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Medicare spending

Read more about the transition from CMHS-based to claims-based reimbursement measures.

Claims-based: Price, age, sex and race-adjusted
(20% sample for 2003-09: 100% sample for 2010-13)
CMHS-based: Age, sex and race-adjusted
(5% sample)
State level HRR level HSA level County level State level HRR level HSA level
2013 2013 2013 2013      
2012 2012 2012 2012      
2011 2011 2011 2011      
2010 2010 2010 2010      
2009 2009 2009 2009      
2008 2008 2008 2008      
2007 2007 2007 2007 2007 2007 2007
2006 2006 2006 2006 2006 2006 2006
2005 2005 2005 2005 2005 2005 2005
2004 2004 2004 2004 2004 2004 2004
2003 2003 2003 2003 2003 2003 2003
        2002 2002 2002
        2001 2001 2001
        2000 2000 2000
        1999 1999 1999
        1998 1998 1998
        1997 1997 1997
        1996 1996 1996
        1995 1995 1995
        1994 1994 1994
        1993 1993 1993
        1992 1992 1992

Health care for an aging population

Data are for older adults in Medicare and measure the demographics and care experienced by this population, including patients with multiple chronic conditions and dementia. More information can be found in Our Parents, Ourselves: Health Care for an Aging Population.


Medicare mortality rates

State level HRR level HSA level
2014 2014 2014
2013 2013 2013
2012 2012 2012
2011 2011 2011
2010 2010 2010
2009 2009 2009
2008 2008 2008
2007 2007 2007
2006 2006 2006
2005 2005 2005
2004 2004 2004
2003 2003 2003
2002 2002 2002
2001 2001 2001
2000 2000 2000
1999 1999 1999

Selected measures of primary care access and quality

Data include measures of primary care utilization, quality of care for diabetes, mammography, leg amputation and preventable hospitalizations. More information can be found in Regional and Racial Variation in Primary Care and the Quality of Care among Medicare Beneficiaries.

State level HRR level HSA level County level
2014 2014 2014 2014
2013 2013 2013 2013
2012 2012 2012 2012
2011 2011 2011 2011
2010 2010 2010 2010
2009 2009 2009 2009
2008 2008 2008 2008
2003-07 2003-07 2003-07 2003-07

Selected hospital and physician capacity measures

HRR level HSA level  
2012* 2012*  
2011* 2011*  
2006 2006  
1996 1996  

*2011 rates for physician workforce only. 2012 rates for hospital resources only.

Note: some HSAs show large population shifts between the 2006 estimates and the 2010 estimates (used for 2011 and 2012 data). These shifts are attributed to several factors. Some may represent actual population changes. Others may reflect changes in methodology. The 2006 estimates were extrapolated from the 2000 Census, which used ZIP Code Tabulation Areas (ZCTAs) as their basis. The 2010 Census counts are based on Census tracts, which may change the geographic relationships. Users should be aware of this when comparing 2006 to 2011 or 2012 data. These changes have little to no impact at the HRR level.


Variation in the care of surgical conditions

These indicators were created for a series of six 2014 Dartmouth Atlas reports that examined unwarranted variations in U.S. surgical care. More information can be found in Variations in the Care of Surgical Conditions.


Children's health care in Northern New England, 2007-10

Data include claims for children from commercial insurers and Medicaid for ambulatory physician services, hospitalization, common surgery, imaging, and outpatient prescription fills. More information can be found in The Dartmouth Atlas of Children's Health Care in Northern New England.


Prescription drug use, 2010

Data include the percent of Part D enrollees receiving effective prescription therapy, discretionary medications, and high-risk medications, as well as overall utilization and spending for prescription drugs. More information can be found in The Dartmouth Atlas of Medicare Prescription Drug Use.


Miscellaneous measures

These measures were created for specific purposes and may be of use to some users.

Hip replacement surgery per 1,000 Medicare enrollees (.xls). Data are for 2003-12 at the HRR level. Rates are adjusted for age, sex, and race.

Knee replacement surgery per 1,000 Medicare enrollees (.xls). Data are for 2003-12 at the HRR level (HSA-level data available upon request). Rates are adjusted for age, sex, and race.

Shoulder replacement surgery per 1,000 Medicare enrollees (.xls). Data are for 2003-12 at the HRR level (HSA-level data available upon request). Rates are adjusted for age, sex, and race.

Strabismus surgery per 1,000 Medicare enrollees (.xls). Data are for 2003-12 at the HRR level. Rates are adjusted for age, sex, and race.

Cardiac echocardiogram per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Cataract surgery per 1,000 Medicare enrollees (.xls). Data for 2003-12 are available at the HRR, HSA, state, and county levels and are adjusted for age, sex, and race. Data for 2013 are stratified by age, sex, and race, as well as adjusted.

Carotid echocardiogram per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Routine ECG per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Ambulatory ECG monitoring per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Cardiac stress testing per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Electrophysiologic testing per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Coronary angiography per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Coronary artery stenting per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

PTCA per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Pacemaker insertion per 1,000 Medicare enrollees (.xls). Data are available for 2012 and 2006 at the HRR level. Rates are adjusted for age, sex, and race.

Implantable defibrillator insertion per 1,000 Medicare enrollees (.xls). Data for 2008-12 are available at the HRR, HSA, state, and county levels and are adjusted for age, sex, and race. Data for 2013 are stratified by age, as well as adjusted.

CT of chest per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

CT of head per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

MRI of head per 1,000 Medicare enrollees (.xls). Data are for 2012 at the HRR level. Rates are adjusted for age, sex, and race.

Mohs surgery per 1,000 Medicare enrollees (.xls). Data for 2008-12 are available at the HRR, HSA, state, and county levels and are adjusted for age, sex, and race. Data for 2013 are stratified by age, as well as adjusted.

Emergency department visits per Medicare beneficiary (.xls). Data are for 2012 at the HRR, HSA, and state levels. Rates are adjusted for age, sex, and race.

Office visits per Medicare beneficiary (.xls). Data are for 2012 at the HRR, HSA, and state levels. Rates are adjusted for age, sex, and race.

Urgent care visits per Medicare beneficiary (.xls). Data are for 2012 at the HRR, HSA, and state levels. Rates are adjusted for age, sex, and race.

Lumbar radiofrequency ablation per 1,000 Medicare beneficiaries (.xls). Data are for 2003-12 at the HRR and state levels (HSA and county-level data available upon request). Rates are adjusted for age, sex, and race.

Counts of Medicare beneficiaries in the ESRD program (.xls). Data are for 2002-12 at the HRR and state levels, overall and stratified by age.

Obesity rate per 1,000 Medicare beneficiaries (.xls). Data are for 2012-13 at the HRR and state levels. Rates are adjusted for age, sex, and race. Rates are defined two ways: using both ICD-9 and CPT codes, and using CPT codes only.

Internal mammary use in CABG per 1,000 Medicare beneficiaries (.xls). Data are for 2008-13 at the HRR, HSA, state, and county levels. Rates are adjusted for age, sex, and race. Rates are defined by individual CPT code: 33533, 33534, and 33535.

Acute coronary syndrome revascularization rate per 1,000 Medicare beneficiaries (.xls). Data are for 2013 at the HRR and HSA levels. Rates are stratified by age, sex, and race, as well as adjusted.






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The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation, including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.