Annual Statistical Supplement, 2006

 

Health Care Programs

Medicare

Enrollment, Utilization, and Reimbursement

Table 8.B1 Hospital Insurance and/or Supplementary Medical Insurance: Aged persons enrolled, served, and amount reimbursed, by type of coverage and service, selected years 1967–2003
Type of coverage and service 1967 1975 1980 1990 2000 2003
Persons enrolled (fee-for-service and managed care) (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 19,521 22,790 25,515 30,948 34,261 35,049
Hospital Insurance 19,494 22,472 25,104 30,464 33,841 34,622
Supplementary Medical Insurance 17,893 21,945 24,680 29,685 32,602 33,249
Persons enrolled (fee-for-service only) (thousands)
Hospital Insurance and/or Supplementary Medical Insurance -- -- -- -- 27,833 30,082
Hospital Insurance -- -- -- -- 27,422 29,659
Supplementary Medical Insurance -- -- -- -- 26,174 28,282
Persons served (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 7,154 12,032 16,271 24,809 25,486 27,665
Hospital Insurance 3,960 4,963 6,024 6,367 6,361 6,860
Inpatient hospital 3,601 4,913 5,951 5,906 5,975 6,387
Skilled nursing services 354 260 248 615 1,390 1,588
Home health services a 126 329 675 1,818 1,325 1,467
Hospice services b . . . . . . . . . -- 514 695
Supplementary Medical Insurance 6,523 11,762 16,099 24,687 25,256 27,443
Physicians' and other medical services 6,415 11,396 15,627 24,193 24,846 27,084
Outpatient services 1,511 3,768 6,629 14,055 18,159 20,059
Home health services a 118 161 302 38 1,081 1,061
Persons served per 1,000 enrollees
Hospital Insurance and/or Supplementary Medical Insurance 367 528 638 802 916 920
Hospital Insurance 203 221 240 209 232 231
Inpatient hospital 185 219 237 194 218 215
Skilled nursing services 18 12 10 21 51 54
Home health servicesa 7 15 27 60 48 49
Hospice services b . . . . . . . . . -- 19 23
Supplementary Medical Insurance 365 536 652 832 965 970
Physicians' and other medical services 359 519 633 815 949 958
Outpatient services 77 172 269 474 694 709
Home health services a 7 7 12 1 41 38
Amount reimbursed (millions of dollars)
Hospital Insurance and/or Supplementary Medical Insurance 4,239 12,689 29,134 88,778 148,488 195,726
Hospital Insurance 2,967 9,209 20,353 54,244 87,549 110,396
Inpatient hospital 2,659 8,840 19,583 48,952 72,041 86,772
Skilled nursing services 274 233 331 1,886 10,066 13,871
Home health services  a 26 136 440 3,406 2,679 4,475
Hospice services b . . . . . . . . . -- 2,763 5,278
Supplementary Medical Insurance 1,272 3,481 8,871 34,533 60,939 85,331
Physicians' and other medical services 1,224 3,050 7,361 27,379 44,506 60,990
Outpatient services 38 374 1,261 7,077 12,588 19,736
Home health services a 17 56 159 78 3,845 4,605
Amount reimbursed per person served (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 592 1,055 1,791 3,578 5,826 7,075
Hospital Insurance 749 1,855 3,379 8,520 13,763 16,093
Inpatient hospital 738 1,799 3,291 8,289 12,057 13,586
Skilled nursing services 774 896 1,336 3,068 7,242 8,733
Home health services a 204 413 652 1,874 2,022 3,051
Hospice services b . . . . . . . . . -- 5,375 7,597
Supplementary Medical Insurance 195 296 545 1,399 2,413 3,109
Physicians' and other medical services 191 268 471 1,132 1,791 2,252
Outpatient services 25 99 190 503 693 984
Home health servicesa 145 347 526 2,033 3,557 4,340
Amount reimbursed per enrollee (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 217 557 1,142 2,869 5,335 6,506
Hospital Insurance 152 410 811 1,781 3,193 3,722
Inpatient hospital 137 394 780 1,607 2,627 2,926
Skilled nursing services 14 11 13 62 367 468
Home health services a 1 6 18 112 98 151
Hospice services b . . . . . . . . . -- 101 178
Supplementary Medical Insurance 71 159 356 1,163 2,328 3,017
Physicians' and other medical services 69 139 298 922 1,700 2,156
Outpatient services 2 17 51 238 481 698
Home health services  a 1 2 6 3 147 163
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Measurement of the use of services represents those persons receiving a reimbursed service under the original (or fee-for-service) Medicare plan. Amount reimbursed represents payments recorded on fee-for-service claims only and excludes nonbilling reimbursements, such as end-of-year cost settlements and premiums paid to managed care plans. For all years, total enrollment as of July 1 in the original (or fee-for-service) Medicare program as well as those enrolled in alternative prepaid plans, such as Medicare managed care, are shown. Beginning in 2000, data for the original fee-for-service enrollment population are shown separately, as they provide a more accurate population for denominators for computing persons served per 1,000 enrollees and average fee-for-service reimbursement per enrollee.
. . . = not applicable; -- = not available.
a. The Balanced Budget Act of 1997, enacted on August 5, 1997, specified that, effective January 1998, coverage for the majority of home health services not associated with a hospital or skilled nursing facility will be transferred from the Hospital Insurance (HI) program to the Supplementary Medical Insurance (SMI) program. The HI program will cover the first 100 home health agency visits following a hospital or skilled nursing facility stay of at least 3 days. From July 1981 to December 1997, home health agency services were almost exclusively provided by the HI program. For more information, refer to the 1998 HI and SMI trust fund reports.
b. The hospice care benefit was enacted in 1982. Therefore, for calendar years 1967, 1975, and 1980, hospice services were not applicable.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B2 Hospital Insurance and/or Supplementary Medical Insurance: Disabled persons enrolled, served, and amount reimbursed, by type of coverage and service, selected years 1974–2003
Type of coverage and service 1974 1975 1980 1990 2000 2003
Persons enrolled (fee-for-service and managed care) (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 1,928 2,168 2,963 3,255 5,371 6,077
Hospital Insurance 1,928 2,168 2,963 3,255 5,370 6,074
Supplementary Medical Insurance 1,745 1,959 2,719 2,943 4,768 5,381
Persons enrolled (fee-for-service only) (thousands)
Hospital Insurance and/or Supplementary Medical Insurance -- -- -- -- 4,907 5,732
Hospital Insurance -- -- -- -- 4,907 5,729
Supplementary Medical Insurance -- -- -- -- 4,304 5,036
Persons served (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 792 975 1,760 2,390 4,096 4,922
Hospital Insurance 400 475 728 680 964 1,162
Inpatient hospital 397 472 721 644 942 1,134
Skilled nursing services 8 8 9 23 78 105
Home health services a 15 22 51 122 119 152
Hospice services b . . . . . . . . . -- 27 35
Supplementary Medical Insurance 740 924 1,723 2,365 4,057 4,880
Physicians' and other medical services 691 865 1,631 2,249 3,917 4,746
Outpatient services 296 399 909 1,496 2,870 3,541
Home health services a 9 13 25 c 110 123
Persons served per 1,000 enrollees
Hospital Insurance and/or Supplementary Medical Insurance 411 450 594 734 835 859
Hospital Insurance 208 219 246 209 196 203
Inpatient hospital 206 218 243 198 192 198
Skilled nursing services 4 4 3 7 16 18
Home health services a 8 10 17 38 24 27
Hospice services b . . . . . . . . . -- 6 6
Supplementary Medical Insurance 424 471 634 804 943 969
Physicians' and other medical services 396 442 600 764 910 942
Outpatient services 170 204 334 508 667 703
Home health services a 5 7 9 c 26 24
Amount reimbursed (millions of dollars)
Hospital Insurance and/or Supplementary Medical Insurance 1,049 1,509 4,478 11,239 25,773 37,095
Hospital Insurance 694 987 2,765 6,694 14,114 19,156
Inpatient hospital 681 968 2,714 6,346 13,156 17,511
Skilled nursing services 7 9 13 85 555 904
Home health services a 6 10 38 264 239 441
Hospice services b . . . . . . . . . -- 164 300
Supplementary Medical Insurance 355 522 1,713 4,545 11,660 17,939
Physicians' and other medical services 206 295 997 2,831 6,968 10,801
Outpatient services 145 221 701 1,714 4,198 6,550
Home health services a 3 5 16 c 493 587
Amount reimbursed per person served (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 1,324 1,548 2,544 4,703 6,292 7,536
Hospital Insurance 1,735 2,077 3,798 9,847 14,641 16,480
Inpatient hospital 1,714 2,051 3,765 9,849 13,966 15,445
Skilled nursing services 936 1,049 1,571 3,702 7,115 8,652
Home health services a 399 478 733 2,156 2,008 2,910
Hospice services b . . . . . . . . . -- 6,074 8,646
Supplementary Medical Insurance 479 565 994 1,922 2,874 3,676
Physicians' and other medical services 298 341 611 1,259 1,779 2,276
Outpatient services 490 554 771 1,146 1,463 1,850
Home health services a 345 420 619 c 4,482 4,760
Amount reimbursed per enrollee (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 544 696 1,511 3,453 5,252 6,471
Hospital Insurance 360 455 933 2,057 2,876 3,344
Inpatient hospital 353 446 916 1,950 2,681 3,055
Skilled nursing services 4 4 4 26 113 158
Home health services a 3 5 13 81 49 77
Hospice services b . . . . . . . . . -- 33 52
Supplementary Medical Insurance 208 266 630 1,544 2,709 3,562
Physicians' and other medical services 118 151 639 962 1,619 2,145
Outpatient services 83 113 258 582 975 1,301
Home health services a 2 3 5 c 115 117
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Measurement of the use of services represents those persons receiving a reimbursed service under the original (or fee-for-service) Medicare plan. Amount reimbursed represents payments recorded on fee-for-service claims only and excludes nonbilling reimbursements, such as end-of-year cost settlements and premiums paid to managed care plans. For all years, total enrollment as of July 1 in the original (or fee-for-service) Medicare program as well as those enrolled in alternative prepaid plans, such as Medicare managed care, are shown. Beginning in 2000, data for the original fee-for-service enrollment population are shown separately, as they provide a more accurate population for denominators for computing persons served per 1,000 enrollees and average fee-for-service reimbursement per enrollee.
-- = not available; . . . = not applicable.
a. The Balanced Budget Act of 1997, enacted on August 5, 1997, specified that, effective January 1998, coverage for the majority of home health services not associated with a hospital or skilled nursing facility will be transferred from the Hospital Insurance (HI) program to the Supplementary Medical Insurance (SMI) program. The HI program will cover the first 100 home health agency visits following a hospital or skilled nursing facility stay of at least 3 days. From July 1981 to December 1997, home health agency services were almost exclusively provided by the HI program. For more information, refer to the 1998 HI and SMI trust fund reports.
b. The hospice care benefit was enacted in 1982. Therefore, for calendar years 1974, 1975, and 1980, hospice services were not applicable.
c. Sample population too small to yield valid calculated results.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B3a Hospital Insurance and/or Supplementary Medical Insurance: Number of enrollees aged 65 or older, by census division and state or other area, July 1, 1980–2005, selected years (in thousands)
Census division and state or area 1980 1990 1995 2000 2002 2003 2004 2005
Total
All areas 25,515 30,948 33,142 34,253 34,679 35,008 35,334 35,777
United States a 25,027 30,350 32,492 33,549 33,947 34,261 34,571 34,994
New England 1,506 1,734 1,816 1,838 1,836 1,841 1,843 1,843
Connecticut 362 436 455 458 456 458 458 457
Maine 142 165 174 180 183 185 186 188
Massachusetts 715 795 825 829 824 822 819 815
New Hampshire 103 126 139 147 150 152 156 160
Rhode Island 125 145 149 148 146 146 145 143
Vermont 59 68 72 76 77 78 79 80
Middle Atlantic 4,496 5,084 5,267 5,282 5,276 5,279 5,277 5,258
New Jersey 851 1,006 1,058 1,070 1,071 1,073 1,073 1,070
New York 2,128 2,280 2,328 2,347 2,356 2,361 2,365 2,353
Pennsylvania 1,516 1,798 1,881 1,865 1,849 1,845 1,839 1,835
East North Central 4,462 5,224 5,500 5,552 5,567 5,599 5,625 5,650
Illinois 1,238 1,401 1,446 1,440 1,439 1,446 1,452 1,455
Indiana 579 685 725 736 740 746 751 759
Michigan 916 1,101 1,177 1,203 1,210 1,218 1,226 1,231
Ohio 1,162 1,387 1,471 1,480 1,480 1,486 1,489 1,492
Wisconsin 567 650 683 693 698 703 707 713
West North Central 2,186 2,424 2,510 2,519 2,523 2,532 2,542 2,561
Iowa 387 422 432 427 425 426 426 427
Kansas 304 337 348 347 345 345 345 347
Minnesota 479 544 570 583 590 595 600 606
Missouri 639 706 733 736 737 740 744 751
Nebraska 205 221 228 227 227 227 227 228
North Dakota 81 91 94 93 92 92 92 92
South Dakota 91 102 106 106 107 107 108 110
South Atlantic 4,179 5,536 6,091 6,410 6,542 6,630 6,730 6,884
Delaware 59 80 90 97 100 102 104 108
District of Columbia 71 71 70 66 64 64 63 62
Florida 1,579 2,174 2,396 2,493 2,531 2,558 2,596 2,641
Georgia 499 636 700 750 771 785 799 831
Maryland 381 496 542 570 582 589 596 602
North Carolina 588 786 878 939 965 980 997 1,025
South Carolina 279 383 428 463 477 486 496 516
Virginia 490 645 714 761 782 795 808 827
West Virginia 233 264 274 271 270 271 271 272
East South Central 1,613 1,887 2,000 2,060 2,084 2,107 2,128 2,174
Alabama 428 508 541 558 564 569 573 584
Kentucky 402 459 482 491 494 499 504 514
Mississippi 280 313 325 330 333 336 339 343
Tennessee 503 607 652 681 693 703 712 732
West South Central 2,363 2,880 3,120 3,274 3,328 3,369 3,414 3,472
Arkansas 303 343 356 359 360 362 365 370
Louisiana 380 460 488 498 500 504 507 492
Oklahoma 361 412 432 438 440 442 445 451
Texas 1,318 1,665 1,845 1,979 2,028 2,061 2,097 2,159
Mountain 1,043 1,490 1,726 1,906 1,983 2,028 2,079 2,154
Arizona 295 456 536 591 614 628 645 674
Colorado 244 324 367 403 416 424 434 447
Idaho 95 121 134 144 150 153 157 163
Montana 85 106 114 119 121 123 124 126
Nevada 65 128 172 209 227 236 246 253
New Mexico 114 160 182 200 207 211 215 222
Utah 108 147 168 183 189 193 198 206
Wyoming 38 47 54 57 59 60 60 61
Pacific 3,157 4,082 4,444 4,697 4,798 4,865 4,924 4,993
Alaska 11 22 28 35 38 39 41 42
California 2,346 2,990 3,241 3,436 3,509 3,556 3,592 3,628
Hawaii 74 118 138 151 155 157 159 162
Oregon 300 390 422 432 440 446 453 463
Washington 426 562 614 643 656 667 679 697
Unknown 22 10 18 11 10 10 10 6
Outlying areas 270 344 383 420 439 448 459 467
Puerto Rico 263 337 367 401 418 427 436 444
Virgin Islands 4 6 8 9 10 10 11 11
Other 3 1 8 10 11 11 12 12
Foreign countries 217 254 268 284 293 299 304 316
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Characterization of beneficiaries as to Medicare status and demographic categories may differ from that in other tables on enrollment because of differences in sources and methodology.
Totals do not necessarily equal the sums of rounded components.
a. Represents beneficiaries of the 50 states and the District of Columbia and beneficiaries with unknown residence.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B3b Hospital Insurance and/or Supplementary Medical Insurance: Number of disabled enrollees, by census division and state or other area, July 1, 1980–2005, selected years (in thousands)
Census division and state or area 1980 1990 1995 2000 2002 2003 2004 2005
Total
All areas 2,963 3,255 4,393 5,367 5,810 6,079 6,395 6,723
United States a 2,863 3,149 4,266 5,208 5,648 5,912 6,225 6,548
New England 141 156 228 285 307 319 335 349
Connecticut 31 33 47 58 62 64 67 69
Maine 16 18 27 36 40 42 45 47
Massachusetts 64 72 108 131 139 144 150 156
New Hampshire 9 11 17 23 26 27 30 32
Rhode Island 14 14 19 24 26 27 28 29
Vermont 7 7 10 13 14 15 15 16
Middle Atlantic 493 473 603 731 784 814 848 878
New Jersey 91 86 110 133 142 147 153 157
New York 237 229 302 368 391 402 414 423
Pennsylvania 165 158 190 230 251 265 281 297
East North Central 486 561 715 823 877 916 962 1,009
Illinois 113 132 172 195 207 215 226 236
Indiana 63 77 99 117 125 132 138 146
Michigan 118 132 170 200 216 227 240 251
Ohio 141 156 196 221 233 241 251 262
Wisconsin 50 64 79 90 96 101 107 113
West North Central 180 211 280 338 370 387 408 431
Iowa 29 34 43 50 54 57 59 62
Kansas 22 26 35 43 47 49 52 55
Minnesota 35 44 60 72 78 82 87 91
Missouri 67 75 100 124 137 144 152 162
Nebraska 14 16 22 26 29 30 32 33
North Dakota 6 7 9 10 11 11 11 12
South Dakota 7 8 11 13 14 14 15 15
South Atlantic 545 607 834 1,075 1,179 1,236 1,301 1,372
Delaware 7 8 11 15 16 17 19 20
District of Columbia 8 7 8 10 10 10 11 11
Florida 147 165 232 311 345 363 384 405
Georgia 88 96 134 166 180 188 196 208
Maryland 41 46 60 75 82 85 89 93
North Carolina 91 106 149 194 214 225 237 252
South Carolina 51 59 81 105 115 121 127 135
Virginia 68 77 105 132 144 151 158 166
West Virginia 43 44 55 67 73 76 80 83
East South Central 246 287 397 495 543 570 602 636
Alabama 63 74 101 127 142 151 160 171
Kentucky 62 75 105 132 143 149 156 164
Mississippi 46 53 72 88 96 101 107 111
Tennessee 76 85 119 148 162 169 179 190
West South Central 288 317 452 539 584 614 655 696
Arkansas 45 48 67 80 86 90 96 102
Louisiana 63 71 93 104 112 116 122 118
Oklahoma 41 39 56 69 75 79 84 91
Texas 139 159 236 286 311 329 353 386
Mountain 112 148 228 284 312 327 349 374
Arizona 34 42 66 84 95 101 109 119
Colorado 24 34 54 65 68 69 72 75
Idaho 9 11 16 21 23 25 27 29
Montana 9 12 16 18 19 20 21 22
Nevada 8 13 22 30 35 37 41 44
New Mexico 15 19 28 34 37 39 41 45
Utah 9 13 20 24 26 27 29 31
Wyoming 3 4 7 8 9 9 9 10
Pacific 367 388 529 637 692 726 766 803
Alaska 2 3 5 7 8 9 9 10
California 284 289 392 465 500 522 550 573
Hawaii 7 9 11 15 17 18 19 19
Oregon 31 34 47 57 64 68 72 77
Washington 43 53 74 93 103 109 116 124
Unknown 4 2 1 1 2 2 2 1
Outlying areas 88 93 111 139 147 152 155 159
Puerto Rico 88 92 110 136 144 148 151 154
Virgin Islands -- 1 1 1 1 2 2 2
Other -- -- -- 2 2 2 2 2
Foreign countries 12 14 14 14 15 15 15 16
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Characterization of beneficiaries as to Medicare status and demographic categories may differ from that in other tables on enrollment because of differences in sources and methodology.
Totals do not necessarily equal the sums of rounded components.
-- = not available.
a. Represents beneficiaries of the 50 states and the District of Columbia and beneficiaries with unknown residence.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B4 Hospital Insurance and/or Supplementary Medical Insurance: Number of enrollees aged 65 or older, by program, age, sex, and race, July 1, 1980–2005, selected years (in thousands)
Age, sex, and race 1980 1985 1990 1995 2000 2003 2004 2005
Hospital Insurance and/or Supplementary Medical Insurance
Total 25,515 28,176 30,948 33,142 34,253 35,008 35,334 35,783
Age
65–69 8,459 8,956 9,695 9,517 9,167 9,466 9,698 9,905
70–74 6,756 7,441 7,951 8,756 8,609 8,394 8,321 8,353
75–79 4,809 5,453 6,058 6,563 7,285 7,302 7,258 7,251
80–84 3,081 3,463 3,957 4,470 4,870 5,283 5,429 5,494
85 or older 2,410 2,861 3,286 3,837 4,322 4,563 4,627 4,780
Sex
Men 10,268 11,282 12,416 13,434 14,112 14,625 14,837 15,095
Women 15,247 16,894 18,532 19,708 20,141 20,382 20,497 20,688
Race
White 22,534 24,745 26,855 29,011 29,757 30,195 30,413 30,693
Black -- -- -- -- 2,721 2,826 2,868 2,932
All other races a 2,257 2,585 3,114 3,253 1,682 1,915 1,986 2,094
Native American -- -- -- -- 42 105 109 121
Asian/Pacific -- -- -- -- 494 580 608 648
Hispanic -- -- -- -- 710 737 746 768
Other -- -- -- -- 436 493 523 557
Unknown 724 846 979 878 92 72 67 64
Hospital Insurance
Total 25,104 27,683 30,464 32,742 33,833 34,581 34,996 35,413
Age
65–69 8,302 8,818 9,565 9,411 9,074 9,373 9,622 9,811
70–74 6,592 7,292 7,829 8,652 8,505 8,295 8,248 8,274
75–79 4,731 5,315 5,947 6,483 7,189 7,206 7,186 7,176
80–84 3,072 3,403 3,872 4,409 4,806 5,211 5,369 5,432
85 or older 2,407 2,854 3,252 3,787 4,259 4,496 4,572 4,721
Sex
Men 10,156 11,146 12,280 13,310 13,979 14,489 14,727 14,975
Women 14,948 16,536 18,184 19,431 19,854 20,092 20,269 20,438
Race
White 22,244 24,424 26,591 28,822 29,570 30,013 30,272 30,544
Black -- -- -- -- 2,668 2,775 2,830 2,886
All other races a 2,160 2,444 2,931 3,127 1,507 1,726 1,829 1,922
Native American -- -- -- -- 40 102 106 117
Asian/Pacific -- -- -- -- 406 486 526 559
Hispanic -- -- -- -- 656 677 700 716
Other -- -- -- -- 405 461 497 530
Unknown 699 815 942 792 87 68 65 60
Supplementary Medical Insurance
Total 24,680 27,311 29,686 31,742 32,590 33,203 33,440 33,784
Age
65–69 8,156 8,607 9,008 8,830 8,330 8,554 8,724 8,852
70–74 6,570 7,277 7,740 8,430 8,256 8,012 7,929 7,949
75–79 4,684 5,333 5,942 6,431 7,088 7,100 7,053 7,042
80–84 2,981 3,381 3,879 4,392 4,782 5,169 5,306 5,367
85 or older 2,289 2,712 3,118 3,659 4,134 4,368 4,429 4,575
Sex
Men 9,868 10,852 11,758 12,694 13,205 13,640 13,802 14,000
Women 14,813 16,459 17,927 19,048 19,384 19,562 19,639 19,784
Race
White 21,876 24,060 25,849 27,899 28,432 28,765 28,914 29,113
Black -- -- -- -- 2,544 2,638 2,674 2,730
All other races a 2,114 2,441 2,910 3,028 1,542 1,747 1,806 1,898
Native American -- -- -- -- 39 95 99 110
Asian/Pacific -- -- -- -- 470 546 569 604
Hispanic -- -- -- -- 665 687 694 711
Other -- -- -- -- 368 419 444 473
Unknown 691 810 927 815 71 52 47 43
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Characterization of beneficiaries as to Medicare status and demographic categories may differ from that in other tables on enrollment because of differences in sources and methodology.
-- = not available.
a. Before 2000, black enrollees and members of other races were combined into "All other races." In 1994, the Health Care Financing Administration expanded the race codes to include Hispanic, Asian or Pacific islander, and Native Americans. There were a number of efforts during the 1990s to populate these codes and identify persons coded as "Unknown." Consequently for 2000 and later, blacks are broken out separately from "All other races" and the detail for that category is shown.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B5 Hospital Insurance and/or Supplementary Medical Insurance: Number of enrollees under age 65 who are disabled or have end-stage renal disease, by program, age, sex, and race, July 1, 1980–2005, selected years
Age, sex, and race 1980 1990 2000 2004 2005
All
disabled
End-stage
renal
disease
only
All
disabled
End-stage
renal
disease
only
All
disabled
End-stage
renal
disease
only
All
disabled a
End-stage
renal
disease
only
All
disabled
End-stage
renal
disease
only
Hospital Insurance and/or Supplementary Medical Insurance
Total 2,963,175 28,334 3,255,007 64,692 5,367,151 73,890 6,311,771 83,111 6,716,668 86,183
Age
Under 35 371,204 8,773 483,265 16,603 522,321 13,255 565,761 13,680 599,983 13,870
35–44 369,460 5,188 654,957 14,159 1,129,288 15,084 1,153,154 15,527 1,180,904 15,975
45–54 657,486 6,977 741,200 15,800 1,627,238 22,647 1,961,154 25,715 2,094,100 26,473
55–64 1,565,025 7,396 1,375,585 18,130 2,088,304 22,904 2,631,702 28,189 2,841,681 29,865
Sex
Men 1,870,558 14,547 2,042,944 33,647 3,014,107 40,062 3,411,286 45,637 3,606,531 47,513
Women 1,092,617 13,787 1,212,063 31,045 2,353,044 33,828 2,900,485 37,474 3,110,137 38,670
Race
White 2,422,253 19,232 2,480,767 35,638 3,989,357 35,636 4,686,861 38,304 4,954,857 39,226
Black -- -- -- -- 1,007,147 27,404 1,172,730 30,318 1,264,570 31,309
All other races b 486,677 7,907 712,315 26,477 355,310 37,820 434,973 13,996 481,017 14,842
Native American -- -- -- -- 23,379 739 46,719 1,366 51,672 1,471
Asian/Pacific -- -- -- -- 41,384 2,143 57,364 2,919 66,754 3,175
Hispanic -- -- -- -- 200,808 4,087 221,488 5,736 241,690 6,382
Other -- -- -- -- 89,739 3,447 109,402 3,975 120,901 3,814
Unknown 54,245 1,195 61,925 2,577 15,337 434 17,207 493 16,224 806
Hospital Insurance
Total 2,963,156 28,334 3,254,983 64,677 5,366,598 73,890 6,311,437 83,103 6,716,267 86,175
Age
Under 35 371,199 8,773 483,262 16,601 522,123 13,255 565,698 13,679 599,916 13,868
35–44 369,458 5,188 654,953 14,157 1,129,170 15,084 1,153,074 15,525 1,180,806 15,974
45–54 657,483 6,977 741,193 15,794 1,627,107 22,647 1,961,074 25,712 2,094,001 26,470
55–64 1,565,016 7,396 1,375,575 18,125 2,088,198 22,904 2,631,591 28,187 2,841,544 29,863
Sex
Men 1,870,543 14,547 2,042,929 33,639 3,013,803 40,062 3,411,088 45,632 3,606,296 47,510
Women 1,092,613 13,787 1,212,054 31,038 2,352,795 33,828 2,900,349 37,471 3,109,971 38,665
Race
White 2,422,239 19,232 2,480,754 35,631 3,988,957 35,636 4,686,631 38,302 4,954,608 39,220
Black -- -- -- -- 1,007,035 27,404 1,172,657 30,315 1,264,461 31,308
All other races b 486,672 7,907 712,304 26,469 355,270 37,820 434,942 13,994 480,975 14,841
Native American -- -- -- -- 23,378 739 46,719 1,366 51,670 1,471
Asian/Pacific -- -- -- -- 41,379 2,143 57,359 2,918 66,745 3,175
Hispanic -- -- -- -- 200,793 4,087 221,476 5,735 241,674 6,382
Other -- -- -- -- 89,720 3,447 109,388 3,975 120,886 3,813
Unknown 54,245 1,195 61,925 2,577 15,336 434 17,207 492 16,223 806
Supplementary Medical Insurance
Total 2,719,226 27,046 2,943,480 58,912 4,769,804 68,800 5,584,413 76,173 5,945,978 78,887
Age
Under 35 339,665 8,294 441,640 14,782 466,869 12,159 505,202 12,392 536,855 12,574
35–44 337,146 4,963 586,537 12,567 998,230 13,783 1,012,955 13,964 1,037,009 14,304
45–54 596,287 6,683 666,257 14,559 1,421,904 20,961 1,717,578 23,370 1,837,630 24,164
55–64 1,446,128 7,106 1,249,046 17,004 1,882,801 21,897 2,348,678 26,447 2,534,484 27,845
Sex
Men 1,694,569 13,887 1,833,959 30,338 2,665,252 37,037 2,999,387 41,429 3,170,862 43,056
Women 1,024,657 13,159 1,109,521 28,574 2,104,552 31,763 2,585,026 34,744 2,775,116 35,831
Race
White 2,218,176 18,458 2,236,781 32,347 3,535,008 33,154 4,134,472 35,228 4,372,131 35,932
Black -- -- -- -- 917,336 25,581 1,060,518 27,783 1,143,894 28,726
All other races b 449,753 7,446 650,121 24,240 304,500 35,256 375,078 12,776 416,223 13,528
Native American -- -- -- -- 20,994 688 41,947 1,246 46,449 1,337
Asian/Pacific -- -- -- -- 36,401 2,003 49,873 2,707 58,379 2,920
Hispanic -- -- -- -- 176,093 3,850 194,758 5,325 212,719 5,912
Other -- -- -- -- 71,012 3,134 88,500 3,498 98,676 3,359
Unknown 51,297 1,142 56,578 2,325 12,960 390 14,345 386 13,730 701
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Characterization of beneficiaries as to Medicare status and demographic categories may differ from that in other tables on enrollment because of differences in sources and methodology.
-- = not available.
a. The 2004 data for "All disabled" exclude beneficiaries with end-stage renal disease only.
b. Before 2000, black enrollees and members of other races were combined into "All other races." In 1994, the Health Care Financing Administration expanded the race codes to include Hispanic, Asian or Pacific Islanders, and Native Americans. There were a number of efforts during the 1990s to populate these codes and identify persons coded as "Unknown." Consequently for 2000 and later, blacks are broken out separately from "All other races" and the detail for that category is shown.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B8a Hospital Insurance: Average covered charge per covered day of care in short-stay hospitals, by census division and state or other area, selected years 1975–2005 (in dollars)
Census division and state or area a 1975 1980 1990 1995 2000 2003 2004 2005
Total
All areas b 143 292 1,090 1,908 2,762 4,117 4,559 4,999
United States c 144 293 1,081 1,920 2,787 4,157 4,603 5,043
New England 159 298 988 1,763 2,436 3,194 3,512 3,766
Connecticut 167 287 1,177 2,013 2,608 3,413 3,746 4,063
Maine 133 284 927 1,645 2,328 3,042 3,306 3,515
Massachusetts 168 316 942 1,705 2,429 3,100 3,415 3,618
New Hampshire 123 264 1,022 1,699 2,480 3,384 3,676 4,069
Rhode Island 154 284 851 1,638 2,316 3,290 3,703 3,980
Vermont 124 230 923 1,580 1,995 2,660 2,889 3,087
Middle Atlantic 163 304 943 1,704 2,743 4,763 5,209 5,628
New Jersey 157 300 725 1,865 3,757 7,447 8,142 8,621
New York 176 301 836 1,366 2,116 3,412 3,752 4,123
Pennsylvania 145 312 1,236 2,109 3,003 4,791 5,287 5,806
East North Central 140 294 1,097 1,866 2,550 3,547 3,979 4,387
Illinois 148 322 1,202 2,126 3,017 4,094 4,566 4,980
Indiana 116 236 997 1,713 2,271 3,061 3,477 3,847
Michigan 156 332 1,193 1,881 2,451 3,310 3,715 4,089
Ohio 134 277 1,030 1,730 2,360 3,443 3,861 4,307
Wisconsin 128 251 933 1,690 2,424 3,541 3,984 4,426
West North Central 117 248 1,052 1,831 2,638 3,732 4,166 4,580
Iowa 110 239 902 1,573 2,124 3,031 3,391 3,847
Kansas 113 244 1,093 1,957 2,589 3,768 4,321 4,748
Minnesota 124 248 1,132 1,938 2,913 4,162 4,683 5,095
Missouri 119 257 1,108 1,922 2,783 3,747 4,107 4,514
Nebraska 116 251 1,043 1,850 3,007 4,497 4,968 5,279
North Dakota 118 237 937 1,509 2,180 2,989 3,318 3,549
South Dakota 107 228 915 1,518 2,167 3,266 3,762 4,255
South Atlantic 135 273 1,106 1,876 2,637 3,776 4,162 4,546
Delaware 153 274 1,191 1,831 1,971 2,631 2,954 3,336
District of Columbia 174 373 1,374 2,129 3,331 4,437 4,892 5,355
Florida 161 321 1,360 2,351 3,439 5,030 5,477 5,936
Georgia 125 258 1,081 1,744 2,527 3,552 3,947 4,357
Maryland 164 274 813 1,365 1,608 1,951 2,141 2,286
North Carolina 101 214 932 1,603 2,175 2,963 3,303 3,611
South Carolina 106 229 1,021 1,818 2,611 3,799 4,240 4,702
Virginia 118 247 1,022 1,732 2,432 3,474 3,862 4,237
West Virginia 108 247 1,009 1,472 1,821 2,433 2,641 2,886
East South Central 115 243 1,019 1,718 2,451 3,457 3,844 4,237
Alabama 126 282 1,176 2,054 2,914 4,143 4,609 5,068
Kentucky 107 216 967 1,630 2,269 3,117 3,497 3,866
Mississippi 98 213 865 1,437 2,017 2,883 3,278 3,654
Tennessee 122 250 1,012 1,662 2,479 3,485 3,798 4,184
West South Central 117 253 1,138 1,937 2,767 4,045 4,538 5,029
Arkansas 104 231 923 1,511 2,194 3,152 3,491 3,860
Louisiana 116 265 1,180 1,926 2,724 3,700 4,063 4,427
Oklahoma 128 271 997 1,620 2,335 3,263 3,696 4,145
Texas 118 250 1,212 2,118 3,008 4,486 5,049 5,600
Mountain 142 305 1,350 2,321 3,279 4,630 5,226 5,760
Arizona 155 325 1,442 2,617 3,885 5,197 5,800 6,304
Colorado 144 288 1,308 2,240 3,392 4,859 5,539 6,271
Idaho 129 273 1,140 1,951 2,471 3,304 3,700 4,108
Montana 116 262 1,036 1,742 2,233 3,091 3,491 3,757
Nevada 177 424 2,031 3,253 4,320 6,237 6,889 7,475
New Mexico 133 293 1,140 1,913 2,533 3,591 4,112 4,464
Utah 142 316 1,283 2,069 2,871 3,777 4,206 4,567
Wyoming 109 245 1,094 1,985 2,373 3,319 3,623 4,028
Pacific 196 416 1,651 2,877 4,228 6,495 7,149 7,886
Alaska 228 379 1,470 2,385 3,144 4,521 4,951 5,438
California 206 448 1,794 3,156 4,701 7,283 7,976 8,803
Hawaii 148 333 1,224 2,319 2,991 3,800 4,170 4,582
Oregon 158 329 1,275 1,987 2,717 3,707 4,223 4,602
Washington 163 293 1,162 1,924 2,708 3,972 4,570 5,144
Outlying areas 77 152 510 739 947 1,077 1,084 1,138
Puerto Rico 77 151 505 736 946 1,069 1,074 1,124
Virgin Islands 92 161 746 843 1,007 1,568 1,618 1,922
Other 88 263 . . . . . . . . . . . . . . . . . .
SOURCE: Centers for Medicare & Medicaid.
NOTES: Data for 2000 through 2005 are based on short-stay inpatient hospital stay records for claims processed and recorded in the agency's Medicare Provider Analysis and Review (MEDPAR) file through June 2006 for all beneficiaries, aged and disabled, residing in the same state, territory, or possession where they received their care.
. . . = not applicable.
a. Geographic distribution reflects the beneficiaries' area of residence.
b. Excludes claims for persons residing in foreign countries.
c. Includes claims for persons whose place of residence is unknown.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B8b Hospital Insurance: Average covered charge per covered day of care in skilled nursing facilities, by census division and state or other area, selected years 1975–2005 (in dollars)
Census division and state or area a 1975 1980 1990 1995 2000 2003 2004 2005
Total
All areas b 43 70 193 402 462 487 493 504
United States c 43 70 193 402 462 487 493 504
New England 50 77 172 347 431 478 500 521
Connecticut 35 51 165 314 388 442 464 493
Maine 52 100 274 308 406 485 510 548
Massachusetts 63 98 181 380 484 518 536 554
New Hampshire 41 86 218 412 410 482 506 513
Rhode Island 43 59 129 265 392 428 439 456
Vermont 38 62 155 266 357 412 452 415
Middle Atlantic 50 73 168 308 428 489 499 511
New Jersey 45 81 164 344 434 531 546 563
New York 61 80 168 240 360 430 446 463
Pennsylvania 40 65 170 373 510 535 528 529
East North Central 40 68 167 358 450 481 481 493
Illinois 37 77 215 421 528 556 550 551
Indiana 35 60 180 399 447 448 446 463
Michigan 45 60 130 270 376 425 429 451
Ohio 41 69 157 375 462 485 484 496
Wisconsin 35 64 149 315 343 398 429 443
West North Central 45 82 194 367 473 507 506 515
Iowa 46 84 269 406 490 558 570 599
Kansas 39 66 255 461 539 511 497 506
Minnesota 46 94 125 245 306 407 427 466
Missouri 47 95 263 465 603 575 542 532
Nebraska 41 71 205 338 484 521 523 486
North Dakota 43 49 118 221 408 440 464 504
South Dakota 33 61 160 270 326 433 485 474
South Atlantic 34 59 168 396 405 420 431 446
Delaware 31 50 132 328 345 411 432 454
District of Columbia 34 64 193 389 437 504 513 521
Florida 34 59 195 488 447 432 447 466
Georgia 34 71 146 346 356 394 407 410
Maryland 37 56 141 347 403 428 428 445
North Carolina 31 52 132 283 342 380 397 408
South Carolina 26 46 159 337 384 404 404 428
Virginia 42 68 168 331 374 418 426 439
West Virginia 36 64 171 364 446 493 478 482
East South Central 37 56 154 358 420 433 445 448
Alabama 33 38 143 353 381 405 423 411
Kentucky 36 58 151 352 439 450 469 487
Mississippi 45 105 160 377 480 524 537 513
Tennessee 41 70 162 358 407 406 412 420
West South Central 45 94 267 539 579 537 533 526
Arkansas 44 84 238 372 499 574 570 558
Louisiana 43 83 374 683 754 674 648 588
Oklahoma 60 145 312 563 579 583 575 564
Texas 43 78 238 542 556 497 496 499
Mountain 38 64 226 486 477 456 462 477
Arizona 41 71 236 549 535 432 425 415
Colorado 42 73 266 538 502 471 478 500
Idaho 27 46 152 381 384 428 458 472
Montana 30 44 123 291 362 406 415 456
Nevada 37 66 232 569 592 425 428 429
New Mexico 57 122 267 488 534 552 549 528
Utah 36 75 266 473 435 483 494 542
Wyoming 36 49 208 379 421 475 473 515
Pacific 45 81 269 576 584 630 633 644
Alaska 68 115 283 437 0 660 735 718
California 46 87 287 629 0 698 702 713
Hawaii 49 83 217 467 469 550 580 602
Oregon 40 63 207 421 382 401 426 453
Washington 34 62 196 412 390 427 443 451
Outlying areas
Puerto Rico 51 97 202 261 362 370 391 430
Virgin Islands 43 104 171 370 399 490 404 370
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: Data for 1975 and 1980 are based on bills approved in each year and recorded in the Health Care Financing Administration before December 29, 1995. Data for 1990 and 1995 are based on bills incurred in each year and recorded in the agency before December 30, 1995. Data for 2000 through 2005 are based on skilled nursing facility stay records for claims processed and recorded in the agency's Medicare Provider Analysis and Review (MEDPAR) file through June 2006 for stays with dates of admission in the reference year and an indication of discharge by that update. Includes data for services rendered to both aged and disabled persons.
a. Geographic distribution reflects the beneficiaries' area of residence.
b. Excludes claims for persons residing in foreign countries.
c. Includes claims for persons whose place of residence is unknown.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B8.1 Hospital Insurance: Short-stay hospital discharges, by state or other area, selected fiscal years 1990–2005
State or area 1990 1995 1998 1999 2000 2001 2002 2003 2004 2005
All areas 10,472,587 11,680,874 11,912,079 11,659,885 11,778,705 12,192,174 12,499,749 12,698,388 12,986,560 12,980,067
Alabama 226,359 255,013 266,603 266,541 274,518 282,999 291,991 294,850 299,746 289,916
Alaska 6,491 8,635 10,633 11,031 11,684 11,748 11,794 11,398 11,554 11,506
Arizona 140,069 139,564 150,190 128,363 135,143 144,989 156,302 165,231 182,094 191,400
Arkansas 143,363 152,516 160,379 160,880 164,310 166,445 170,102 170,421 174,242 170,003
California 834,829 875,926 921,068 780,295 740,564 756,629 801,758 836,444 847,296 846,286
Colorado 98,262 105,216 97,479 100,648 101,486 101,258 107,180 109,879 114,051 116,310
Connecticut 114,938 141,765 133,672 125,115 124,951 135,169 148,864 154,460 159,594 164,766
Delaware 26,125 30,336 30,738 33,287 34,049 36,386 36,541 38,216 40,959 42,295
District of Columbia 36,062 39,526 38,661 38,693 39,112 40,138 39,389 39,151 40,527 40,881
Florida 579,368 742,862 758,714 736,958 765,130 823,957 869,777 899,404 925,090 921,995
Georgia 274,957 316,301 320,774 311,998 324,286 334,599 338,687 342,392 353,846 355,683
Hawaii 26,340 32,526 33,331 26,347 26,146 26,343 26,932 26,302 27,453 28,125
Idaho 31,559 36,327 42,451 43,353 44,027 43,272 40,996 40,738 39,756 37,580
Illinois 460,926 533,238 531,184 539,314 556,122 578,327 601,373 607,561 624,034 625,493
Indiana 254,404 276,601 289,743 289,693 297,851 306,202 304,034 303,404 310,393 312,461
Iowa 141,191 146,448 154,152 155,497 159,451 162,466 156,854 148,591 145,095 138,025
Kansas 117,017 120,593 127,045 126,920 128,024 129,973 129,334 131,412 130,138 128,439
Kentucky 199,042 222,162 231,352 237,553 243,886 252,454 257,205 255,264 258,938 260,340
Louisiana 213,819 234,663 232,942 223,794 237,154 243,724 248,183 253,774 254,224 244,437
Maine 54,963 63,013 67,895 68,128 69,030 68,547 66,705 67,401 67,914 65,640
Maryland 179,835 214,989 195,489 199,012 208,038 234,162 244,595 251,754 259,460 265,963
Massachusetts 286,332 310,455 280,333 268,179 263,152 271,657 275,984 291,062 300,460 303,171
Michigan 366,349 435,455 456,972 452,461 452,367 468,675 497,195 506,259 522,536 531,888
Minnesota 170,808 178,018 192,488 194,935 200,918 209,469 210,382 208,364 212,125 207,340
Mississippi 142,662 162,934 185,149 181,575 183,952 185,626 182,535 183,965 185,131 182,237
Missouri 281,059 298,509 297,554 293,724 300,576 315,642 317,278 320,454 331,919 335,644
Montana 40,505 40,770 41,854 42,343 44,208 45,697 42,880 40,952 41,719 40,734
Nebraska 69,299 70,113 77,188 76,841 76,960 74,217 71,921 71,577 72,718 75,456
Nevada 37,478 49,254 55,150 48,369 49,613 51,836 56,622 57,345 62,742 65,749
New Hampshire 39,103 42,746 42,918 42,054 45,712 48,206 46,282 46,304 46,893 44,246
New Jersey 338,509 385,145 364,034 373,224 372,063 374,250 389,938 404,035 410,302 415,558
New Mexico 50,391 50,334 52,913 51,459 51,085 51,396 51,469 51,533 52,083 53,247
New York 723,060 797,453 787,116 777,269 750,793 761,352 771,835 780,893 793,919 827,445
North Carolina 267,370 336,173 385,533 395,004 406,700 413,429 418,725 431,441 439,157 437,330
North Dakota 37,543 37,014 38,332 38,847 39,672 38,764 34,707 34,645 34,712 34,214
Ohio 527,006 562,234 541,958 533,499 536,335 550,989 559,223 565,314 588,640 596,857
Oklahoma 155,100 156,239 166,068 170,592 176,021 179,543 182,998 187,913 193,773 190,727
Oregon 106,164 105,878 111,028 100,569 91,806 98,854 102,568 102,182 99,869 92,710
Pennsylvania 685,403 766,535 692,290 664,002 634,802 649,458 656,105 654,661 665,143 666,969
Rhode Island 46,578 49,740 46,484 39,625 38,489 39,658 40,229 38,506 39,556 40,098
South Carolina 112,232 156,060 184,188 194,344 204,038 213,513 216,412 218,775 221,825 223,044
South Dakota 38,175 41,714 44,350 44,846 45,239 45,202 43,134 42,626 40,946 39,276
Tennessee 290,371 310,335 324,831 318,793 327,423 341,212 344,524 348,700 357,600 355,948
Texas 603,621 671,734 732,255 725,166 742,628 798,667 843,945 868,784 897,873 883,811
Utah 39,963 43,819 45,698 48,898 53,003 55,207 56,244 57,928 61,309 60,885
Vermont 20,251 22,815 22,585 23,133 24,014 24,778 22,658 22,690 22,174 20,866
Virginia 240,165 271,620 286,752 289,195 295,790 305,346 310,602 315,181 324,379 323,414
Washington 157,942 157,146 152,867 148,620 153,660 162,197 166,846 167,102 171,361 175,107
West Virginia 111,305 124,293 131,473 134,483 134,585 135,458 132,356 131,953 134,992 128,795
Wisconsin 217,727 227,774 233,103 233,432 238,572 240,711 243,774 244,100 243,116 230,655
Wyoming 15,255 16,009 17,256 17,429 18,764 18,932 18,044 16,416 16,097 15,958
Outlying areas
Puerto Rico 93,436 111,950 123,752 130,209 137,315 138,713 139,682 134,979 131,223 118,565
Virgin Islands 528 1,374 1,569 1,511 1,552 1,468 1,571 1,641 1,743 1,785
Unknown 978 1,012 1,543 1,835 1,936 2,265 2,485 2,061 2,121 2,794
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: Data for 2000 through 2005 are based on short-stay inpatient hospital stay records for claims processed and recorded in the agency's Medicare Provider Analysis and Review (MEDPAR) file through June 2006 for all beneficiaries, aged and disabled, residing in the same state, territory, or possession where they received their care.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B9 Supplementary Medical Insurance: Number of reimbursed bills, charges, and amount reimbursed, by type of beneficiary and type of service, for claims incurred 1997–2005 (in thousands)
Year a All
services
Physicians' services Outpatient
hospital
services
Independent
laboratory
services
Home
health
services b
All
other
services
Total Surgical c Medical c
Persons aged 65 or older
Number of bills
1997 600,228 418,826 46,517 372,309 52,364 49,917 245 78,876
1998 611,356 427,891 46,273 381,618 52,807 42,715 4,632 83,311
1999 486,296 d 429,299 45,496 383,803 51,498 d 5,499 d
2000 -- -- -- -- -- -- -- --
2001 -- -- -- -- -- -- -- --
2002 -- -- -- -- -- -- -- --
2003 -- -- -- -- -- -- -- --
2004 -- -- -- -- -- -- -- --
2005 -- -- -- -- -- -- -- --
Allowed charges e (dollars)
1997 92,897,397 40,447,640 12,953,314 27,493,847 37,669,213 1,490,474 336,443 12,953,627
1998 101,840,926 41,704,109 12,061,669 29,634,502 38,746,856 1,333,198 6,051,859 14,004,904
1999 105,664,413 43,771,964 12,080,067 31,637,737 40,243,635 1,264,426 6,874,113 13,510,275
2000 114,463,963 48,335,051 12,358,986 35,902,761 44,217,919 1,583,630 5,558,701 14,768,662
2001 131,329,657 55,171,872 13,091,543 40,923,161 52,867,374 1,860,323 4,197,515 17,232,573
2002 152,936,873 58,773,592 -- -- 67,490,131 2,101,103 4,362,532 20,209,515
2003 175,715,306 64,647,019 -- -- 81,020,493 2,293,330 4,803,648 22,950,816
2004 201,358,895 71,328,961 -- -- 97,328,115 2,551,093 5,378,244 24,772,482
2005 224,315,314 73,640,361 -- -- 115,941,793 2,750,594 6,076,649 25,905,917
Amount reimbursed f (dollars)
1997 52,437,116 31,683,721 10,218,613 21,464,753 11,208,190 1,440,441 235,099 7,869,665
1998 56,706,261 32,668,167 9,517,777 23,144,124 10,686,605 1,278,720 4,261,952 7,810,817
1999 58,242,119 34,424,846 9,523,625 24,857,734 10,365,512 1,209,285 4,836,246 7,406,230
2000 62,317,913 37,964,491 9,743,222 28,166,179 10,677,318 1,503,061 4,180,363 7,992,680
2001 71,345,982 43,354,009 10,351,499 32,120,569 12,947,907 1,760,106 4,061,628 9,222,332
2002 77,660,520 46,201,607 -- -- 14,749,186 1,982,842 4,313,458 10,413,427
2003 85,868,864 50,850,701 -- -- 16,694,728 2,163,223 4,579,139 11,581,073
2004 95,545,640 56,135,544 -- -- 19,383,619 2,404,412 5,287,512 12,334,553
2005 101,714,387 57,968,543 -- -- 21,781,457 2,590,805 6,049,620 13,323,962
Disabled beneficiaries
Number of bills
1997 86,071 55,260 4,773 50,487 12,415 8,073 0 10,323
1998 89,890 58,244 4,991 53,253 12,639 6,776 475 11,756
1999 72,288 d 59,281 5,042 54,239 12,413 d 594 d
2000 -- -- -- -- -- -- -- --
2001 -- -- -- -- -- -- -- --
2002 -- -- -- -- -- -- -- --
2003 -- -- -- -- -- -- -- --
2004 -- -- -- -- -- -- -- --
2005 -- -- -- -- -- -- -- --
Allowed charges e (dollars)
1997 17,062,714 5,399,416 1,409,583 3,989,586 9,395,017 281,459 575 1,986,247
1998 18,746,687 5,828,284 1,401,045 4,421,251 9,551,832 252,458 721,884 2,392,229
1999 20,046,826 6,298,890 1,453,807 4,812,231 10,130,120 245,525 867,209 2,505,082
2000 22,097,171 7,140,407 1,526,798 5,582,913 11,122,256 294,758 730,750 2,809,000
2001 25,872,075 8,339,487 1,631,945 6,383,077 13,310,513 343,196 561,099 3,317,780
2002 32,797,113 9,233,277 -- -- 18,557,925 402,193 607,024 3,996,694
2003 41,421,583 10,768,708 -- -- 24,805,775 457,506 692,869 4,696,725
2004 52,621,219 12,705,530 -- -- 33,424,812 531,285 804,738 5,154,854
2005 64,764,825 13,503,399 -- -- 43,944,675 582,907 948,497 5,785,347
Amount reimbursed f (dollars)
1997 9,592,858 4,093,669 1,103,074 2,990,428 3,839,784 276,057 454 1,382,894
1998 10,446,294 4,409,966 1,095,140 3,310,214 3,778,150 246,338 497,581 1,514,259
1999 11,002,708 4,782,133 1,135,375 3,621,070 3,841,626 239,194 594,950 1,544,805
2000 11,938,053 5,418,901 1,192,908 4,203,799 4,007,106 286,675 529,591 1,695,780
2001 13,851,513 6,333,057 1,278,008 4,823,352 4,728,326 333,191 489,650 1,967,289
2002 15,685,143 7,023,892 -- -- 5,430,328 390,035 540,938 2,299,950
2003 18,075,888 8,215,711 -- -- 6,164,920 443,179 600,605 2,651,473
2004 20,954,731 9,719,744 -- -- 7,175,429 514,470 720,820 2,824,268
2005 23,007,049 10,347,063 -- -- 7,950,866 565,175 864,646 3,279,299
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Data are subject to revision.
-- = not available.
a. Period for which the claim incurred.
b. Because of provisions in the Balanced Budget Act, beginning in 1998, Part A now has a 100-visit limit, and additional home health services will be billed under Part B.
c. Where both medical and surgical charges are included on a single bill, the highest-priced service is the determining factor in classifying the bill.
d. Total for "All services" excludes "Independent laboratory services" and "All other services"; for those services, data are not available because of programmatic problems.
e. Includes physician or supplier allowed charges as determined by the carrier and amounts actually billed by providers for outpatient hospital and home health services.
f. Amount reimbursed to or on behalf of the beneficiary—generally 80 percent of the allowed charges, once the beneficiary has satisfied the deductible in the current year. Some radiology and pathology services are reimbursed at a 100 percent rate, regardless of the beneficiary's deductible status.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B10 Supplementary Medical Insurance: Claims received by carriers and assignment rates, 1969–2005
Year Total number
of claims
(thousands)
Net
assignment
rate a
(percent)
1969 37,542 61.5
1970 42,148 60.8
1971 46,572 58.5
1972 51,041 54.9
1973 57,007 52.7
1974 68,307 51.9
1975 79,980 51.8
1976 91,624 50.5
1977 105,339 50.5
1978 117,886 50.6
1979 132,098 51.3
1980 150,048 51.5
1981 167,154 52.3
1982 182,440 53.0
1983 204,122 53.9
1984 238,362 59.0
1985 279,559 68.5
1986 306,714 68.0
1987 346,551 73.1
1988 386,763 77.3
1989 421,305 79.7
1990 474,226 81.1
1991 517,123 83.1
1992 554,619 86.2
1993 583,863 90.1
1994 622,514 92.8
1995 647,855 94.7
1996 678,030 95.9
1997 688,891 96.7
1998 697,523 97.3
1999 703,227 97.6
2000 720,493 97.9
2001 766,758 98.1
2002 821,993 98.4
2003 860,746 98.5
2004 922,197 98.7
2005 951,551 98.9
SOURCE: Centers for Medicare & Medicaid Services.
a. Represents the number of assigned claims as a percentage of claims received.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B11 Supplementary Medical Insurance: Reasonable charge determination for claims assigned and unassigned for aged and disabled persons, 1971–2005
Year Claims approved Charges before reduction
Number
(thousands)
Percentage
reduced
Amount
(millions
of dollars)
Percentage
reduced
Assigned claims
1971 25,919 44.5 1,571 11.1
1972 26,798 47.5 1,630 10.9
1973 28,376 55.6 1,751 11.9
1974 33,295 64.5 2,194 14.3
1975 39,218 70.8 2,716 17.8
1976 44,065 74.3 3,261 19.9
1977 50,260 72.8 3,936 19.4
1978 56,493 73.6 4,678 19.9
1979 64,051 77.0 5,746 21.2
1980 73,068 80.8 7,303 22.7
1981 a 80,127 82.8 8,868 24.0
1982 91,615 83.3 11,315 24.3
1983 103,139 81.0 13,657 23.6
1984 128,559 80.8 16,571 25.4
1985 176,956 81.7 22,008 27.4
1986 191,139 82.8 24,662 28.4
1987 234,488 83.4 31,179 28.0
1988 271,225 85.6 37,275 29.8
1989 304,649 86.9 44,567 31.0
1990 341,220 87.5 51,012 32.9
1991 384,168 87.4 60,057 36.2
1992 412,924 86.2 67,667 39.7
1993 460,761 88.8 76,186 42.8
1994 508,981 87.7 85,170 42.5
1995 539,630 86.4 93,300 42.3
1996 550,587 87.1 97,744 44.9
1997 566,591 87.4 103,389 45.9
1998 575,799 87.9 106,947 46.9
1999 590,463 88.9 114,981 47.8
2000 615,862 87.9 126,391 47.7
2001 665,196 87.5 145,641 48.0
2002 722,826 87.7 152,373 56.3
2003 759,783 88.9 189,920 52.0
2004 781,000 89.8 208,027 52.9
2005 846,093 87.2 236,430 52.0
Unassigned claims
1971 17,955 57.6 1,348 12.5
1972 21,286 59.3 1,608 12.0
1973 24,691 66.4 1,886 12.6
1974 30,492 72.7 2,401 14.7
1975 36,182 77.4 2,973 17.7
1976 42,100 78.9 3,591 19.8
1977 48,619 77.1 4,233 19.0
1978 53,700 77.5 4,749 19.2
1979 59,961 80.9 5,596 20.7
1980 68,113 84.3 6,836 22.5
1981 a 72,765 85.8 7,870 23.8
1982 80,253 85.4 9,545 23.9
1983 87,436 82.7 10,885 22.9
1984 88,594 83.7 11,216 24.2
1985 77,965 84.6 10,059 25.9
1986 87,121 85.0 10,757 26.9
1987 83,116 82.4 10,258 24.7
1988 76,503 86.4 9,005 25.0
1989 74,947 90.1 8,971 25.0
1990 77,746 90.4 8,789 25.3
1991 77,520 91.3 7,884 23.1
1992 66,403 82.9 6,215 18.5
1993 51,080 86.5 4,267 16.5
1994 39,364 86.4 3,255 16.3
1995 29,975 83.4 2,543 15.4
1996 22,819 84.4 1,952 15.8
1997 18,615 84.4 1,650 16.4
1998 15,172 82.3 1,382 17.1
1999 13,834 81.3 1,316 17.7
2000 12,755 78.6 1,287 18.1
2001 12,085 76.7 1,252 18.2
2002 11,352 79.8 1,107 17.2
2003 11,100 82.1 1,066 15.9
2004 10,016 83.0 1,009 16.3
2005 9,589 82.2 1,000 17.4
SOURCE: Centers for Medicare & Medicaid Services.
a. Excludes Texas Blue-Shield plan from July to December 1981.
CONTACT: Maria Diacogiannis (410) 786-0178.
Table 8.B12 Supplementary Medical Insurance: State buy-ins, by state or other area, selected years 1991–2006
State or area 1991 1995 1999 2000 2001 2002 2003 2004 2005 2006
All areas 3,640,121 4,705,625 5,273,573 5,425,048 5,615,326 5,810,613 6,145,589 6,305,467 6,577,577 6,885,326
Alabama 97,601 116,916 128,875 136,860 141,436 144,603 162,912 164,499 169,460 175,134
Alaska 4,539 6,193 7,799 8,486 8,832 9,324 10,008 10,318 10,748 11,465
Arizona 28,650 44,236 53,450 57,712 61,989 74,678 91,782 95,804 110,977 116,065
Arkansas 64,996 77,660 79,508 79,606 80,231 82,040 86,597 86,181 89,372 96,906
California 646,108 747,814 793,510 818,846 848,361 892,260 950,503 977,676 1,012,804 1,047,842
Colorado 36,470 46,660 53,964 55,325 56,934 57,987 59,114 61,140 61,294 64,505
Connecticut 23,535 48,047 52,134 53,141 55,933 60,083 65,223 66,664 66,191 66,968
Delaware 4,499 6,645 8,231 10,737 12,094 13,252 15,224 16,081 17,104 19,534
District of Columbia 12,791 14,152 13,181 14,233 14,621 15,065 15,079 15,586 15,246 15,365
Florida 196,992 271,430 324,172 342,109 358,642 369,092 389,599 406,006 431,764 459,146
Georgia 128,976 160,380 171,638 176,596 181,312 186,466 193,807 199,524 205,476 212,257
Hawaii 11,529 16,695 19,962 20,326 21,090 21,748 22,904 22,988 23,703 26,040
Idaho 9,127 12,931 15,868 17,081 18,550 19,725 21,255 22,291 23,482 24,628
Illinois 94,434 137,571 149,850 155,743 161,141 163,368 175,822 189,044 206,014 215,631
Indiana 60,297 76,460 82,901 87,543 91,311 95,553 102,654 105,011 109,669 114,933
Iowa 41,170 48,517 50,954 51,976 52,891 54,536 56,920 58,023 60,458 63,221
Kansas 26,960 34,708 40,365 41,217 42,126 43,123 44,602 46,175 47,707 49,483
Kentucky 76,456 97,978 111,789 117,697 118,641 122,096 126,690 126,343 126,468 134,469
Louisiana 87,570 112,090 116,602 117,179 117,867 120,478 127,340 132,498 139,802 140,291
Maine 22,176 29,453 35,211 36,946 38,161 39,575 42,269 43,800 46,510 52,560
Maryland 48,028 58,865 64,086 65,372 68,010 70,224 73,994 75,366 79,234 83,078
Massachusetts 89,163 125,859 143,779 152,587 160,198 164,510 167,681 170,689 178,691 188,576
Michigan 91,340 123,948 139,411 145,172 148,760 152,758 158,998 161,519 170,044 180,235
Minnesota 39,366 52,192 59,926 63,607 66,874 70,873 75,080 77,499 79,428 81,353
Mississippi 90,530 108,577 107,176 107,495 116,503 125,832 131,706 133,337 135,023 137,715
Missouri 55,116 72,659 85,329 88,343 91,244 93,512 99,127 103,449 109,561 110,734
Montana 10,058 11,031 12,274 12,828 13,120 13,359 13,889 13,917 14,455 15,097
Nebraska 11,358 16,146 19,064 20,520 21,121 22,120 22,922 23,082 24,210 25,243
Nevada 8,657 14,227 18,322 19,155 20,709 22,207 24,587 26,977 27,408 28,639
New Hampshire 3,807 5,405 6,875 7,434 8,866 9,231 10,120 10,732 11,584 12,597
New Jersey 95,795 122,923 143,024 146,705 149,303 151,644 155,377 153,231 159,110 169,804
New Mexico 22,246 29,855 36,023 37,330 39,275 41,263 44,534 44,642 49,333 52,078
New York 255,952 325,882 372,824 369,479 395,830 409,388 432,681 448,373 465,068 487,736
North Carolina 117,656 186,328 216,563 223,402 228,997 233,229 240,422 241,543 251,739 258,981
North Dakota 4,639 5,560 5,758 5,908 6,275 6,317 6,541 6,560 6,757 7,185
Ohio 112,598 164,044 181,407 171,139 176,602 182,821 191,295 195,792 204,905 223,726
Oklahoma 51,457 60,080 66,115 67,413 67,787 68,905 70,761 72,758 75,903 80,536
Oregon 28,537 43,642 55,896 59,169 62,910 66,255 68,421 69,610 70,927 72,394
Pennsylvania 127,519 162,788 198,492 206,468 215,351 218,691 229,814 232,885 242,552 258,675
Rhode Island 10,585 15,517 18,513 19,787 21,620 22,928 25,146 25,361 26,311 27,002
South Carolina 78,701 95,970 110,032 112,232 116,288 118,635 117,997 118,393 118,843 121,469
South Dakota 9,399 12,346 13,112 13,146 13,237 13,542 14,231 14,045 14,534 15,176
Tennessee 116,861 148,391 178,707 182,342 184,570 187,438 203,567 208,678 218,894 228,849
Texas 234,169 314,991 350,959 360,191 370,598 380,954 410,248 423,560 440,938 457,346
Utah 10,263 13,506 15,569 16,231 16,712 17,497 18,548 19,361 21,787 24,114
Vermont 8,223 12,428 13,598 13,754 14,296 14,650 15,016 15,079 15,509 20,857
Virginia 77,898 102,964 111,404 113,259 113,898 116,496 120,711 124,996 131,083 137,991
Washington 54,774 71,531 91,976 97,390 94,852 99,552 105,516 108,780 113,233 119,180
West Virginia 28,086 39,720 45,406 46,305 47,774 47,547 50,008 51,365 54,200 57,688
Wisconsin 67,516 75,247 74,681 74,101 73,875 75,179 78,124 79,889 83,383 85,661
Wyoming 3,505 5,265 6,183 6,444 6,746 7,087 7,422 7,454 7,749 8,015
Outlying areas
Guam 443 669 583 417 385 339 339 375 409 647
Northern Mariana Islands 273 314 335 342 367 372 358 340 358 354
Virgin Islands 727 219 207 204 210 206 194 178 165 152
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: Data are as of July except for 1995 data, which are as of June.
CONTACT: Maria Diacogiannis (410) 786-0178.