8.

B 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 1967–2002
Type of coverage and service

1967

1975

1980

1990

2000

2002

Persons enrolled (fee-for-service and managed care) (thousands)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Supplementary Medical Insurance

19,521
19,494
17,893

Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Supplementary Medical Insurance

----

22,790
22,472
21,945

25,515
25,104
24,680

30,948
30,464
29,685

34,261
33,841
32,602

34,698
34,275
32,955

Persons enrolled (fee-for-service only) (thousands)
----

----

----

27,833
27,422
26,174

29,529
29,109
27,786

24,809
6,367
5,906
615
1,818
-24,687
24,193
14,055
38

25,486
6,361
5,975
1,390
1,325
514
25,256
24,846
18,159
1,081

27,117
6,739
6,308
1,526
1,428
620
26,900
26,525
19,691
998

916
232
218
51
48
19
965
949
694
41

918
232
217
52
49
21
968
955
709
36

148,488
87,549
72,041
10,066
2,679
2,763
60,939
44,506
12,588
3,845

182,303
105,384
83,246
13,546
4,382
4,211
76,919
55,126
17,518
4,275

5,826
13,763
12,057
7,242
2,022
5,375
2,413
1,791
693
3,557

6,723
15,638
13,197
8,877
3,069
6,792
2,859
2,078
890
4,284

Persons served (thousands)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

7,154
3,960
3,601
354
126
...
6,523
6,415
1,511
118

12,032
4,963
4,913
260
329
...
11,762
11,396
3,768
161

16,271
6,024
5,951
248
675
...
16,099
15,627
6,629
302

Persons served per 1,000 enrollees
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health servicesa
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

367
203
185
18
7
...
365
359
77
7

528
221
219
12
15
...
536
519
172
7

638
240
237
10
27
...
652
633
269
12

802
209
94
21
60
-832
815
474
1

Amount reimbursed (millions of dollars)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

4,239
2,967
2,659
274
26
...
1,272
1,224
38
17

12,689
9,209
8,840
233
136
...
3,481
3,050
374
56

29,134
20,353
19,583
331
440
...
8,871
7,361
1,261
159

88,778
54,244
48,952
1,886
3,406
-34,533
27,379
7,077
78

Amount reimbursed per person served (dollars)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health servicesa

592
749
738
774
204
...
195
191
25
145

1,055
1,855
1,799
896
413
...
296
268
99
347

1,791
3,379
3,291
1,336
652
...
545
471
190
526

3,578
8,520
8,289
3,068
1,874
-1,399
1,132
503
2,033

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.5

8.B 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 1967–2002—Continued
Type of coverage and service

1967

1975

1980

1990

2000

2002

5,335
3,193
2,627
367
98
101
2,328
1,700
481
147

6,174
3,620
2,860
465
151
145
2,768
1,984
630
154

Amount reimbursed per enrollee (dollars)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

217
152
137
14
1
...
71
69
2
1

557
410
394
11
6
...
159
139
17
2

1,142
811
780
13
18
...
356
298
51
6

2,869
1,781
1,607
62
112
-1,163
922
238
3

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.

b.

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.
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.

8.6 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1974–2002
Type of coverage and service

1974

Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Supplementary Medical Insurance

1,928
1,928
1,745

Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Supplementary Medical Insurance

----

1975

1980

1990

2000

2001

2002

Persons enrolled (fee-for-service and managed care) (thousands)
2,168
2,168
1,959

2,963
2,963
2,719

3,255
3,255
2,943

5,371
5,370
4,768

5,567
5,567
4,934

5,805
5,804
5,133

4,907
4,907
4,304

5,172
5,172
4,539

5,449
5,448
4,777

4,096
964
942
78
119
27
4,057
3,917
2,870
110

4,358
1,031
1,009
86
123
28
4,319
4,187
3,090
100

4,637
1,098
1,072
95
137
32
4,599
4,468
3,324
109

843
199
195
17
24
5
952
922
681
22

851
202
197
17
25
6
963
935
696
23

29,680
16,039
14,794
711
345
189
13,641
8,187
4,988
467

33,108
17,609
16,136
817
406
249
15,499
9,146
5,828
525

6,810
15,557
14,662
8,267
2,805
6,750
3,158
1,955
1,614
4,670

7,140
16,037
15,052
8,600
2,964
7,781
3,370
2,047
1,753
4,817

Persons enrolled (fee-for-service only) (thousands)
----

----

----

Persons served (thousands)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

792
400
397
8
15
...
740
691
296
9

975
475
472
8
22
...
924
865
399
13

1,760
728
721
9
51
...
1,723
1,631
909
25

2,390
680
644
23
122
-2,365
2,249
1,496
c

Persons served per 1,000 enrollees
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

411
208
206
4
8
...
424
396
170
5

450
219
218
4
10
...
471
442
204
7

594
246
243
3
17
...
634
600
334
9

734
209
198
7
38
-804
764
508
c

835
196
192
16
24
6
943
910
667
26

Amount reimbursed (millions of dollars)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

1,049
694
681
7
6
...
355
206
145
3

1,509
987
968
9
10
...
522
295
221
5

4,478
2,765
2,714
13
38
...
1,713
997
701
16

11,239
6,694
6,346
85
264
-4,545
2,831
1,714
c

25,773
14,114
13,156
555
239
164
11,660
6,968
4,198
493

Amount reimbursed per person served (dollars)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

1,324
1,735
1,714
936
399
...
479
298
490
345

1,548
2,077
2,051
1,049
478
...
565
341
554
420

2,544
3,798
3,765
1,571
733
...
994
611
771
619

4,703
9,847
9,849
3,702
2,156
-1,922
1,259
1,146
c

6,292
14,641
13,966
7,115
2,008
6,074
2,874
1,779
1,463
4,482

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.7

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1974–2002—Continued
Type of coverage and service

1974

1975

544
360
353
4
3
...
208
118
83
2

696
455
446
4
5
...
266
151
113
3

1980

1990

2000

2001

2002

5,739
3,101
2,860
137
67
37
3,005
1,804
1,099
103

6,076
3,232
2,962
150
75
46
3,245
1,915
1,220
110

Amount reimbursed per enrollee (dollars)
Hospital Insurance and/or Supplementary Medical Insurance
Hospital Insurance
Inpatient hospital
Skilled nursing services
Home health services a
Hospice services b
Supplementary Medical Insurance
Physicians' and other medical services
Outpatient services
Home health services a

1,511
933
916
4
13
...
630
639
258
5

3,453
2,057
1,950
26
81
-1,544
962
582
c

5,252
2,876
2,681
113
49
33
2,709
1,619
975
115

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.

b.
c.

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.
The hospice care benefit was enacted in 1982. Therefore, for calendar years 1974, 1975, and 1980, hospice services were not applicable.
Sample population too small to yield valid calculated results.

CONTACT: Maria Diacogiannis (410) 786-0178.

8.8 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
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, 1980–2004, selected years (in thousands)
Census division and state or area

1980

1990

1995

2000

2001

2002

2003

2004

25,515
25,027

30,948
30,350

33,142
32,492

34,253
33,549

34,462
33,743

34,679
33,947

35,008
34,261

35,334
34,571

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

1,506
362
142
715
103
125
59

1,734
436
165
795
126
145
68

1,816
455
174
825
139
149
72

1,838
458
180
829
147
148
76

1,837
457
182
827
148
147
76

1,836
456
183
824
150
146
77

1,841
458
185
822
152
146
78

1,843
458
186
819
156
145
79

Middle Atlantic
New Jersey
New York
Pennsylvania

4,496
851
2,128
1,516

5,084
1,006
2,280
1,798

5,267
1,058
2,328
1,881

5,282
1,070
2,347
1,865

5,277
1,070
2,351
1,856

5,276
1,071
2,356
1,849

5,279
1,073
2,361
1,845

5,277
1,073
2,365
1,839

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

4,462
1,238
579
916
1,162
567

5,224
1,401
685
1,101
1,387
650

5,500
1,446
725
1,177
1,471
683

5,552
1,440
736
1,203
1,480
693

5,560
1,440
738
1,207
1,480
695

5,567
1,439
740
1,210
1,480
698

5,599
1,446
746
1,218
1,486
703

5,625
1,452
751
1,226
1,489
707

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

2,186
387
304
479
639
205
81
91

2,424
422
337
544
706
221
91
102

2,510
432
348
570
733
228
94
106

2,519
427
347
583
736
227
93
106

2,522
426
346
586
737
227
93
107

2,523
425
345
590
737
227
92
107

2,532
426
345
595
740
227
92
107

2,542
426
345
600
744
227
92
108

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

4,179
59
71
1,579
499
381
588
279
490
233

5,536
80
71
2,174
636
496
786
383
645
264

6,091
90
70
2,396
700
542
878
428
714
274

6,410
97
66
2,493
750
570
939
463
761
271

6,474
99
65
2,511
760
576
952
470
771
270

6,542
100
64
2,531
771
582
965
477
782
270

6,630
102
64
2,558
785
589
980
486
795
271

6,730
104
63
2,596
799
596
997
496
808
271

East South Central
Alabama
Kentucky
Mississippi
Tennessee

1,613
428
402
280
503

1,887
508
459
313
607

2,000
541
482
325
652

2,060
558
491
330
681

2,072
561
492
331
688

2,084
564
494
333
693

2,107
569
499
336
703

2,128
573
504
339
712

West South Central
Arkansas
Louisiana
Oklahoma
Texas

2,363
303
380
361
1,318

2,880
343
460
412
1,665

3,120
356
488
432
1,845

3,274
359
498
438
1,979

3,299
359
498
439
2,003

3,328
360
500
440
2,028

3,369
362
504
442
2,061

3,414
365
507
445
2,097

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

1,043
295
244
95
85
65
114
108
38

1,490
456
324
121
106
128
160
147
47

1,726
536
367
134
114
172
182
168
54

1,906
591
403
144
119
209
200
183
57

1,944
602
410
147
120
218
203
186
58

1,983
614
416
150
121
227
207
189
59

2,028
628
424
153
123
236
211
193
60

2,079
645
434
157
124
246
215
198
60

Total
All areas
United States a

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.9

8.B Medicare: Enrollment, Utilization, and Reimbursement
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, 1980–2004, selected years (in thousands)—Continued
Census division and state or area

1980

1990

1995

2000

2001

2002

2003

2004

Pacific
Alaska
California
Hawaii
Oregon
Washington

3,157
11
2,346
74
300
426

4,082
22
2,990
118
390
562

4,444
28
3,241
138
422
614

4,697
35
3,436
151
432
643

4,747
36
3,474
153
435
649

4,798
38
3,509
155
440
656

4,865
39
3,556
157
446
667

4,924
41
3,592
159
453
679

22

10

18

11

11

10

10

10

Outlying areas
Puerto Rico
Virgin Islands
Other

270
263
4
3

344
337
6
1

383
367
8
8

420
401
9
10

430
410
10
10

439
418
10
11

448
427
10
11

459
436
11
12

Foreign countries

217

254

268

284

289

293

299

304

Unknown

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.

8.10 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B3b—Hospital Insurance and/or Supplementary Medical Insurance: Number of disabled enrollees,
by census division and state or other area, July 1, 1980–2004, selected years (in thousands)
Census division and state or area

1980

1990

1995

2000

2001

2002

2003

2004

2,963
2,863

3,255
3,149

4,393
4,266

5,367
5,208

5,563
5,406

5,810
5,648

6,079
5,912

6,395
6,225

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

141
31
16
64
9
14
7

156
33
18
72
11
14
7

228
47
27
108
17
19
10

285
58
36
131
23
24
13

295
59
38
135
24
25
14

307
62
40
139
26
26
14

319
64
42
144
27
27
15

335
67
45
150
30
28
15

Middle Atlantic
New Jersey
New York
Pennsylvania

493
91
237
165

473
86
229
158

603
110
302
190

731
133
368
230

755
138
378
239

784
142
391
251

814
147
402
265

848
153
414
281

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

486
113
63
118
141
50

561
132
77
132
156
64

715
172
99
170
196
79

823
195
117
200
221
90

845
200
120
207
226
92

877
207
125
216
233
96

916
215
132
227
241
101

962
226
138
240
251
107

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

180
29
22
35
67
14
6
7

211
34
26
44
75
16
7
8

280
43
35
60
100
22
9
11

338
50
43
72
124
26
10
13

351
52
45
74
130
27
10
13

370
54
47
78
137
29
11
14

387
57
49
82
144
30
11
14

408
59
52
87
152
32
11
15

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

545
7
8
147
88
41
91
51
68
43

607
8
7
165
96
46
106
59
77
44

834
11
8
232
134
60
149
81
105
55

1,075
15
10
311
166
75
194
105
132
67

1,125
15
10
328
173
78
203
110
138
70

1,179
16
10
345
180
82
214
115
144
73

1,236
17
10
363
188
85
225
121
151
76

1,301
19
11
384
196
89
237
127
158
80

East South Central
Alabama
Kentucky
Mississippi
Tennessee

246
63
62
46
76

287
74
75
53
85

397
101
105
72
119

495
127
132
88
148

518
134
137
92
155

543
142
143
96
162

570
151
149
101
169

602
160
156
107
179

West South Central
Arkansas
Louisiana
Oklahoma
Texas

288
45
63
41
139

317
48
71
39
159

452
67
93
56
236

539
80
104
69
286

559
83
107
72
297

584
86
112
75
311

614
90
116
79
329

655
96
122
84
353

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

112
34
24
9
9
8
15
9
3

148
42
34
11
12
13
19
13
4

228
66
54
16
16
22
28
20
7

284
84
65
21
18
30
34
24
8

295
89
66
22
18
32
35
25
8

312
95
68
23
19
35
37
26
9

327
101
69
25
20
37
39
27
9

349
109
72
27
21
41
41
29
9

Total
All areas
United States a

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.11

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B3b—Hospital Insurance and/or Supplementary Medical Insurance: Number of disabled enrollees,
by census division and state or other area, July 1, 1980–2004, selected years (in thousands)—Continued
Census division and state or area

1980

1990

1995

2000

2001

2002

2003

2004

367
2
284
7
31
43

388
3
289
9
34
53

529
5
392
11
47
74

637
7
465
15
57
93

662
8
481
15
61
97

692
8
500
17
64
103

726
9
522
18
68
109

766
9
550
19
72
116

4

2

1

1

1

2

2

2

Outlying areas
Puerto Rico
Virgin Islands
Other

88
88
---

93
92
1
--

111
110
1
--

139
136
1
2

142
139
1
2

147
144
1
2

152
148
2
2

155
151
2
2

Foreign countries

12

14

14

14

15

15

15

15

Pacific
Alaska
California
Hawaii
Oregon
Washington
Unknown

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.

8.12 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
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, 1980–2004, selected years (in thousands)
Age, sex, and race

1980

1985

1990

1995

2000

25,515

28,176

30,948

33,142

34,253

8,459
6,756
4,809
3,081
2,410

8,956
7,441
5,453
3,463
2,861

9,695
7,951
6,058
3,957
3,286

9,517
8,756
6,563
4,470
3,837

10,268
15,247

11,282
16,894

12,416
18,532

22,534
2,257
724

24,745
2,585
846

26,855
3,114
979

25,104

27,683

30,464

32,742

8,302
6,592
4,731
3,072
2,407

8,818
7,292
5,315
3,403
2,854

9,565
7,829
5,947
3,872
3,252

10,156
14,948

11,146
16,536

22,244
2,160
699

24,424
2,444
815

2002

2003

2004

34,680

35,008

35,334

9,167
8,609
7,285
4,870
4,322

9,274
8,480
7,292
5,173
4,461

9,466
8,394
7,302
5,283
4,563

9,698
8,321
7,258
5,429
4,627

13,434
19,708

14,112
20,141

14,418
20,261

14,625
20,382

14,837
20,497

29,011
3,253
878

29,757
4,403
92

29,974
4,627
78

30,195
4,741
72

30,413
4,853
67

33,833

34,257

34,581

34,996

9,411
8,652
6,483
4,409
3,787

9,074
8,505
7,189
4,806
4,259

9,183
8,380
7,196
5,103
4,395

9,373
8,295
7,206
5,211
4,496

9,622
8,248
7,186
5,369
4,572

12,280
18,184

13,310
19,431

13,979
19,854

14,284
19,974

14,489
20,092

14,727
20,269

26,591
2,931
942

28,822
3,127
792

29,570
4,176
87

29,792
4,392
73

30,013
4,500
68

30,272
4,660
65

Hospital Insurance and/or Supplementary Medical Insurance
Total
Age
65–69
70–74
75–79
80–84
85 or older
Sex
Men
Women
Race
White
All other races
Unknown

Hospital Insurance
Total
Age
65–69
70–74
75–79
80–84
85 or older
Sex
Men
Women
Race
White
All other races
Unknown

Supplementary Medical Insurance
Total

24,680

27,311

29,686

31,742

32,590

32,934

33,203

33,440

8,156
6,570
4,684
2,981
2,289

8,607
7,277
5,333
3,381
2,712

9,008
7,740
5,942
3,879
3,118

8,830
8,430
6,431
4,392
3,659

8,330
8,256
7,088
4,782
4,134

8,401
8,107
7,090
5,068
4,268

8,554
8,012
7,100
5,169
4,368

8,724
7,929
7,053
5,306
4,429

9,868
14,813

10,852
16,459

11,758
17,927

12,694
19,048

13,205
19,384

13,466
19,468

13,640
19,562

13,802
19,639

21,876
2,114
691

24,060
2,441
810

25,849
2,910
927

27,899
3,028
815

28,432
4,086
71

28,592
4,285
58

28,765
4,386
52

28,914
4,479
47

Age
65–69
70–74
75–79
80–84
85 or older
Sex
Men
Women
Race
White
All other races
Unknown

SOURCE: Centers for Medicare & Medicaid Services.
CONTACT: Maria Diacogiannis (410) 786-0178.

Annual Statistical Supplement, 2005 ♦ 8.13

8.B Medicare: Enrollment, Utilization, and Reimbursement
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, 1980–2004, selected
years
1980

1990

2000

All
disabled

End-stage
renal
disease
only

All
disabled

All
disabled

Total

2,963,175

28,334

3,255,007

64,692

5,367,151

73,890

6,079,424

81,662

6,311,771

83,111

Under 35
35–44
45–54
55–64

371,204
369,460
657,486
1,565,025

8,773
5,188
6,977
7,396

483,265
654,957
741,200
1,375,585

16,603
14,159
15,800
18,130

522,321
1,129,288
1,627,238
2,088,304

13,255
15,084
22,647
22,904

553,946
1,154,953
1,885,826
2,484,699

13,801
15,428
25,323
27,110

565,761
1,153,154
1,961,154
2,631,702

13,680
15,527
25,715
28,189

Men
Women

1,870,558
1,092,617

14,547
13,787

2,042,944
1,212,063

33,647
31,045

3,014,107
2,353,044

40,062
33,828

3,311,265
2,768,159

44,736
36,926

3,411,286
2,900,485

45,637
37,474

2,422,253
486,677
54,245

19,232
7,907
1,195

2,480,767
712,315
61,925

35,638
26,477
2,577

3,989,357
1,362,457
15,337

35,636
37,820
434

4,495,109
1,571,271
13,044

37,913
43,551
198

4,686,861
1,607,703
17,207

38,304
44,314
493

Total

2,963,156

28,334

3,254,983

64,677

5,366,598

73,890

6,076,034

81,652

6,311,437

83,103

Under 35
35–44
45–54
55–64

371,199
369,458
657,483
1,565,016

8,773
5,188
6,977
7,396

483,262
654,953
741,193
1,375,575

16,601
14,157
15,794
18,125

522,123
1,129,170
1,627,107
2,088,198

13,255
15,084
22,647
22,904

553,083
1,154,266
1,884,907
2,483,778

13,797
15,427
25,320
27,108

565,698
1,153,074
1,961,074
2,631,591

13,679
15,525
25,712
28,187

Men
Women

1,870,543
1,092,613

14,547
13,787

2,042,929
1,212,054

33,639
31,038

3,013,803
2,352,795

40,062
33,828

3,309,440
2,766,594

44,729
36,923

3,411,088
2,900,349

45,632
37,471

2,422,239
486,672
54,245

19,232
7,907
1,195

2,480,754
712,304
61,925

35,631
26,469
2,577

3,988,957
1,362,305
15,336

35,636
37,820
434

4,493,014
1,569,996
13,024

37,907
43,547
198

4,686,631
1,607,599
17,207

38,302
44,309
492

Total

2,719,226

27,046

2,943,480

58,912

4,769,804

68,800

5,386,970

75,042

5,584,413

76,173

Under 35
35–44
45–54
55–64

339,665
337,146
596,287
1,446,128

8,294
4,963
6,683
7,106

441,640
586,537
666,257
1,249,046

14,782
12,567
14,559
17,004

466,869
998,230
1,421,904
1,882,801

12,159
13,783
20,961
21,897

494,729
1,015,672
1,650,064
2,226,505

12,520
13,854
23,087
25,581

505,202
1,012,955
1,717,578
2,348,678

12,392
13,964
23,370
26,447

Men
Women

1,694,569
1,024,657

13,887
13,159

1,833,959
1,109,521

30,338
28,574

2,665,252
2,104,552

37,037
31,763

2,917,468
2,469,502

40,651
34,391

2,999,387
2,585,026

41,429
34,744

2,218,176
449,753
51,297

18,458
7,446
1,142

2,236,781
650,121
56,578

32,347
24,240
2,325

3,535,008
1,221,836
12,960

33,154
35,256
390

3,974,030
1,401,696
11,244

34,952
39,907
183

4,134,472
1,435,596
14,345

35,228
40,559
386

All
disabled

End-stage
renal
disease
only

2004
End-stage
renal
disease
only

Age, sex, and race

End-stage
renal
disease
only

2003

End-stage
renal
disease
only

All
disabled

Hospital Insurance and/or Supplementary Medical Insurance

Age

Sex

Race
White
All other races
Unknown

Hospital Insurance

Age

Sex

Race
White
All other races
Unknown

Supplementary Medical Insurance

Age

Sex

Race
White
All other races
Unknown

SOURCE: Centers for Medicare & Medicaid Services.
CONTACT: Maria Diacogiannis (410) 786-0178.

8.14 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1975–2004 (in dollars)
Census division and state or area a

1975

1980

1990

1995

2000

2002

2003

2004

143
144

292
293

1,090
1,081

1,908
1,920

2,762
2,787

3,574
3,608

4,117
4,157

4,559
4,603

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

159
167
133
168
123
154
124

298
287
284
316
264
284
230

988
1,177
927
942
1,022
851
923

1,763
2,013
1,645
1,705
1,699
1,638
1,580

2,436
2,608
2,328
2,429
2,480
2,316
1,995

2,862
3,014
2,763
2,797
3,027
2,967
2,356

3,194
3,413
3,042
3,100
3,384
3,290
2,660

3,512
3,746
3,306
3,415
3,676
3,703
2,889

Middle Atlantic
New Jersey
New York
Pennsylvania

163
157
176
145

304
300
301
312

943
725
836
1,236

1,704
1,865
1,366
2,109

2,743
3,757
2,116
3,003

3,925
6,157
2,817
3,979

4,763
7,447
3,412
4,791

5,209
8,142
3,752
5,287

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

140
148
116
156
134
128

294
322
236
332
277
251

1,097
1,202
997
1,193
1,030
933

1,866
2,126
1,713
1,881
1,730
1,690

2,550
3,017
2,271
2,451
2,360
2,424

3,135
3,645
2,731
2,925
2,995
3,154

3,547
4,094
3,061
3,310
3,443
3,541

3,979
4,566
3,477
3,715
3,861
3,984

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

117
110
113
124
119
116
118
107

248
239
244
248
257
251
237
228

1,052
902
1,093
1,132
1,108
1,043
937
915

1,831
1,573
1,957
1,938
1,922
1,850
1,509
1,518

2,638
2,124
2,589
2,913
2,783
3,007
2,180
2,167

3,305
2,663
3,225
3,666
3,385
4,031
2,663
2,870

3,732
3,031
3,768
4,162
3,747
4,497
2,989
3,266

4,166
3,391
4,321
4,683
4,107
4,968
3,318
3,762

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

135
153
174
161
125
164
101
106
118
108

273
274
373
321
258
274
214
229
247
247

1,106
1,191
1,374
1,360
1,081
813
932
1,021
1,022
1,009

1,876
1,831
2,129
2,351
1,744
1,365
1,603
1,818
1,732
1,472

2,637
1,971
3,331
3,439
2,527
1,608
2,175
2,611
2,432
1,821

3,337
2,384
3,829
4,406
3,101
1,859
2,672
3,368
3,082
2,193

3,776
2,631
4,437
5,030
3,552
1,951
2,963
3,799
3,474
2,433

4,162
2,954
4,892
5,477
3,947
2,141
3,303
4,240
3,862
2,641

East South Central
Alabama
Kentucky
Mississippi
Tennessee

115
126
107
98
122

243
282
216
213
250

1,019
1,176
967
865
1,012

1,718
2,054
1,630
1,437
1,662

2,451
2,914
2,269
2,017
2,479

3,016
3,612
2,751
2,504
3,031

3,457
4,143
3,117
2,883
3,485

3,844
4,609
3,497
3,278
3,798

West South Central
Arkansas
Louisiana
Oklahoma
Texas

117
104
116
128
118

253
231
265
271
250

1,138
923
1,180
997
1,212

1,937
1,511
1,926
1,620
2,118

2,767
2,194
2,724
2,335
3,008

3,539
2,773
3,369
2,841
3,890

4,045
3,152
3,700
3,263
4,486

4,538
3,491
4,063
3,696
5,049

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

142
155
144
129
116
177
133
142
109

305
325
288
273
262
424
293
316
245

1,350
1,442
1,308
1,140
1,036
2,031
1,140
1,283
1,094

2,321
2,617
2,240
1,951
1,742
3,253
1,913
2,069
1,985

3,279
3,885
3,392
2,471
2,233
4,320
2,533
2,871
2,373

4,090
4,663
4,329
2,997
2,756
5,418
3,149
3,375
2,911

4,630
5,197
4,859
3,304
3,091
6,237
3,591
3,777
3,319

5,226
5,800
5,539
3,700
3,491
6,889
4,112
4,206
3,623

Total
All areas b
United States c

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.15

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1975–2004 (in dollars)—Continued
Census division and state or area a
Pacific
Alaska
California
Hawaii
Oregon
Washington
Outlying areas
Puerto Rico
Virgin Islands
Other

1975

1980

1990

1995

2000

2002

2003

2004

196
228
206
148
158
163

416
379
448
333
329
293

1,651
1,470
1,794
1,224
1,275
1,162

2,877
2,385
3,156
2,319
1,987
1,924

4,228
3,144
4,701
2,991
2,717
2,708

5,648
3,757
6,363
3,440
3,245
3,455

6,495
4,521
7,283
3,800
3,707
3,972

7,149
4,951
7,976
4,170
4,223
4,570

77
77
92
88

152
151
161
263

510
505
746
...

739
736
843
...

947
946
1,007
...

1,055
1,050
1,372
...

1,077
1,069
1,568
...

1,084
1,074
1,618
...

SOURCE: Centers for Medicare & Medicaid.
NOTES: Data from 1975 to 1995 are based on bills approved in each year and recorded before June 1996. Data from 2000 to 2004 are based on the stay records for
100 percent of Medicare-aged and disabled beneficiaries as recorded in the MEDPAR file.
. . . = not applicable.
a.
b.
c.

Geographic distribution reflects the beneficiaries’ area of residence.
Excludes claims for persons residing in foreign countries.
Includes claims for persons whose place of residence is unknown.

CONTACT: Maria Diacogiannis (410) 786-0178.

8.16 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1975–2004 (in dollars)
Census division and state or area a

1975

1980

1990

1995

2000

2002

2003

2004

43
43

70
70

193
193

402
402

462
462

475
475

487
487

493
493

New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont

50
35
52
63
41
43
38

77
51
100
98
86
59
62

172
165
274
181
218
129
155

347
314
308
380
412
265
266

431
388
406
484
410
392
357

459
427
469
494
470
405
392

478
442
485
518
482
428
412

500
464
510
536
506
439
452

Middle Atlantic
New Jersey
New York
Pennsylvania

50
45
61
40

73
81
80
65

168
164
168
170

308
344
240
373

428
434
360
510

466
504
402
522

489
531
430
535

499
546
446
528

East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin

40
37
35
45
41
35

68
77
60
60
69
64

167
215
180
130
157
149

358
421
399
270
375
315

450
528
447
376
462
343

464
533
444
405
476
372

481
556
448
425
485
398

481
550
446
429
484
429

West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota

45
46
39
46
47
41
43
33

82
84
66
94
95
71
49
61

194
269
255
125
263
205
118
160

367
406
461
245
465
338
221
270

473
490
539
306
603
484
408
326

483
539
507
363
562
503
409
380

507
558
511
407
575
521
440
433

506
570
497
427
542
523
464
485

South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia

34
31
34
34
34
37
31
26
42
36

59
50
64
59
71
56
52
46
68
64

168
132
193
195
146
141
132
159
168
171

396
328
389
488
346
347
283
337
331
364

405
345
437
447
356
403
342
384
374
446

410
380
483
421
385
416
368
414
404
466

420
411
504
432
394
428
380
404
418
493

431
432
513
447
407
428
397
404
426
478

East South Central
Alabama
Kentucky
Mississippi
Tennessee

37
33
36
45
41

56
38
58
105
70

154
143
151
160
162

358
353
352
377
358

420
381
439
480
407

439
400
431
522
435

433
405
450
524
406

445
423
469
537
412

West South Central
Arkansas
Louisiana
Oklahoma
Texas

45
44
43
60
43

94
84
83
145
78

267
238
374
312
238

539
372
683
563
542

579
499
754
579
556

549
571
687
588
511

537
574
674
583
497

533
570
648
575
496

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

38
41
42
27
30
37
57
36
36

64
71
73
46
44
66
122
75
49

226
236
266
152
123
232
267
266
208

486
549
538
381
291
569
488
473
379

477
535
502
384
362
592
534
435
421

461
450
488
419
405
467
545
460
441

456
432
471
428
406
425
552
483
475

462
425
478
458
415
428
549
494
473

Total
All areas b
United States c

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.17

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1975–2004 (in dollars)—Continued
Census division and state or area a

1975

1980

1990

1995

2000

2002

2003

2004

Pacific
Alaska
California
Hawaii
Oregon
Washington

45
68
46
49
40
34

81
115
87
83
63
62

269
283
287
217
207
196

576
437
629
467
421
412

584
0
0
469
382
390

613
746
683
532
387
421

630
660
698
550
401
427

633
735
702
580
426
443

Outlying areas
Puerto Rico
Virgin Islands

51
43

97
104

202
171

261
370

362
399

354
763

370
490

391
404

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 2004 are based on bills incurred in each year and recorded in the Centers for Medicare & Medicaid Services before June 27, 2005. Includes data for services rendered to both aged and disabled persons.
a.
b.
c.

Geographic distribution reflects the beneficiaries’ area of residence.
Excludes claims for persons residing in foreign countries.
Includes claims for persons whose place of residence is unknown.

CONTACT: Maria Diacogiannis (410) 786-0178.

8.18 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B8.1—Hospital Insurance: Short-stay hospital discharges, by state or other area, selected fiscal
years 1990–2004
State or area
All areas

1990

1995

1997

1998

1999

2000

2001

2002

2003

2004

10,472,587

11,680,874

11,952,088

11,912,079

11,659,885

11,778,705

12,192,174

12,499,749

12,698,388

12,986,560

Alabama
Alaska
Arizona
Arkansas
California

226,359
6,491
140,069
143,363
834,829

255,013
8,635
139,564
152,516
875,926

265,029
9,917
150,597
157,920
901,018

266,603
10,633
150,190
160,379
921,068

266,541
11,031
128,363
160,880
780,295

274,518
11,684
135,143
164,310
740,564

282,999
11,748
144,989
166,445
756,629

291,991
11,794
156,302
170,102
801,758

294,850
11,398
165,231
170,421
836,444

299,746
11,554
182,094
174,242
847,296

Colorado
Connecticut
Delaware
District of Columbia
Florida

98,262
114,938
26,125
36,062
579,368

105,216
141,765
30,336
39,526
742,862

103,735
143,071
30,632
38,508
743,556

97,479
133,672
30,738
38,661
758,714

100,648
125,115
33,287
38,693
736,958

101,486
124,951
34,049
39,112
765,130

101,258
135,169
36,386
40,138
823,957

107,180
148,864
36,541
39,389
869,777

109,879
154,460
38,216
39,151
899,404

114,051
159,594
40,959
40,527
925,090

Georgia
Hawaii
Idaho
Illinois
Indiana

274,957
26,340
31,559
460,926
254,404

316,301
32,526
36,327
533,238
276,601

327,839
34,795
41,066
538,476
287,615

320,774
33,331
42,451
531,184
289,743

311,998
26,347
43,353
539,314
289,693

324,286
26,146
44,027
556,122
297,851

334,599
26,343
43,272
578,327
306,202

338,687
26,932
40,996
601,373
304,034

342,392
26,302
40,738
607,561
303,404

353,846
27,453
39,756
624,034
310,393

Iowa
Kansas
Kentucky
Louisiana
Maine

141,191
117,017
199,042
213,819
54,963

146,448
120,593
222,162
234,663
63,013

151,815
125,481
231,081
237,390
66,278

154,152
127,045
231,352
232,942
67,895

155,497
126,920
237,553
223,794
68,128

159,451
128,024
243,886
237,154
69,030

162,466
129,973
252,454
243,724
68,547

156,854
129,334
257,205
248,183
66,705

148,591
131,412
255,264
253,774
67,401

145,095
130,138
258,938
254,224
67,914

Maryland
Massachusetts
Michigan
Minnesota
Mississippi

179,835
286,332
366,349
170,808
142,662

214,989
310,455
435,455
178,018
162,934

204,988
293,217
457,401
187,164
181,599

195,489
280,333
456,972
192,488
185,149

199,012
268,179
452,461
194,935
181,575

208,038
263,152
452,367
200,918
183,952

234,162
271,657
468,675
209,469
185,626

244,595
275,984
497,195
210,382
182,535

251,754
291,062
506,259
208,364
183,965

259,460
300,460
522,536
212,125
185,131

Missouri
Montana
Nebraska
Nevada
New Hampshire

281,059
40,505
69,299
37,478
39,103

298,509
40,770
70,113
49,254
42,746

299,996
41,542
75,630
54,509
44,758

297,554
41,854
77,188
55,150
42,918

293,724
42,343
76,841
48,369
42,054

300,576
44,208
76,960
49,613
45,712

315,642
45,697
74,217
51,836
48,206

317,278
42,880
71,921
56,622
46,282

320,454
40,952
71,577
57,345
46,304

331,919
41,719
72,718
62,742
46,893

New Jersey
New Mexico
New York
North Carolina
North Dakota

338,509
50,391
723,060
267,370
37,543

385,145
50,334
797,453
336,173
37,014

371,173
53,329
798,611
369,667
38,272

364,034
52,913
787,116
385,533
38,332

373,224
51,459
777,269
395,004
38,847

372,063
51,085
750,793
406,700
39,672

374,250
51,396
761,352
413,429
38,764

389,938
51,469
771,835
418,725
34,707

404,035
51,533
780,893
431,441
34,645

410,302
52,083
793,919
439,157
34,712

Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island

527,006
155,100
106,164
685,403
46,578

562,234
156,239
105,878
766,535
49,740

562,603
163,842
111,656
728,572
50,498

541,958
166,068
111,028
692,290
46,484

533,499
170,592
100,569
664,002
39,625

536,335
176,021
91,806
634,802
38,489

550,989
179,543
98,854
649,458
39,658

559,223
182,998
102,568
656,105
40,229

565,314
187,913
102,182
654,661
38,506

588,640
193,773
99,869
665,143
39,556

South Carolina
South Dakota
Tennessee
Texas
Utah

112,232
38,175
290,371
603,621
39,963

156,060
41,714
310,335
671,734
43,819

171,889
44,101
324,380
721,006
44,513

184,188
44,350
324,831
732,255
45,698

194,344
44,846
318,793
725,166
48,898

204,038
45,239
327,423
742,628
53,003

213,513
45,202
341,212
798,667
55,207

216,412
43,134
344,524
843,945
56,244

218,775
42,626
348,700
868,784
57,928

221,825
40,946
357,600
897,873
61,309

Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

20,251
240,165
157,942
111,305
217,727
15,255

22,815
271,620
157,146
124,293
227,774
16,009

23,456
285,721
158,264
131,334
232,721
16,557

22,585
286,752
152,867
131,473
233,103
17,256

23,133
289,195
148,620
134,483
233,432
17,429

24,014
295,790
153,660
134,585
238,572
18,764

24,778
305,346
162,197
135,458
240,711
18,932

22,658
310,602
166,846
132,356
243,774
18,044

22,690
315,181
167,102
131,953
244,100
16,416

22,174
324,379
171,361
134,992
243,116
16,097

93,436
528

111,950
1,374

120,547
1,402

123,752
1,569

130,209
1,511

137,315
1,552

138,713
1,468

139,682
1,571

134,979
1,641

131,223
1,743

978

1,012

1,351

1,543

1,835

1,936

2,265

2,485

2,061

2,121

Outlying areas
Puerto Rico
Virgin Islands
Unknown

SOURCE: Centers for Medicare & Medicaid Services.
NOTE: Discharge data for fiscal year 2004 are final as of June 2005.
CONTACT: Maria Diacogiannis (410) 786-0178.

Annual Statistical Supplement, 2005 ♦ 8.19

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1996–2004 (in thousands)
Physicians’ services
Year a

All services

Total

Surgical c

Outpatient
hospital
services

Medical c

Independent
laboratory
services

Home
health
services b

All
other
services

Persons aged 65 or older
Number of bills
1996
1997
1998
1999
2000
2001
2002
2003
2004

d

590,301
600,228
611,356
486,296

411,789
418,826
427,891
429,299

46,171
46,517
46,273
45,496

365,618
372,309
381,618
383,803

50,578
52,364
52,807
51,498

52,417
49,917
42,715

248
245
4,632
5,499

75,269
78,876
83,311

------

------

------

------

------

------

------

------

d

d

Allowed charges e (dollars)
1996
1997
1998
1999

88,175,817
92,897,145
101,840,529
105,662,969

39,483,655
40,447,618
41,704,119
43,771,886

13,164,645
12,953,314
12,061,669
12,080,067

26,318,914
27,493,847
29,634,502
31,637,737

34,958,694
37,669,144
38,746,727
40,242,409

1,634,475
1,490,474
1,333,198
1,264,426

320,718
336,345
6,051,693
6,874,109

11,778,275
12,953,564
14,004,792
13,510,139

2000
2001
2002
2003
2004

114,454,943
131,291,215
152,885,772
175,667,107
198,398,314

48,334,792
55,171,969
58,778,210
64,653,983
70,232,291

12,358,986
13,091,543
----

35,902,761
40,923,161
----

44,212,849
52,843,382
67,445,207
80,959,313
96,151,578

1,583,630
1,860,351
2,101,436
2,292,008
2,502,012

5,555,627
4,185,640
4,357,737
4,799,099
5,223,243

14,768,045
17,229,873
20,203,182
22,962,704
24,289,190

Amount reimbursed f (dollars)
1996
1997
1998
1999

50,800,766
52,436,955
56,706,407
58,241,615

30,914,663
31,683,703
32,668,172
34,424,777

10,381,197
10,218,613
9,517,777
9,523,625

20,533,397
21,464,753
23,144,124
24,857,734

10,732,311
11,208,164
10,686,575
10,365,173

1,583,843
1,440,441
1,278,720
1,209,285

228,972
235,031
4,262,203
4,836,243

7,340,977
7,869,616
7,810,737
7,406,137

2000
2001
2002
2003
2004

62,314,344
71,330,918
77,650,281
85,882,891
94,058,001

37,964,285
43,354,135
46,205,476
50,859,377
55,304,787

9,743,222
10,351,499
----

28,166,179
32,120,569
----

10,676,020
12,941,110
14,739,204
16,685,157
19,152,316

1,503,061
1,760,131
1,983,166
2,162,092
2,360,186

4,178,643
4,054,566
4,310,321
4,574,119
5,146,055

7,992,335
9,220,976
10,412,114
11,602,146
12,094,657

Disabled beneficiaries
Number of bills
1996
1997
1998
1999

82,908
86,071
89,890
d
72,288

53,010
55,260
58,244
59,281

4,594
4,773
4,991
5,042

48,416
50,487
53,253
54,239

12,068
12,415
12,639
12,413

8,193
8,073
6,776

1
0
475
594

9,636
10,323
11,756

2000
2001
2002
2003
2004

------

------

------

------

------

------

------

------

d

d

Allowed charges e (dollars)
1996
1997
1998
1999

15,902,303
17,062,640
18,746,643
20,045,719

5,168,573
5,399,410
5,828,275
6,298,865

1,401,285
1,409,583
1,401,045
1,453,807

3,767,217
3,989,586
4,421,251
4,812,231

8,682,159
9,394,955
9,551,763
10,129,090

284,031
281,459
252,549
245,525

194
575
721,865
867,217

1,767,346
1,986,241
2,392,191
2,505,022

2000
2001
2002
2003
2004

22,093,729
25,861,014
32,783,675
41,385,238
51,158,604

7,140,023
8,339,437
9,233,983
10,772,085
12,341,835

1,526,798
1,631,945
----

5,582,913
6,383,077
----

11,119,952
13,302,288
18,546,603
24,767,523
32,575,598

294,758
343,218
402,351
457,010
514,090

730,337
559,581
606,204
691,767
774,420

2,808,659
3,316,490
3,994,534
4,696,853
4,952,661
(Continued)

8.20 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
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 1996–2004 (in thousands)—Continued
Physicians’ services
Year a

Total

All services

Surgical c

Medical c

Outpatient
hospital
services

Independent
laboratory
services

Home
health
services b

All
other
services

Amount reimbursed f (dollars)
1996
1997
1998
1999

9,099,774
9,592,801
10,446,211
11,002,342

3,908,985
4,093,664
4,409,959
4,782,110

1,095,977
1,103,074
1,095,140
1,135,375

2,812,960
2,990,428
3,310,214
3,621,070

3,652,755
3,839,736
3,778,109
3,841,309

278,816
276,057
246,338
239,194

142
454
497,569
594,961

1,259,076
1,382,890
1,514,236
1,544,768

2000
2001
2002
2003
2004

11,936,775
13,846,924
15,681,526
18,077,481
20,387,472

5,418,838
6,333,051
7,024,579
8,220,466
9,462,029

1,192,908
1,278,008
----

4,203,799
4,823,352
----

4,006,256
4,725,340
5,427,642
6,157,923
7,008,792

286,675
333,212
390,192
442,757
498,483

529,400
488,759
540,364
599,769
695,847

1,695,606
1,966,562
2,298,749
2,656,566
2,722,321

SOURCE: Centers for Medicare & Medicaid Services.
NOTE: -- = not available.
a.
b.
c.
d.
e.
f.

Period for which the claim incurred.
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.
Where both medical and surgical charges are included on a single bill, the highest-priced service is the determining factor in classifying the bill.
Total for “All services” excludes “Independent laboratory services” and “All other services”; for those services, data are not available because of programmatic problems.
Includes physician or supplier allowed charges as determined by the carrier and amounts actually billed by providers for outpatient hospital and home health services.
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.

Annual Statistical Supplement, 2005 ♦ 8.21

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B10—Supplementary Medical Insurance:
Claims received by carriers and assignment rates,
1969–2004
Year

Total number of claims
(thousands)

Net assignment rate a
(percent)

1969
1970
1971
1972
1973
1974

37,542
42,148
46,572
51,041
57,007
68,307

61.5
60.8
58.5
54.9
52.7
51.9

1975
1976
1977
1978
1979

79,980
91,624
105,339
117,886
132,098

51.8
50.5
50.5
50.6
51.3

1980
1981
1982
1983
1984

150,048
167,154
182,440
204,122
238,362

51.5
52.3
53.0
53.9
59.0

1985
1986
1987
1988
1989

279,559
306,714
346,551
386,763
421,305

68.5
68.0
73.1
77.3
79.7

1990
1991
1992
1993
1994

474,226
517,123
554,619
583,863
622,514

81.1
83.1
86.2
90.1
92.8

1995
1996
1997
1998
1999

647,855
678,030
688,891
697,523
703,227

94.7
95.9
96.7
97.3
97.6

2000
2001
2002
2003
2004

720,493
766,758
821,993
860,746
922,197

97.9
98.1
98.4
98.5
98.7

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.

8.22 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B11—Supplementary Medical Insurance: Reasonable charge determination for claims assigned
and unassigned for aged and disabled persons, 1971–2004
Claims approved
Year

Number (thousands)

1971
1972
1973
1974

25,919
26,798
28,376
33,295

1975
1976
1977
1978
1979

Charges before reduction
Percentage reduced

Amount (millions of dollars)

Percentage reduced

44.5
47.5
55.6
64.5

1,571
1,630
1,751
2,194

11.1
10.9
11.9
14.3

39,218
44,065
50,260
56,493
64,051

70.8
74.3
72.8
73.6
77.0

2,716
3,261
3,936
4,678
5,746

17.8
19.9
19.4
19.9
21.2

1980
1981 a
1982
1983
1984

73,068
80,127
91,615
103,139
128,559

80.8
82.8
83.3
81.0
80.8

7,303
8,868
11,315
13,657
16,571

22.7
24.0
24.3
23.6
25.4

1985
1986
1987
1988
1989

176,956
191,139
234,488
271,225
304,649

81.7
82.8
83.4
85.6
86.9

22,008
24,662
31,179
37,275
44,567

27.4
28.4
28.0
29.8
31.0

1990
1991
1992
1993
1994

341,220
384,168
412,924
460,761
508,981

87.5
87.4
86.2
88.8
87.7

51,012
60,057
67,667
76,186
85,170

32.9
36.2
39.7
42.8
42.5

1995
1996
1997
1998
1999

539,630
550,587
566,591
575,799
590,463

86.4
87.1
87.4
87.9
88.9

93,300
97,744
103,389
106,947
114,981

42.3
44.9
45.9
46.9
47.8

2000
2001
2002
2003
2004

615,862
665,196
722,826
759,783
781,000

87.9
87.5
87.7
88.9
89.8

126,391
145,641
152,373
189,920
208,027

47.7
48.0
56.3
52.0
52.9

1971
1972
1973
1974

17,955
21,286
24,691
30,492

57.6
59.3
66.4
72.7

1,348
1,608
1,886
2,401

12.5
12.0
12.6
14.7

1975
1976
1977
1978
1979

36,182
42,100
48,619
53,700
59,961

77.4
78.9
77.1
77.5
80.9

2,973
3,591
4,233
4,749
5,596

17.7
19.8
19.0
19.2
20.7

1980
1981 a
1982
1983
1984

68,113
72,765
80,253
87,436
88,594

84.3
85.8
85.4
82.7
83.7

6,836
7,870
9,545
10,885
11,216

22.5
23.8
23.9
22.9
24.2

1985
1986
1987
1988
1989

77,965
87,121
83,116
76,503
74,947

84.6
85.0
82.4
86.4
90.1

10,059
10,757
10,258
9,005
8,971

25.9
26.9
24.7
25.0
25.0

Assigned claims

Unassigned claims

(Continued)

Annual Statistical Supplement, 2005 ♦ 8.23

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B11—Supplementary Medical Insurance: Reasonable charge determination for claims assigned
and unassigned for aged and disabled persons, 1971–2004—Continued
Claims approved

Charges before reduction

Year

Number (thousands)

Percentage reduced

Amount (millions of dollars)

Percentage reduced

1990
1991
1992
1993
1994

77,746
77,520
66,403
51,080
39,364

90.4
91.3
82.9
86.5
86.4

8,789
7,884
6,215
4,267
3,255

25.3
23.1
18.5
16.5
16.3

1995
1996
1997
1998
1999

29,975
22,819
18,615
15,172
13,834

83.4
84.4
84.4
82.3
81.3

2,543
1,952
1,650
1,382
1,316

15.4
15.8
16.4
17.1
17.7

2000
2001
2002
2003
2004

12,755
12,085
11,352
11,100
10,016

78.6
76.7
79.8
82.1
83.0

1,287
1,252
1,107
1,066
1,009

18.1
18.2
17.2
15.9
16.3

SOURCE: Centers for Medicare & Medicaid Services.
a.

Excludes Texas Blue-Shield plan from July to December 1981.

CONTACT: Maria Diacogiannis (410) 786-0178.

8.24 ♦ Annual Statistical Supplement, 2005

8.B Medicare: Enrollment, Utilization, and Reimbursement
Table 8.B12—Supplementary Medical Insurance: State buy-ins, by state or other area,
selected years 1991–2005
State or area
All areas

1991

1995

1998

1999

2000

2001

2002

2003

2004

2005

3,640,121

4,705,625

5,109,228

5,273,573

5,425,048

5,615,326

5,810,613

6,145,589

6,305,467

6,577,577

Alabama
Alaska
Arizona
Arkansas
California

97,601
4,539
28,650
64,996
646,108

116,916
6,193
44,236
77,660
747,814

121,990
7,093
51,141
78,514
776,832

128,875
7,799
53,450
79,508
793,510

136,860
8,486
57,712
79,606
818,846

141,436
8,832
61,989
80,231
848,361

144,603
9,324
74,678
82,040
892,260

162,912
10,008
91,782
86,597
950,503

164,499
10,318
95,804
86,181
977,676

169,460
10,748
110,977
89,372
1,012,804

Colorado
Connecticut
Delaware
District of Columbia
Florida

36,470
23,535
4,499
12,791
196,992

46,660
48,047
6,645
14,152
271,430

52,175
51,335
8,900
14,582
313,744

53,964
52,134
8,231
13,181
324,172

55,325
53,141
10,737
14,233
342,109

56,934
55,933
12,094
14,621
358,642

57,987
60,083
13,252
15,065
369,092

59,114
65,223
15,224
15,079
389,599

61,140
66,664
16,081
15,586
406,006

61,294
66,191
17,104
15,246
431,764

Georgia
Hawaii
Idaho
Illinois
Indiana

128,976
11,529
9,127
94,434
60,297

160,380
16,695
12,931
137,571
76,460

171,047
19,226
14,909
145,976
81,184

171,638
19,962
15,868
149,850
82,901

176,596
20,326
17,081
155,743
87,543

181,312
21,090
18,550
161,141
91,311

186,466
21,748
19,725
163,368
95,553

193,807
22,904
21,255
175,822
102,654

199,524
22,988
22,291
189,044
105,011

205,476
23,703
23,482
206,014
109,669

Iowa
Kansas
Kentucky
Louisiana
Maine

41,170
26,960
76,456
87,570
22,176

48,517
34,708
97,978
112,090
29,453

49,844
39,008
106,537
115,031
33,006

50,954
40,365
111,789
116,602
35,211

51,976
41,217
117,697
117,179
36,946

52,891
42,126
118,641
117,867
38,161

54,536
43,123
122,096
120,478
39,575

56,920
44,602
126,690
127,340
42,269

58,023
46,175
126,343
132,498
43,800

60,458
47,707
126,468
139,802
46,510

Maryland
Massachusetts
Michigan
Minnesota
Mississippi

48,028
89,163
91,340
39,366
90,530

58,865
125,859
123,948
52,192
108,577

61,669
138,796
135,769
57,559
106,336

64,086
143,779
139,411
59,926
107,176

65,372
152,587
145,172
63,607
107,495

68,010
160,198
148,760
66,874
116,503

70,224
164,510
152,758
70,873
125,832

73,994
167,681
158,998
75,080
131,706

75,366
170,689
161,519
77,499
133,337

79,234
178,691
170,044
79,428
135,023

Missouri
Montana
Nebraska
Nevada
New Hampshire

55,116
10,058
11,358
8,657
3,807

72,659
11,031
16,146
14,227
5,405

81,841
11,882
18,029
17,191
6,295

85,329
12,274
19,064
18,322
6,875

88,343
12,828
20,520
19,155
7,434

91,244
13,120
21,121
20,709
8,866

93,512
13,359
22,120
22,207
9,231

99,127
13,889
22,922
24,587
10,120

103,449
13,917
23,082
26,977
10,732

109,561
14,455
24,210
27,408
11,584

New Jersey
New Mexico
New York
North Carolina
North Dakota

95,795
22,246
255,952
117,656
4,639

122,923
29,855
325,882
186,328
5,560

137,598
34,411
363,331
210,388
5,612

143,024
36,023
372,824
216,563
5,758

146,705
37,330
369,479
223,402
5,908

149,303
39,275
395,830
228,997
6,275

151,644
41,263
409,388
233,229
6,317

155,377
44,534
432,681
240,422
6,541

153,231
44,642
448,373
241,543
6,560

159,110
49,333
465,068
251,739
6,757

Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island

112,598
51,457
28,537
127,519
10,585

164,044
60,080
43,642
162,788
15,517

180,172
63,142
51,392
179,295
17,729

181,407
66,115
55,896
198,492
18,513

171,139
67,413
59,169
206,468
19,787

176,602
67,787
62,910
215,351
21,620

182,821
68,905
66,255
218,691
22,928

191,295
70,761
68,421
229,814
25,146

195,792
72,758
69,610
232,885
25,361

204,905
75,903
70,927
242,552
26,311

South Carolina
South Dakota
Tennessee
Texas
Utah

78,701
9,399
116,861
234,169
10,263

95,970
12,346
148,391
314,991
13,506

104,111
12,791
171,653
339,648
14,900

110,032
13,112
178,707
350,959
15,569

112,232
13,146
182,342
360,191
16,231

116,288
13,237
184,570
370,598
16,712

118,635
13,542
187,438
380,954
17,497

117,997
14,231
203,567
410,248
18,548

118,393
14,045
208,678
423,560
19,361

118,843
14,534
218,894
440,938
21,787

8,223
77,898
54,774
28,086
67,516
3,505

12,428
102,964
71,531
39,720
75,247
5,265

13,197
108,427
89,419
43,019
74,429
5,963

13,598
111,404
91,976
45,406
74,681
6,183

13,754
113,259
97,390
46,305
74,101
6,444

14,296
113,898
94,852
47,774
73,875
6,746

14,650
116,496
99,552
47,547
75,179
7,087

15,016
120,711
105,516
50,008
78,124
7,422

15,079
124,996
108,780
51,365
79,889
7,454

15,509
131,083
113,233
54,200
83,383
7,749

443
273
727

669
314
219

650
311
199

583
335
207

417
342
204

385
367
210

339
372
206

339
358
194

375
340
178

409
358
165

Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Outlying areas
Guam
Northern Mariana Islands
Virgin Islands

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.

Annual Statistical Supplement, 2005 ♦ 8.25