns":["standardized_payment_per_capita","actual_payment_per_capita","standardized_payment_amount","actual_payment_amount","pct_of_total_standardized_payment","pct_of_total_actual_payment","standardized_payment_per_user","actual_payment_per_user","num_om_beneficiaries"],"usage":"Star-schema fact table at state and county grain: state rows have county_fips NULL, county rows join the counties dimension on county_fips; tract_geoid is always NULL. Pin service = 'all' for total spending and age_bracket = 'all' to compare places. Compare places with standardized_payment_per_capita (prices evened out); use actual_payment_per_capita for what Medicare actually paid. Per-capita figures are per Original Medicare (fee-for-service) beneficiary with Parts A and B, counted for each month entitled (num_om_beneficiaries), not per Medicare enrollee or resident: never multiply them by total Medicare enrollment or population. For several counties, pool per capita as SUM(standardized_payment_amount) / SUM(num_om_beneficiaries) (or the actual pair) within one service, year and age bracket, never an average of county figures. num_om_beneficiaries repeats on every service row of a place: never add it across services. The 18 services other than 'all' add up to 'all' (amounts and per capita), but a suppressed service is never filled in as 'all' minus the other services: CMS withholds it because fewer than 11 beneficiaries used it. A service's share for several places is SUM(its amount) / SUM(the 'all' amount). Per-user payment pools as SUM(amount) / SUM(users of the service); users are not in this table, so never average per-user figures. Never add standardized and actual figures to each other. Read directly with DuckDB over Parquet.","limitations":"Original Medicare (fee-for-service) only: beneficiaries in Original Medicare Parts A and B, counted for each month entitled, not all enrollees. In 2024 those beneficiaries were 35% of Georgia's Medicare beneficiaries and 20-49% of each county's (Medicare Advantage up to 76%, Clayton County), so county figures can describe a fee-for-service minority. Standardized figures remove geographic price differences; actual is what Medicare paid. Figures on under 11 users are suppressed (NULL). Per-capita figures divide by those beneficiaries (num_om_beneficiaries), not by all Medicare enrollees or residents. Who is covered: CMS counts beneficiaries with Part A, Part B and Original Medicare for every month they were entitled (num_om_beneficiaries), new enrollees and people who died during the year included; anyone in Medicare Advantage at any point in the year, or with Part A or Part B alone, is left out. CMS suppresses figures built on fewer than 11 beneficiaries or service users ('*'); they are NULL here and never filled in from other figures. Per-user payment is NULL where no beneficiary used the service (CMS shows 0 over zero users), and on the 'all' and 'other_part_b_services' rows, which CMS publishes no per-user figure for. For 'other_part_b_services' CMS publishes only the amounts: its per capita and share are our calculation (amount / num_om_beneficiaries; amount / the all-services amount), CMS's own formulas for the other services; the 'all' row's share is 1 by definition. Standardized figures adjust for prices only (CMS's dictionary: adjusted for geographic differences in payment rates; the file has no risk-adjusted figure), so places with sicker or older beneficiaries still spend more per capita. Georgia's row is CMS's own figure, not a sum of the county rows: it also counts the handful of beneficiaries CMS places in no county (GA-UNKNOWN), so the 159 counties need not add up to it exactly. CMS's GA-UNKNOWN row (13000), beneficiaries placed in no county, is fully suppressed and left out. One source inconsistency is served as published: in 2024 the standardized service amounts of Washington County (13303) add to $42,494 less than CMS's standardized total, so its shares add to slightly under 1. Payments CMS routed to accountable care organizations instead of providers (its Population-Based Payment reduction, from 2017) are already inside actual payment and are not shown separately. age_bracket 'under_65' (beneficiaries entitled by disability or end-stage renal disease) and '65_plus' exist for Georgia only; county rows are 'all'. From CMS's 2014-2024 release (file updated 2026-04-29); each release restates earlier years, so the figures here are replaced when the data is refreshed. tract_geoid is always NULL.","null_semantics":{"suppressed_to_null":true,"zero_is_real":true},"available_years":[2014,2015,2016,2017,2018,2019,2020,2021,2022,2023,2024],"schema_hash":"d89ae00c201b95ca0773106b219f78a4030bae90920219cb74b825b38dea69d6","tags":["health","centers for medicare & medicaid services","medicare_spending_per_capita"],"granularity_description":"One row per year, county_fips, tract_geoid, age_bracket, service (geography columns are NULL at higher aggregation levels).","example_queries":[{"description":"Latest year (2024), counties detail","query":"SELECT * FROM medicare_spending_per_capita WHERE year = 2024 LIMIT 100"},{"description":"Filter by age_bracket = all","query":"SELECT * FROM medicare_spending_per_capita WHERE age_bracket = 'all' AND year = 2024 LIMIT 100"}],"foreign_keys":[{"column":"county_fips","target_object":"counties","target_columns":["county_fips"],"attribute_columns_added":["county_name"],"scope":"global"},{"column":"tract_geoid","target_object":"tracts","target_columns":["tract_geoid"],"attribute_columns_added":["tract_name"],"scope":"global"}],"filters":[{"param":"year","kind":"year_exact","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"year_min","kind":"year_range","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"year_max","kind":"year_range","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"detail","kind":"detail","type":"string","multi_value":false,"enum_enforced":true,"values":["counties","states"],"default":"counties"},{"param":"county_fips","kind":"foreign_key","column":"county_fips","type":"string","multi_value":true,"enum_enforced":false,"values":null},{"param":"tract_geoid","kind":"foreign_key","column":"tract_geoid","type":"string","multi_value":true,"enum_enforced":false,"values":null},{"param":"age_bracket","kind":"categorical","column":"age_bracket","type":"string","multi_value":true,"enum_enforced":true,"values":["all","under_65","65_plus"],"has_total":true,"total_value":"all","requires_single_value":false,"nullable":false,"null_filter_token":null},{"param":"service","kind":"categorical","column":"service","type":"string","multi_value":true,"enum_enforced":true,"values":["all","inpatient","outpatient","ambulatory_surgery_center","skilled_nursing_facility","inpatient_rehabilitation_facility","long_term_care_hospital","home_health","hospice","evaluation_and_management","procedures","tests","imaging","durable_medical_equipment","outpatient_dialysis_facility","fqhc_and_rural_health_clinic","ambulance","treatments","other_part_b_services"],"has_total":true,"total_value":"all","requires_single_value":false,"nullable":false,"null_filter_token":null}],"filter_hints":[],"non_additive":[{"column":"service","reason":"num_om_beneficiaries is the place's count of Original Medicare beneficiaries, repeated on every service row: the same people, so it never adds across services. (The payment amounts do add: the services other than 'all' sum to 'all'.)","metrics":["num_om_beneficiaries"]},{"column":"standardized_payment_amount","reason":"The standardized and actual amounts are the same payments measured two ways: never add them.","with":["actual_payment_amount"]},{"column":"standardized_payment_per_capita","reason":"Standardized and actual spending per beneficiary are the same payments measured two ways: never add them.","with":["actual_payment_per_capita"]}],"partitions":[],"value_implications":[],"year_meaning":null,"pooled_rates":[{"column":"standardized_payment_per_capita","numerator":"standardized_payment_amount","denominator":"num_om_beneficiaries","scale":1},{"column":"actual_payment_per_capita","numerator":"actual_payment_amount","denominator":"num_om_beneficiaries","scale":1}],"series_breaks":[],"year_window":null,"pooled_min_count":null,"values_endpoint":"/api/v1/health/medicare_spending_per_capita/values"}