Our Data

Under data use agreements with the Centers for Medicare and Medicaid Services (CMS) we have over 10 years of claims data for all Medicare fee-for-service beneficiaries. Under data use agreements with the Agency for Health Care Research and Quality (AHRQ) we have over 20 years of Healthcare Cost and Utilization Project (HCUP) Databases. We also have various other files available.

Some of the files we have include:

Centers for Medicare and Medicaid Services (CMS) Data

Medicare Standard Analytic Files

These are final action paid claims and enrollment information available for research. A 100% sample is available for hospital inpatient, outpatient, skilled nursing facility, home health and hospice claims. Ambulatory surgical centers (ASC), physician professional and durable medical equipment (DME) claims are available in a 5% sample. These files are released both in full-year annual files seven months after the end of the year and earlier in quarterly files four months after the end of the quarter.

Medicare Physician/ Supplier Procedure Summary Master File (PSPS)

The PSPS file contains a summary of all physician, ASC and DME claims billed for services in the calendar year and paid within six months from the end of the year. This file can be used for analysis by carrier/Medicare Administrative Contractor (MAC), counts of denied services, specific procedure code and modifier combinations, and an accurate count of the total services provided by physicians to Medicare beneficiaries in traditional fee-for-service Medicare.

Medicare rate-setting files

These are the claims files that CMS uses to set the payment program rates. These are available for the following settings: hospital outpatient departments, inpatient acute care hospitals (MedPAR file), and ASCs.

Medicare Cost Reports

All institutional providers participating in Medicare are required to submit an annual cost report to their Fiscal Intermediary (FI) or Medicare Administrative Contractor (MAC). The cost report contains information on facility ownership type (non-profit, for-profit, government), utilization data (inpatient days, discharges, visits), cost and charges by cost center (in total and for Medicare), Medicare settlement data and financial statement data. The cost report data are maintained by CMS in the Healthcare Provider Cost Reporting Information System (HCRIS) and are updated quarterly.

Healthcare Cost and Utilization Project (HCUP) Databases

National Inpatient Sample (NIS)

The NIS is the largest publicly available all-payer inpatient health care database in the United States, consisting of a 20-percent stratified sample of all discharges from community hospitals, excluding rehabilitation and long-term acute care hospitals. It covers all patients, including individuals covered by Medicare, Medicaid, or private insurance, as well as those who are uninsured. When weighed, the data estimates more than 35 million hospitalizations annually across the US.

Nationwide Readmissions Database (NRD)

The NRD is a large national database that allows estimates and analyses of potential readmissions for patients within the same state and year. It covers approximately 60 percent of all US hospitalizations regardless of payer.

Nationwide Ambulatory Surgery Sample (NASS)

The NASS is an all-payer sample of major ambulatory surgical encounters that includes select surgical procedures determined to be in-scope, defined as a major surgery performed in an operating room that involves penetrating or breaking the skin, requires the use of anesthesia or sedation for pain, and is performed in relatively high volume.