Annual Statistical Supplement, 2004

 

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 1967–1999
Type of coverage and service 1967 1975 1980 1990 1997 1999 Average annual
rate change
(percent),
1967–1999
Persons enrolled (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 19,521 22,790 25,515 30,948 33,630 27,449 1.1
Hospital Insurance 19,494 22,472 25,104 30,464 33,237 27,047 1.0
Supplementary Medical Insurance 17,893 21,945 24,680 29,685 32,164 25,923 1.2
Persons served (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 7,154 12,032 16,271 24,809 26,130 25,274 4.0
Hospital Insurance 3,960 4,963 6,024 6,367 7,136 6,282 1.5
Inpatient hospital 3,601 4,913 5,951 5,906 6,004 5,930 1.6
Skilled nursing services 354 260 248 615 1,433 1,374 4.3
Home health services a 126 329 675 1,818 3,169 1,417 7.9
Hospice services b . . . . . . . . . -- 360 450 . . .
Supplementary Medical Insurance 6,523 11,762 16,099 24,687 25,943 25,048 4.3
Physicians' and other medical services 6,415 11,396 15,627 24,193 25,434 24,615 4.3
Outpatient services 1,511 3,768 6,629 14,055 17,957 17,844 8.0
Home health services a 118 161 302 38 47 1,221 7.6
Persons served per 1,000 enrollees
Hospital Insurance and/or Supplementary Medical Insurance 367 528 638 802 777 921 2.9
Hospital Insurance 203 221 240 209 215 232 0.4
Inpatient hospital 185 219 237 194 181 219 0.5
Skilled nursing services 18 12 10 21 43 51 3.3
Home health servicesa 7 15 27 60 95 52 6.5
Hospice services b . . . . . . . . . -- 11 17 . . .
Supplementary Medical Insurance 365 536 652 832 807 966 3.1
Physicians' and other medical services 359 519 633 815 791 950 3.1
Outpatient services 77 172 269 474 558 688 7.1
Home health services a 7 7 12 1 1 47 6.1
Amount reimbursed (millions of dollars)
Hospital Insurance and/or Supplementary Medical Insurance 4,239 12,689 29,134 88,778 151,655 142,425 11.6
Hospital Insurance 2,967 9,209 20,353 54,244 100,034 85,413 11.1
Inpatient hospital 2,659 8,840 19,583 48,952 72,430 71,290 10.8
Skilled nursing services 274 233 331 1,886 10,708 9,191 11.6
Home health services  a 26 136 440 3,406 14,976 2,581 15.5
Hospice services b . . . . . . . . . -- 1,920 2,351 . . .
Supplementary Medical Insurance 1,272 3,481 8,871 34,533 51,621 57,012 12.6
Physicians' and other medical services 1,224 3,050 7,361 27,379 38,096 40,298 11.5
Outpatient services 38 374 1,261 7,077 13,307 12,181 19.8
Home health services a 17 56 159 78 218 4,532 19.1
Amount reimbursed per person served (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 592 1,055 1,791 3,578 5,804 5,635 7.3
Hospital Insurance 749 1,855 3,379 8,520 14,018 13,596 9.5
Inpatient hospital 738 1,799 3,291 8,289 12,064 12,022 9.1
Skilled nursing services 774 896 1,336 3,068 7,472 6,689 7.0
Home health services a 204 413 652 1,874 4,726 1,821 7.1
Hospice services b . . . . . . . . . -- 5,333 5,224 . . .
Supplementary Medical Insurance 195 296 545 1,399 1,990 2,276 8.0
Physicians' and other medical services 191 268 471 1,132 1,498 1,637 6.9
Outpatient services 25 99 190 503 741 683 10.9
Home health servicesa 145 347 526 2,033 4,638 3,712 10.7
Amount reimbursed per enrollee (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 217 557 1,142 2,869 4,510 5,189 10.4
Hospital Insurance 152 410 811 1,781 3,010 3,158 9.9
Inpatient hospital 137 394 780 1,607 2,179 2,636 9.7
Skilled nursing services 14 11 13 62 322 340 10.5
Home health services a 1 6 18 112 451 95 15.3
Hospice services b . . . . . . . . . -- 58 87 . . .
Supplementary Medical Insurance 71 159 356 1,163 1,605 2,199 11.3
Physicians' and other medical services 69 139 298 922 1,184 1,555 10.2
Outpatient services 2 17 51 238 414 470 18.6
Home health services  a 1 2 6 3 7 175 17.5
SOURCE: Centers for Medicare & Medicaid Services.
NOTES: Data for persons enrolled as of July 1 are 100 percent and include Health Maintenance Organization (HMO) beneficiaries. Calendar year utilization for persons served and amounts reimbursed are inflated to represent 100 percent and exclude HMO services.
. . . = 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 1974–1999
Type of coverage and service 1974 1975 1980 1990 1997 1998 1999 Average annual
rate change
(percent),
1974–1999
Persons enrolled (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 1,928 2,168 2,963 3,255 4,815 4,605 4,738 3.7
Hospital Insurance 1,928 2,168 2,963 3,255 4,815 4,604 4,738 3.7
Supplementary Medical Insurance 1,745 1,959 2,719 2,943 4,296 4,055 4,164 3.5
Persons served (thousands)
Hospital Insurance and/or Supplementary Medical Insurance 792 975 1,760 2,390 3,717 3,792 3,937 6.6
Hospital Insurance 400 475 728 680 982 952 937 3.5
Inpatient hospital 397 472 721 644 883 891 916 3.4
Skilled nursing services 8 8 9 23 70 73 74 9.3
Home health services a 15 22 51 122 289 204 126 8.9
Hospice services b . . . . . . . . . -- 20 21 24 . . .
Supplementary Medical Insurance 740 924 1,723 2,365 3,678 3,757 3,898 6.9
Physicians' and other medical services 691 865 1,631 2,249 3,527 3,619 3,764 7.0
Outpatient services 296 399 909 1,496 2,586 2,629 2,728 9.3
Home health services a 9 13 25 c 360 125 127 11.2
Persons served per 1,000 enrollees
Hospital Insurance and/or Supplementary Medical Insurance 411 450 594 734 772 823 831 2.9
Hospital Insurance 208 219 246 209 204 207 198 -0.2
Inpatient hospital 206 218 243 198 183 194 193 -0.3
Skilled nursing services 4 4 3 7 15 16 16 5.6
Home health services a 8 10 17 38 60 44 27 4.9
Hospice services b . . . . . . . . . -- 4 5 5 . . .
Supplementary Medical Insurance 424 471 634 804 856 927 936 3.2
Physicians' and other medical services 396 442 600 764 821 892 904 3.4
Outpatient services 170 204 334 508 602 648 655 5.5
Home health services a 5 7 9 c 84 31 30 7.5
Amount reimbursed (millions of dollars)
Hospital Insurance and/or Supplementary Medical Insurance 1,049 1,509 4,478 11,239 23,768 23,746 24,262 13.4
Hospital Insurance 694 987 2,765 6,694 14,293 13,529 13,434 12.6
Inpatient hospital 681 968 2,714 6,346 12,133 12,291 12,571 12.4
Skilled nursing services 7 9 13 85 529 582 482 18.4
Home health services a 6 10 38 264 1,512 527 229 15.7
Hospice services b . . . . . . . . . -- 120 129 153 . . .
Supplementary Medical Insurance 355 522 1,713 4,545 9,475 10,217 10,828 14.7
Physicians' and other medical services 206 295 997 2,831 5,525 5,743 6,188 14.6
Outpatient services 145 221 701 1,714 3,949 3,980 4,043 14.2
Home health services a 3 5 16 c 504 494 597 23.6
Amount reimbursed per person served (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 1,324 1,548 2,544 4,703 6,394 6,262 6,163 6.3
Hospital Insurance 1,735 2,077 3,798 9,847 14,555 14,211 14,337 8.8
Inpatient hospital 1,714 2,051 3,765 9,849 13,741 13,795 13,724 8.7
Skilled nursing services 936 1,049 1,571 3,702 7,557 7,973 6,514 8.1
Home health services a 399 478 733 2,156 5,232 2,583 1,817 6.3
Hospice services b . . . . . . . . . -- 6,000 6,143 6,375 . . .
Supplementary Medical Insurance 479 565 994 1,922 2,576 2,719 2,778 7.3
Physicians' and other medical services 298 341 611 1,259 1,566 1,587 1,644 7.1
Outpatient services 490 554 771 1,146 1,527 1,514 1,482 4.5
Home health services a 345 420 619 c 1,400 3,952 4,701 11.0
Amount reimbursed per enrollee (dollars)
Hospital Insurance and/or Supplementary Medical Insurance 544 696 1,511 3,453 4,936 5,157 5,121 9.4
Hospital Insurance 360 455 933 2,057 2,968 2,939 2,835 8.6
Inpatient hospital 353 446 916 1,950 2,520 2,670 2,653 8.4
Skilled nursing services 4 4 4 26 110 126 102 13.8
Home health services a 3 5 13 81 314 114 48 11.8
Hospice services b . . . . . . . . . -- 25 28 32 . . .
Supplementary Medical Insurance 208 266 630 1,544 2,206 2,520 2,600 10.6
Physicians' and other medical services 118 151 639 962 1,286 1,416 1,486 10.7
Outpatient services 83 113 258 582 919 982 971 10.3
Home health services a 2 3 5 c 117 122 143 18.6
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. Through 1997, total enrollment includes beneficiaries enrolled as of July 1 in the original (or fee-for-service) Medicare plan or in an alternative prepaid plan, such as Medicare managed care. Beginning in 1998, enrollment includes only those beneficiaries enrolled in fee-for-service. The use of the fee-for-service population allows for a more accurate computation of persons served per 1,000 enrollees and of 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 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, 1980–2003, selected years (in thousands)
Census division and state or area 1980 1990 1995 1999 2000 2001 2002 2003
Total
All areas 25,515 30,948 33,142 33,929 34,253 34,462 34,679 35,008
United States a 25,027 30,350 32,492 33,240 33,549 33,743 33,947 34,261
New England 1,506 1,734 1,816 1,829 1,838 1,837 1,836 1,841
Connecticut 362 436 455 456 458 457 456 458
Maine 142 165 174 179 180 182 183 185
Massachusetts 715 795 825 826 829 827 824 822
New Hampshire 103 126 139 145 147 148 150 152
Rhode Island 125 145 149 148 148 147 146 146
Vermont 59 68 72 75 76 76 77 78
Middle Atlantic 4,496 5,084 5,267 5,264 5,282 5,277 5,276 5,279
New Jersey 851 1,006 1,058 1,065 1,070 1,070 1,071 1,073
New York 2,128 2,280 2,328 2,334 2,347 2,351 2,356 2,361
Pennsylvania 1,516 1,798 1,881 1,865 1,865 1,856 1,849 1,845
East North Central 4,462 5,224 5,500 5,526 5,552 5,560 5,567 5,599
Illinois 1,238 1,401 1,446 1,437 1,440 1,440 1,439 1,446
Indiana 579 685 725 732 736 738 740 746
Michigan 916 1,101 1,177 1,194 1,203 1,207 1,210 1,218
Ohio 1,162 1,387 1,471 1,474 1,480 1,480 1,480 1,486
Wisconsin 567 650 683 689 693 695 698 703
West North Central 2,186 2,424 2,510 2,513 2,519 2,522 2,523 2,532
Iowa 387 422 432 427 427 426 425 426
Kansas 304 337 348 347 347 346 345 345
Minnesota 479 544 570 579 583 586 590 595
Missouri 639 706 733 734 736 737 737 740
Nebraska 205 221 228 227 227 227 227 227
North Dakota 81 91 94 93 93 93 92 92
South Dakota 91 102 106 106 106 107 107 107
South Atlantic 4,179 5,536 6,091 6,330 6,410 6,474 6,542 6,630
Delaware 59 80 90 96 97 99 100 102
District of Columbia 71 71 70 66 66 65 64 64
Florida 1,579 2,174 2,396 2,473 2,493 2,511 2,531 2,558
Georgia 499 636 700 736 750 760 771 785
Maryland 381 496 542 562 570 576 582 589
North Carolina 588 786 878 925 939 952 965 980
South Carolina 279 383 428 454 463 470 477 486
Virginia 490 645 714 748 761 771 782 795
West Virginia 233 264 274 270 271 270 270 271
East South Central 1,613 1,887 2,000 2,041 2,060 2,072 2,084 2,107
Alabama 428 508 541 553 558 561 564 569
Kentucky 402 459 482 488 491 492 494 499
Mississippi 280 313 325 328 330 331 333 336
Tennessee 503 607 652 672 681 688 693 703
West South Central 2,363 2,880 3,120 3,232 3,274 3,299 3,328 3,369
Arkansas 303 343 356 358 359 359 360 362
Louisiana 380 460 488 495 498 498 500 504
Oklahoma 361 412 432 436 438 439 440 442
Texas 1,318 1,665 1,845 1,943 1,979 2,003 2,028 2,061
Mountain 1,043 1,490 1,726 1,863 1,906 1,944 1,983 2,028
Arizona 295 456 536 577 591 602 614 628
Colorado 244 324 367 395 403 410 416 424
Idaho 95 121 134 142 144 147 150 153
Montana 85 106 114 118 119 120 121 123
Nevada 65 128 172 200 209 218 227 236
New Mexico 114 160 182 196 200 203 207 211
Utah 108 147 168 178 183 186 189 193
Wyoming 38 47 54 57 57 58 59 60
Pacific 3,157 4,082 4,444 4,630 4,697 4,747 4,798 4,865
Alaska 11 22 28 33 35 36 38 39
California 2,346 2,990 3,241 3,385 3,436 3,474 3,509 3,556
Hawaii 74 118 138 148 151 153 155 157
Oregon 300 390 422 429 432 435 440 446
Washington 426 562 614 635 643 649 656 667
Unknown 22 10 18 12 11 11 10 10
Outlying areas 270 344 383 404 420 430 439 448
Puerto Rico 263 337 367 393 401 410 418 427
Virgin Islands 4 6 8 9 9 10 10 10
Other 3 1 8 2 10 10 11 11
Foreign countries 217 254 268 280 284 289 293 299
SOURCE: Centers for Medicare & Medicaid Services.
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, 1980–2003, selected years (in thousands)
Census division and state or area 1980 1990 1995 1999 2000 2001 2002 2003
Total
All areas 2,963 3,255 4,393 5,212 5,367 5,563 5,810 6,079
United States a 2,863 3,149 4,266 5,062 5,208 5,406 5,648 5,912
New England 141 156 228 277 285 295 307 319
Connecticut 31 33 47 56 58 59 62 64
Maine 16 18 27 35 36 38 40 42
Massachusetts 64 72 108 128 131 135 139 144
New Hampshire 9 11 17 22 23 24 26 27
Rhode Island 14 14 19 23 24 25 26 27
Vermont 7 7 10 13 13 14 14 15
Middle Atlantic 493 473 603 713 731 755 784 814
New Jersey 91 86 110 130 133 138 142 147
New York 237 229 302 360 368 378 391 402
Pennsylvania 165 158 190 223 230 239 251 265
East North Central 486 561 715 807 823 845 877 916
Illinois 113 132 172 192 195 200 207 215
Indiana 63 77 99 113 117 120 125 132
Michigan 118 132 170 195 200 207 216 227
Ohio 141 156 196 219 221 226 233 241
Wisconsin 50 64 79 88 90 92 96 101
West North Central 180 211 280 328 338 351 370 387
Iowa 29 34 43 49 50 52 54 57
Kansas 22 26 35 42 43 45 47 49
Minnesota 35 44 60 69 72 74 78 82
Missouri 67 75 100 120 124 130 137 144
Nebraska 14 16 22 25 26 27 29 30
North Dakota 6 7 9 10 10 10 11 11
South Dakota 7 8 11 13 13 13 14 14
South Atlantic 545 607 834 1,034 1,075 1,125 1,179 1,236
Delaware 7 8 11 14 15 15 16 17
District of Columbia 8 7 8 9 10 10 10 10
Florida 147 165 232 298 311 328 345 363
Georgia 88 96 134 161 166 173 180 188
Maryland 41 46 60 72 75 78 82 85
North Carolina 91 106 149 186 194 203 214 225
South Carolina 51 59 81 101 105 110 115 121
Virginia 68 77 105 128 132 138 144 151
West Virginia 43 44 55 65 67 70 73 76
East South Central 246 287 397 480 495 518 543 570
Alabama 63 74 101 123 127 134 142 151
Kentucky 62 75 105 128 132 137 143 149
Mississippi 46 53 72 86 88 92 96 101
Tennessee 76 85 119 143 148 155 162 169
West South Central 288 317 452 528 539 559 584 614
Arkansas 45 48 67 78 80 83 86 90
Louisiana 63 71 93 103 104 107 112 116
Oklahoma 41 39 56 67 69 72 75 79
Texas 139 159 236 280 286 297 311 329
Mountain 112 148 228 276 284 295 312 327
Arizona 34 42 66 81 84 89 95 101
Colorado 24 34 54 64 65 66 68 69
Idaho 9 11 16 20 21 22 23 25
Montana 9 12 16 18 18 18 19 20
Nevada 8 13 22 29 30 32 35 37
New Mexico 15 19 28 33 34 35 37 39
Utah 9 13 20 23 24 25 26 27
Wyoming 3 4 7 8 8 8 9 9
Pacific 367 388 529 618 637 662 692 726
Alaska 2 3 5 7 7 8 8 9
California 284 289 392 452 465 481 500 522
Hawaii 7 9 11 14 15 15 17 18
Oregon 31 34 47 55 57 61 64 68
Washington 43 53 74 90 93 97 103 109
Unknown 4 2 1 1 1 1 2 2
Outlying areas 88 93 111 134 139 142 147 152
Puerto Rico 88 92 110 132 136 139 144 148
Virgin Islands -- 1 1 1 1 1 1 2
Other -- -- -- 1 2 2 2 2
Foreign countries 12 14 14 14 14 15 15 15
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: -- = 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, 1980–2003, selected years (in thousands)
Age, sex, and race 1980 1985 1990 1995 2000 2001 2002 2003
Hospital Insurance and/or Supplementary Medical Insurance
Total 25,515 28,176 30,948 33,142 34,253 34,463 34,680 35,008
Age
65–69 8,459 8,956 9,695 9,517 9,167 9,201 9,274 9,466
70–74 6,756 7,441 7,951 8,756 8,609 8,564 8,480 8,394
75–79 4,809 5,453 6,058 6,563 7,285 7,285 7,292 7,302
80–84 3,081 3,463 3,957 4,470 4,870 5,022 5,173 5,283
85 or older 2,410 2,861 3,286 3,837 4,322 4,391 4,461 4,563
Sex
Men 10,268 11,282 12,416 13,434 14,112 14,263 14,418 14,625
Women 15,247 16,894 18,532 19,708 20,141 20,199 20,261 20,382
Race
White 22,534 24,745 26,855 29,011 29,757 29,883 29,974 30,195
All other races 2,257 2,585 3,114 3,253 4,403 4,495 4,627 4,741
Unknown 724 846 979 878 92 85 78 72
Hospital Insurance
Total 25,104 27,683 30,464 32,742 33,833 34,044 34,257 34,581
Age
65–69 8,302 8,818 9,565 9,411 9,074 9,111 9,183 9,373
70–74 6,592 7,292 7,829 8,652 8,505 8,462 8,380 8,295
75–79 4,731 5,315 5,947 6,483 7,189 7,189 7,196 7,206
80–84 3,072 3,403 3,872 4,409 4,806 4,956 5,103 5,211
85 or older 2,407 2,854 3,252 3,787 4,259 4,326 4,395 4,496
Sex
Men 10,156 11,146 12,280 13,310 13,979 14,130 14,284 14,489
Women 14,948 16,536 18,184 19,431 19,854 19,914 19,974 20,092
Race
White 22,244 24,424 26,591 28,822 29,570 29,700 29,792 30,013
All other races 2,160 2,444 2,931 3,127 4,176 4,264 4,392 4,500
Unknown 699 815 942 792 87 80 73 68
Supplementary Medical Insurance
Total 24,680 27,311 29,686 31,742 32,590 32,749 32,934 33,203
Age
65–69 8,156 8,607 9,008 8,830 8,330 8,340 8,401 8,554
70–74 6,570 7,277 7,740 8,430 8,256 8,200 8,107 8,012
75–79 4,684 5,333 5,942 6,431 7,088 7,083 7,090 7,100
80–84 2,981 3,381 3,879 4,392 4,782 4,926 5,068 5,169
85 or older 2,289 2,712 3,118 3,659 4,134 4,200 4,268 4,368
Sex
Men 9,868 10,852 11,758 12,694 13,205 13,328 13,466 13,640
Women 14,813 16,459 17,927 19,048 19,384 19,420 19,468 19,562
Race
White 21,876 24,060 25,849 27,899 28,432 28,519 28,592 28,765
All other races 2,114 2,441 2,910 3,028 4,086 4,166 4,285 4,386
Unknown 691 810 927 815 71 64 58 52
SOURCE: Centers for Medicare & Medicaid Services.
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, 1980–2003, selected years
Age, sex, and race 1980 1990 2000 2002 2003
All
disabled
End stage
renal
disease
only
All
disabled
End stage
renal
disease
only
All
disabled
End stage
renal
disease
only
All
disabled
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 5,809,611 79,353 6,079,424 81,662
Age
Under 35 371,204 8,773 483,265 16,603 522,321 13,255 532,378 13,661 553,946 13,801
35–44 369,460 5,188 654,957 14,159 1,129,288 15,084 1,145,800 15,363 1,154,953 15,428
45–54 657,486 6,977 741,200 15,800 1,627,238 22,647 1,797,665 24,287 1,885,826 25,323
55–64 1,565,025 7,396 1,375,585 18,130 2,088,304 22,904 2,333,768 26,042 2,484,699 27,110
Sex
Men 1,870,558 14,547 2,042,944 33,647 3,014,107 40,062 3,194,079 43,239 3,311,265 44,736
Women 1,092,617 13,787 1,212,063 31,045 2,353,044 33,828 2,615,532 36,114 2,768,159 36,926
Race
White 2,422,253 19,232 2,480,767 35,638 3,989,357 35,636 4,301,138 37,556 4,495,109 37,913
All other races 486,677 7,907 712,315 26,477 1,362,457 37,820 1,494,904 41,566 1,571,271 43,551
Unknown 54,245 1,195 61,925 2,577 15,337 434 13,569 231 13,044 198
Hospital Insurance
Total 2,963,156 28,334 3,254,983 64,677 5,366,598 73,890 5,809,174 79,353 6,076,034 81,652
Age
Under 35 371,199 8,773 483,262 16,601 522,123 13,255 532,284 13,661 553,083 13,797
35–44 369,458 5,188 654,953 14,157 1,129,170 15,084 1,145,693 15,363 1,154,266 15,427
45–54 657,483 6,977 741,193 15,794 1,627,107 22,647 1,797,555 24,287 1,884,907 25,320
55–64 1,565,016 7,396 1,375,575 18,125 2,088,198 22,904 2,333,642 26,042 2,483,778 27,108
Sex
Men 1,870,543 14,547 2,042,929 33,639 3,013,803 40,062 3,193,844 43,239 3,309,440 44,729
Women 1,092,613 13,787 1,212,054 31,038 2,352,795 33,828 2,615,330 36,114 2,766,594 36,923
Race
White 2,422,239 19,232 2,480,754 35,631 3,988,957 35,636 4,300,844 37,556 4,493,014 37,907
All other races 486,672 7,907 712,304 26,469 1,362,305 37,820 1,494,763 41,566 1,569,996 43,547
Unknown 54,245 1,195 61,925 2,577 15,336 434 13,567 231 13,024 198
Supplementary Medical Insurance
Total 2,719,226 27,046 2,943,480 58,912 4,769,804 68,800 5,144,421 73,285 5,386,970 75,042
Age
Under 35 339,665 8,294 441,640 14,782 466,869 12,159 474,464 12,429 494,729 12,520
35–44 337,146 4,963 586,537 12,567 998,230 13,783 1,007,411 13,866 1,015,672 13,854
45–54 596,287 6,683 666,257 14,559 1,421,904 20,961 1,568,114 22,343 1,650,064 23,087
55–64 1,446,128 7,106 1,249,046 17,004 1,882,801 21,897 2,094,432 24,647 2,226,505 25,581
Sex
Men 1,694,569 13,887 1,833,959 30,338 2,665,252 37,037 2,813,277 39,551 2,917,468 40,651
Women 1,024,657 13,159 1,109,521 28,574 2,104,552 31,763 2,331,144 33,734 2,469,502 34,391
Race
White 2,218,176 18,458 2,236,781 32,347 3,535,008 33,154 3,799,460 34,747 3,974,030 34,952
All other races 449,753 7,446 650,121 24,240 1,221,836 35,256 1,333,260 38,324 1,401,696 39,907
Unknown 51,297 1,142 56,578 2,325 12,960 390 11,701 214 11,244 183
SOURCE: Centers for Medicare & Medicaid Services.
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 1975–2003 (in dollars)
Census division and state or area a 1975 1980 1990 1995 2000 2001 2002 2003
Total
All areas b 143 292 1,090 1,908 2,762 3,080 3,574 4,117
United States c 144 293 1,081 1,920 2,787 3,108 3,608 4,157
New England 159 298 988 1,763 2,436 2,610 2,862 3,194
Connecticut 167 287 1,177 2,013 2,608 2,726 3,014 3,413
Maine 133 284 927 1,645 2,328 2,489 2,763 3,042
Massachusetts 168 316 942 1,705 2,429 2,598 2,797 3,100
New Hampshire 123 264 1,022 1,699 2,480 2,696 3,027 3,384
Rhode Island 154 284 851 1,638 2,316 2,654 2,967 3,290
Vermont 124 230 923 1,580 1,995 2,145 2,356 2,660
Middle Atlantic 163 304 943 1,704 2,743 3,169 3,925 4,763
New Jersey 157 300 725 1,865 3,757 4,767 6,157 7,447
New York 176 301 836 1,366 2,116 2,328 2,817 3,412
Pennsylvania 145 312 1,236 2,109 3,003 3,334 3,979 4,791
East North Central 140 294 1,097 1,866 2,550 2,786 3,135 3,547
Illinois 148 322 1,202 2,126 3,017 3,282 3,645 4,094
Indiana 116 236 997 1,713 2,271 2,466 2,731 3,061
Michigan 156 332 1,193 1,881 2,451 2,626 2,925 3,310
Ohio 134 277 1,030 1,730 2,360 2,605 2,995 3,443
Wisconsin 128 251 933 1,690 2,424 2,744 3,154 3,541
West North Central 117 248 1,052 1,831 2,638 2,924 3,305 3,732
Iowa 110 239 902 1,573 2,124 2,346 2,663 3,031
Kansas 113 244 1,093 1,957 2,589 2,851 3,225 3,768
Minnesota 124 248 1,132 1,938 2,913 3,217 3,666 4,162
Missouri 119 257 1,108 1,922 2,783 3,074 3,385 3,747
Nebraska 116 251 1,043 1,850 3,007 3,418 4,031 4,497
North Dakota 118 237 937 1,509 2,180 2,376 2,663 2,989
South Dakota 107 228 915 1,518 2,167 2,424 2,870 3,266
South Atlantic 135 273 1,106 1,876 2,637 2,921 3,337 3,776
Delaware 153 274 1,191 1,831 1,971 2,147 2,384 2,631
District of Columbia 174 373 1,374 2,129 3,331 3,544 3,829 4,437
Florida 161 321 1,360 2,351 3,439 3,832 4,406 5,030
Georgia 125 258 1,081 1,744 2,527 2,763 3,101 3,552
Maryland 164 274 813 1,365 1,608 1,708 1,859 1,951
North Carolina 101 214 932 1,603 2,175 2,404 2,672 2,963
South Carolina 106 229 1,021 1,818 2,611 2,935 3,368 3,799
Virginia 118 247 1,022 1,732 2,432 2,674 3,082 3,474
West Virginia 108 247 1,009 1,472 1,821 1,978 2,193 2,433
East South Central 115 243 1,019 1,718 2,451 2,668 3,016 3,457
Alabama 126 282 1,176 2,054 2,914 3,204 3,612 4,143
Kentucky 107 216 967 1,630 2,269 2,448 2,751 3,117
Mississippi 98 213 865 1,437 2,017 2,214 2,504 2,883
Tennessee 122 250 1,012 1,662 2,479 2,675 3,031 3,485
West South Central 117 253 1,138 1,937 2,767 3,094 3,539 4,045
Arkansas 104 231 923 1,511 2,194 2,468 2,773 3,152
Louisiana 116 265 1,180 1,926 2,724 3,019 3,369 3,700
Oklahoma 128 271 997 1,620 2,335 2,559 2,841 3,263
Texas 118 250 1,212 2,118 3,008 3,366 3,890 4,486
Mountain 142 305 1,350 2,321 3,279 3,639 4,090 4,630
Arizona 155 325 1,442 2,617 3,885 4,237 4,663 5,197
Colorado 144 288 1,308 2,240 3,392 3,812 4,329 4,859
Idaho 129 273 1,140 1,951 2,471 2,725 2,997 3,304
Montana 116 262 1,036 1,742 2,233 2,501 2,756 3,091
Nevada 177 424 2,031 3,253 4,320 4,773 5,418 6,237
New Mexico 133 293 1,140 1,913 2,533 2,814 3,149 3,591
Utah 142 316 1,283 2,069 2,871 3,111 3,375 3,777
Wyoming 109 245 1,094 1,985 2,373 2,621 2,911 3,319
Pacific 196 416 1,651 2,877 4,228 4,759 5,648 6,495
Alaska 228 379 1,470 2,385 3,144 3,390 3,757 4,521
California 206 448 1,794 3,156 4,701 5,324 6,363 7,283
Hawaii 148 333 1,224 2,319 2,991 3,138 3,440 3,800
Oregon 158 329 1,275 1,987 2,717 2,980 3,245 3,707
Washington 163 293 1,162 1,924 2,708 3,008 3,455 3,972
Outlying areas 77 152 510 739 947 990 1,055 1,077
Puerto Rico 77 151 505 736 946 988 1,050 1,069
Virgin Islands 92 161 746 843 1,007 1,112 1,372 1,568
Other 88 263 . . . . . . . . . . . . . . . . . .
SOURCE: Centers for Medicare & Medicaid.
NOTES: Data for 1975 and 1980 are based on bills approved in each year and recorded in the Centers for Medicare & Medicaid Services before December 29, 1995. Data from 1990–2003 are based on bills incurred in each year and recorded before June 27, 2003. Includes data for services rendered to both aged and disabled persons.
. . . = 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 1975–2003 (in dollars)
Census division and state or area a 1975 1980 1990 1995 2000 2001 2002 2003
Total
All areas b 43 70 193 402 462 463 475 488
United States c 43 70 193 402 462 463 475 488
New England 50 77 172 347 431 438 459 480
Connecticut 35 51 165 314 388 396 427 445
Maine 52 100 274 308 406 432 469 485
Massachusetts 63 98 181 380 484 487 494 519
New Hampshire 41 86 218 412 410 437 470 484
Rhode Island 43 59 129 265 392 374 405 430
Vermont 38 62 155 266 357 363 392 410
Middle Atlantic 50 73 168 308 428 437 466 491
New Jersey 45 81 164 344 434 450 504 532
New York 61 80 168 240 360 375 402 432
Pennsylvania 40 65 170 373 510 506 522 535
East North Central 40 68 167 358 450 458 464 481
Illinois 37 77 215 421 528 528 533 556
Indiana 35 60 180 399 447 449 444 448
Michigan 45 60 130 270 376 398 405 425
Ohio 41 69 157 375 462 464 476 485
Wisconsin 35 64 149 315 343 358 372 397
West North Central 45 82 194 367 473 465 483 508
Iowa 46 84 269 406 490 506 539 560
Kansas 39 66 255 461 539 515 507 509
Minnesota 46 94 125 245 306 311 363 409
Missouri 47 95 263 465 603 576 562 575
Nebraska 41 71 205 338 484 476 503 524
North Dakota 43 49 118 221 408 389 409 443
South Dakota 33 61 160 270 326 348 380 435
South Atlantic 34 59 168 396 405 401 410 423
Delaware 31 50 132 328 345 351 380 410
District of Columbia 34 64 193 389 437 430 483 509
Florida 34 59 195 488 447 426 421 432
Georgia 34 71 146 346 356 356 385 392
Maryland 37 56 141 347 403 402 416 428
North Carolina 31 52 132 283 342 357 368 399
South Carolina 26 46 159 337 384 389 414 403
Virginia 42 68 168 331 374 388 404 416
West Virginia 36 64 171 364 446 462 466 494
East South Central 37 56 154 358 420 431 439 433
Alabama 33 38 143 353 381 379 400 405
Kentucky 36 58 151 352 439 440 431 450
Mississippi 45 105 160 377 480 513 522 523
Tennessee 41 70 162 358 407 427 435 407
West South Central 45 94 267 539 579 568 549 537
Arkansas 44 84 238 372 499 507 571 575
Louisiana 43 83 374 683 754 719 687 673
Oklahoma 60 145 312 563 579 599 588 584
Texas 43 78 238 542 556 541 511 496
Mountain 38 64 226 486 477 466 461 456
Arizona 41 71 236 549 535 491 450 432
Colorado 42 73 266 538 502 491 488 471
Idaho 27 46 152 381 384 401 419 428
Montana 30 44 123 291 362 378 405 408
Nevada 37 66 232 569 592 580 467 423
New Mexico 57 122 267 488 534 534 545 553
Utah 36 75 266 473 435 432 460 483
Wyoming 36 49 208 379 421 402 441 474
Pacific 45 81 269 576 584 584 613 629
Alaska 68 115 283 437 0 789 746 676
California 46 87 287 629 0 644 683 697
Hawaii 49 83 217 467 469 523 532 555
Oregon 40 63 207 421 382 377 387 400
Washington 34 62 196 412 390 404 421 426
Outlying areas
Puerto Rico 51 97 202 261 362 359 354 371
Virgin Islands 43 104 171 370 399 474 763 490
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: Data from 1975 to 1995 are based on bills approved in each year and recorded in the Centers for Medicare & Medicaid Services before December 29, 1995. Data from 2000 to 2003 are based on bills incurred in each year and recorded in the Centers for Medicare & Medicaid Services before June 27, 2004. 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 1990–2003
State or area 1990 1995 1996 1997 1998 1999 2000 2001 2002 2003
All areas 10,472,587 11,680,874 11,749,394 11,952,088 11,912,079 11,659,885 11,778,705 12,192,174 12,499,749 12,698,388
Alabama 226,359 255,013 258,908 265,029 266,603 266,541 274,518 282,999 291,991 294,850
Alaska 6,491 8,635 9,593 9,917 10,633 11,031 11,684 11,748 11,794 11,398
Arizona 140,069 139,564 146,446 150,597 150,190 128,363 135,143 144,989 156,302 165,231
Arkansas 143,363 152,516 154,626 157,920 160,379 160,880 164,310 166,445 170,102 170,421
California 834,829 875,926 889,323 901,018 921,068 780,295 740,564 756,629 801,758 836,444
Colorado 98,262 105,216 102,450 103,735 97,479 100,648 101,486 101,258 107,180 109,879
Connecticut 114,938 141,765 141,031 143,071 133,672 125,115 124,951 135,169 148,864 154,460
Delaware 26,125 30,336 30,051 30,632 30,738 33,287 34,049 36,386 36,541 38,216
District of Columbia 36,062 39,526 38,661 38,508 38,661 38,693 39,112 40,138 39,389 39,151
Florida 579,368 742,862 739,066 743,556 758,714 736,958 765,130 823,957 869,777 899,404
Georgia 274,957 316,301 323,093 327,839 320,774 311,998 324,286 334,599 338,687 342,392
Hawaii 26,340 32,526 32,939 34,795 33,331 26,347 26,146 26,343 26,932 26,302
Idaho 31,559 36,327 39,236 41,066 42,451 43,353 44,027 43,272 40,996 40,738
Illinois 460,926 533,238 524,936 538,476 531,184 539,314 556,122 578,327 601,373 607,561
Indiana 254,404 276,601 278,303 287,615 289,743 289,693 297,851 306,202 304,034 303,404
Iowa 141,191 146,448 148,724 151,815 154,152 155,497 159,451 162,466 156,854 148,591
Kansas 117,017 120,593 122,917 125,481 127,045 126,920 128,024 129,973 129,334 131,412
Kentucky 199,042 222,162 224,322 231,081 231,352 237,553 243,886 252,454 257,205 255,264
Louisiana 213,819 234,663 235,574 237,390 232,942 223,794 237,154 243,724 248,183 253,774
Maine 54,963 63,013 64,361 66,278 67,895 68,128 69,030 68,547 66,705 67,401
Maryland 179,835 214,989 211,265 204,988 195,489 199,012 208,038 234,162 244,595 251,754
Massachusetts 286,332 310,455 299,734 293,217 280,333 268,179 263,152 271,657 275,984 291,062
Michigan 366,349 435,455 443,753 457,401 456,972 452,461 452,367 468,675 497,195 506,259
Minnesota 170,808 178,018 181,315 187,164 192,488 194,935 200,918 209,469 210,382 208,364
Mississippi 142,662 162,934 170,698 181,599 185,149 181,575 183,952 185,626 182,535 183,965
Missouri 281,059 298,509 298,805 299,996 297,554 293,724 300,576 315,642 317,278 320,454
Montana 40,505 40,770 40,831 41,542 41,854 42,343 44,208 45,697 42,880 40,952
Nebraska 69,299 70,113 72,975 75,630 77,188 76,841 76,960 74,217 71,921 71,577
Nevada 37,478 49,254 52,175 54,509 55,150 48,369 49,613 51,836 56,622 57,345
New Hampshire 39,103 42,746 43,834 44,758 42,918 42,054 45,712 48,206 46,282 46,304
New Jersey 338,509 385,145 375,353 371,173 364,034 373,224 372,063 374,250 389,938 404,035
New Mexico 50,391 50,334 49,758 53,329 52,913 51,459 51,085 51,396 51,469 51,533
New York 723,060 797,453 796,965 798,611 787,116 777,269 750,793 761,352 771,835 780,893
North Carolina 267,370 336,173 353,297 369,667 385,533 395,004 406,700 413,429 418,725 431,441
North Dakota 37,543 37,014 36,807 38,272 38,332 38,847 39,672 38,764 34,707 34,645
Ohio 527,006 562,234 565,237 562,603 541,958 533,499 536,335 550,989 559,223 565,314
Oklahoma 155,100 156,239 158,966 163,842 166,068 170,592 176,021 179,543 182,998 187,913
Oregon 106,164 105,878 106,901 111,656 111,028 100,569 91,806 98,854 102,568 102,182
Pennsylvania 685,403 766,535 731,542 728,572 692,290 664,002 634,802 649,458 656,105 654,661
Rhode Island 46,578 49,740 50,739 50,498 46,484 39,625 38,489 39,658 40,229 38,506
South Carolina 112,232 156,060 163,200 171,889 184,188 194,344 204,038 213,513 216,412 218,775
South Dakota 38,175 41,714 42,916 44,101 44,350 44,846 45,239 45,202 43,134 42,626
Tennessee 290,371 310,335 318,600 324,380 324,831 318,793 327,423 341,212 344,524 348,700
Texas 603,621 671,734 689,627 721,006 732,255 725,166 742,628 798,667 843,945 868,784
Utah 39,963 43,819 45,418 44,513 45,698 48,898 53,003 55,207 56,244 57,928
Vermont 20,251 22,815 23,001 23,456 22,585 23,133 24,014 24,778 22,658 22,690
Virginia 240,165 271,620 274,285 285,721 286,752 289,195 295,790 305,346 310,602 315,181
Washington 157,942 157,146 160,146 158,264 152,867 148,620 153,660 162,197 166,846 167,102
West Virginia 111,305 124,293 125,954 131,334 131,473 134,483 134,585 135,458 132,356 131,953
Wisconsin 217,727 227,774 226,898 232,721 233,103 233,432 238,572 240,711 243,774 244,100
Wyoming 15,255 16,009 15,912 16,557 17,256 17,429 18,764 18,932 18,044 16,416
Outlying areas
Puerto Rico 93,436 111,950 115,410 120,547 123,752 130,209 137,315 138,713 139,682 134,979
Virgin Islands 528 1,374 1,234 1,402 1,569 1,511 1,552 1,468 1,571 1,641
Unknown 978 1,012 1,283 1,351 1,543 1,835 1,936 2,265 2,485 2,061
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: Discharge data for fiscal year 2003 are final as of June 2004.
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 1995–2003 (in thousands)
Year a All
services b
Physicians' services Outpatient
hospital
services
Independent
laboratory
services
Home
health
services c
All
other
services
Total Surgical d Medical d
Persons aged 65 or older
Number of bills
1995 578,104 406,868 44,896 361,972 48,063 53,175 213 69,785
1996 590,301 411,789 46,171 365,618 50,578 52,417 248 75,269
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 e 429,299 45,496 383,803 51,498 e 5,499 e
2000 -- -- -- -- -- -- -- --
2001 -- -- -- -- -- -- -- --
2002 -- -- -- -- -- -- -- --
2003 -- -- -- -- -- -- -- --
Allowed charges f (dollars)
1995 84,329,200 39,754,745 13,734,400 26,020,048 31,785,243 1,802,713 288,835 10,697,664
1996 88,175,258 39,483,654 13,164,645 26,318,914 34,958,600 1,634,475 320,273 11,778,256
1997 92,896,022 40,447,602 12,953,314 27,493,847 37,668,927 1,490,474 335,544 12,953,475
1998 101,834,121 41,703,978 12,061,669 29,634,502 38,742,665 1,333,197 6,049,738 14,004,543
1999 105,655,913 43,770,755 12,080,067 31,637,737 40,236,989 1,264,423 6,874,018 13,509,728
2000 114,436,628 48,332,889 12,358,986 35,902,761 44,205,457 1,583,463 5,548,445 14,766,374
2001 131,252,782 55,171,870 13,091,543 40,923,161 52,831,077 1,859,485 4,160,513 17,229,837
2002 152,809,122 58,783,402 -- -- 67,391,151 2,101,369 4,344,154 20,189,046
2003 172,671,317 63,559,176 -- -- 79,760,992 2,246,105 4,687,920 22,417,124
Amount reimbursed g (dollars)
1995 49,728,498 31,117,714 10,833,812 20,283,666 10,090,546 1,751,376 206,817 6,562,045
1996 50,800,415 30,914,665 10,381,197 20,533,397 10,732,301 1,583,843 228,643 7,340,963
1997 52,436,342 31,683,693 10,218,613 21,464,753 11,208,118 1,440,441 234,529 7,869,561
1998 56,704,083 32,668,073 9,517,777 23,144,124 10,685,651 1,278,720 4,261,053 7,810,586
1999 58,239,867 34,423,899 9,523,625 24,857,734 10,364,021 1,209,283 4,836,740 7,405,924
2000 62,306,221 37,962,804 9,743,222 28,166,179 10,674,291 1,502,927 4,174,537 7,991,662
2001 71,314,045 43,354,148 10,351,499 32,120,569 12,938,887 1,759,409 4,039,929 9,221,672
2002 77,636,886 46,212,868 -- -- 14,728,213 1,983,401 4,300,505 10,411,899
2003 84,356,092 50,024,454 -- -- 16,430,955 2,120,382 4,467,234 11,313,067
Disabled beneficiaries
Number of bills
1995 77,224 49,829 4,261 45,568 11,152 7,758 0 8,485
1996 82,908 53,010 4,594 48,416 12,068 8,193 1 9,636
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 e 59,281 5,042 54,239 12,413 e 594 e
2000 -- -- -- -- -- -- -- --
2001 -- -- -- -- -- -- -- --
2002 -- -- -- -- -- -- -- --
2003 -- -- -- -- -- -- -- --
Allowed charges f (dollars)
1995 14,392,879 5,005,328 1,392,181 3,613,063 7,691,775 280,673 79 1,415,024
1996 15,902,246 5,168,553 1,401,285 3,767,217 8,682,133 284,031 194 1,767,335
1997 17,062,457 5,399,380 1,409,583 3,989,586 9,394,843 281,459 575 1,986,200
1998 18,745,611 5,828,235 1,401,045 4,421,251 9,551,182 252,548 721,512 2,392,134
1999 20,044,042 6,298,631 1,453,807 4,812,231 10,127,713 245,521 867,306 2,504,871
2000 22,088,612 7,139,478 1,526,798 5,582,913 11,117,403 294,743 729,305 2,807,683
2001 25,851,633 8,338,582 1,631,945 6,383,077 13,297,005 343,140 556,071 3,316,835
2002 32,733,223 9,227,564 -- -- 18,508,966 401,935 603,808 3,990,950
2003 40,131,694 10,442,995 -- -- 24,080,585 442,148 667,485 4,498,481
Amount reimbursed g (dollars)
1995 8,408,407 3,791,282 1,088,310 2,702,905 3,331,670 275,955 52 1,009,448
1996 9,099,749 3,908,973 1,095,977 2,812,960 3,652,751 278,816 142 1,259,067
1997 9,592,738 4,093,648 1,103,074 2,990,428 3,839,715 276,057 454 1,382,864
1998 10,445,805 4,409,930 1,095,140 3,310,214 3,777,955 246,337 497,372 1,514,211
1999 11,001,811 4,781,935 1,135,375 3,621,070 3,840,930 239,191 595,048 1,544,707
2000 11,934,550 5,418,442 1,192,908 4,203,799 4,005,611 286,661 528,835 1,695,001
2001 13,844,004 6,332,536 1,278,008 4,823,352 4,724,398 333,141 487,062 1,966,867
2002 15,668,015 7,021,181 -- -- 5,419,005 389,855 538,816 2,299,158
2003 17,552,967 7,985,917 -- -- 6,006,924 428,901 580,471 2,550,754
SOURCE: Centers for Medicare & Medicaid Services.
NOTE: -- = not available.
a. Period for which the claim incurred.
b. Included in total, but not shown separately, are some bills and charges for which type of service is unknown.
c. 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.
d. Where both medical and surgical charges are included on a single bill, the highest-priced service is the determining factor in classifying the bill.
e. Total for "All services" excludes "Independent laboratory services" and "All other services"; for these services, data are not available because of programmatic problems.
f. Includes physician or supplier allowed charges as determined by the carrier and amounts actually billed by providers for outpatient hospital and home health services.
g. 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, 1969–2003
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
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, 1971–2003
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
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
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 1991–2004
State or area 1991 1995 1997 1998 1999 2000 2001 2002 2003 2004
All areas 3,640,121 4,705,625 5,008,860 5,109,228 5,273,573 5,425,048 5,615,326 5,810,613 6,145,589 6,305,467
Alabama 97,601 116,916 122,720 121,990 128,875 136,860 141,436 144,603 162,912 164,499
Alaska 4,539 6,193 6,835 7,093 7,799 8,486 8,832 9,324 10,008 10,318
Arizona 28,650 44,236 49,213 51,141 53,450 57,712 61,989 74,678 91,782 95,804
Arkansas 64,996 77,660 79,176 78,514 79,508 79,606 80,231 82,040 86,597 86,181
California 646,108 747,814 769,335 776,832 793,510 818,846 848,361 892,260 950,503 977,676
Colorado 36,470 46,660 50,749 52,175 53,964 55,325 56,934 57,987 59,114 61,140
Connecticut 23,535 48,047 50,668 51,335 52,134 53,141 55,933 60,083 65,223 66,664
Delaware 4,499 6,645 8,446 8,900 8,231 10,737 12,094 13,252 15,224 16,081
District of Columbia 12,791 14,152 14,482 14,582 13,181 14,233 14,621 15,065 15,079 15,586
Florida 196,992 271,430 304,791 313,744 324,172 342,109 358,642 369,092 389,599 406,006
Georgia 128,976 160,380 168,267 171,047 171,638 176,596 181,312 186,466 193,807 199,524
Hawaii 11,529 16,695 18,751 19,226 19,962 20,326 21,090 21,748 22,904 22,988
Idaho 9,127 12,931 14,296 14,909 15,868 17,081 18,550 19,725 21,255 22,291
Illinois 94,434 137,571 144,684 145,976 149,850 155,743 161,141 163,368 175,822 189,044
Indiana 60,297 76,460 76,846 81,184 82,901 87,543 91,311 95,553 102,654 105,011
Iowa 41,170 48,517 49,344 49,844 50,954 51,976 52,891 54,536 56,920 58,023
Kansas 26,960 34,708 37,486 39,008 40,365 41,217 42,126 43,123 44,602 46,175
Kentucky 76,456 97,978 105,188 106,537 111,789 117,697 118,641 122,096 126,690 126,343
Louisiana 87,570 112,090 114,482 115,031 116,602 117,179 117,867 120,478 127,340 132,498
Maine 22,176 29,453 32,168 33,006 35,211 36,946 38,161 39,575 42,269 43,800
Maryland 48,028 58,865 59,745 61,669 64,086 65,372 68,010 70,224 73,994 75,366
Massachusetts 89,163 125,859 132,874 138,796 143,779 152,587 160,198 164,510 167,681 170,689
Michigan 91,340 123,948 130,682 135,769 139,411 145,172 148,760 152,758 158,998 161,519
Minnesota 39,366 52,192 56,486 57,559 59,926 63,607 66,874 70,873 75,080 77,499
Mississippi 90,530 108,577 106,461 106,336 107,176 107,495 116,503 125,832 131,706 133,337
Missouri 55,116 72,659 79,847 81,841 85,329 88,343 91,244 93,512 99,127 103,449
Montana 10,058 11,031 11,825 11,882 12,274 12,828 13,120 13,359 13,889 13,917
Nebraska 11,358 16,146 17,321 18,029 19,064 20,520 21,121 22,120 22,922 23,082
Nevada 8,657 14,227 16,435 17,191 18,322 19,155 20,709 22,207 24,587 26,977
New Hampshire 3,807 5,405 6,119 6,295 6,875 7,434 8,866 9,231 10,120 10,732
New Jersey 95,795 122,923 135,109 137,598 143,024 146,705 149,303 151,644 155,377 153,231
New Mexico 22,246 29,855 33,472 34,411 36,023 37,330 39,275 41,263 44,534 44,642
New York 255,952 325,882 352,129 363,331 372,824 369,479 395,830 409,388 432,681 448,373
North Carolina 117,656 186,328 204,551 210,388 216,563 223,402 228,997 233,229 240,422 241,543
North Dakota 4,639 5,560 5,684 5,612 5,758 5,908 6,275 6,317 6,541 6,560
Ohio 112,598 164,044 178,365 180,172 181,407 171,139 176,602 182,821 191,295 195,792
Oklahoma 51,457 60,080 62,965 63,142 66,115 67,413 67,787 68,905 70,761 72,758
Oregon 28,537 43,642 49,553 51,392 55,896 59,169 62,910 66,255 68,421 69,610
Pennsylvania 127,519 162,788 173,142 179,295 198,492 206,468 215,351 218,691 229,814 232,885
Rhode Island 10,585 15,517 17,321 17,729 18,513 19,787 21,620 22,928 25,146 25,361
South Carolina 78,701 95,970 101,455 104,111 110,032 112,232 116,288 118,635 117,997 118,393
South Dakota 9,399 12,346 12,778 12,791 13,112 13,146 13,237 13,542 14,231 14,045
Tennessee 116,861 148,391 164,010 171,653 178,707 182,342 184,570 187,438 203,567 208,678
Texas 234,169 314,991 336,801 339,648 350,959 360,191 370,598 380,954 410,248 423,560
Utah 10,263 13,506 14,589 14,900 15,569 16,231 16,712 17,497 18,548 19,361
Vermont 8,223 12,428 13,048 13,197 13,598 13,754 14,296 14,650 15,016 15,079
Virginia 77,898 102,964 108,365 108,427 111,404 113,259 113,898 116,496 120,711 124,996
Washington 54,774 71,531 83,128 89,419 91,976 97,390 94,852 99,552 105,516 108,780
West Virginia 28,086 39,720 43,572 43,019 45,406 46,305 47,774 47,547 50,008 51,365
Wisconsin 67,516 75,247 76,109 74,429 74,681 74,101 73,875 75,179 78,124 79,889
Wyoming 3,505 5,265 5,781 5,963 6,183 6,444 6,746 7,087 7,422 7,454
Outlying areas
Guam 443 669 682 650 583 417 385 339 339 375
Northern Mariana Islands 273 314 322 311 335 342 367 372 358 340
Virgin Islands 727 219 207 199 207 204 210 206 194 178
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.