| Summary: | In this report we present newly developed measures of Medicare expenditures at the hospital referral region level for 2003 to 2008. These estimates reflect a larger sample of Medicare beneficiaries than our past estimates: 20% of the fee-for-service population instead of a 5% sample as in the previous data series. These rates rely on the actual Medicare claims files rather than the Continuous Medicare History Sample, the original 5% sample used for Atlas reimbursement data, which has been discontinued by the Centers for Medicare and Medicaid Services (CMS).The new data series also extends a study by Gottlieb et al. (2010) that adjusted Medicare spending measures for differences across regions in how much CMS pays health care providers for each procedure, treatment or physician visit. In part, this process adjusts for the fact that New York City is more expensive than Fargo, North Dakota. Equally important is that we also removed differences in reimbursement rates generated by Medicare specific provisions for higher payments to hospitals with medical and surgical residency training programs, and for the disproportionate share hospital (DSH) payments designed to compensate hospitals that serve a high percentage of low-income patients
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