Chronic Conditions PUF

This release contains the Chronic Conditions Public Use Files (PUF) with information from Medicare claims. The CMS Chronic Conditions PUF is an aggregated file in which each record is a profile or cell defined by the characteristics of Medicare beneficiaries. A profile is defined by all combinations of age category, gender, various chronic conditions, and dual-eligibility status of the beneficiaries. Hence, the number of rows (or records) in a CMS Chronic Conditions PUF represents the number of unique profiles in the Medicare population. For each profile many claim-related variables are provided in the form of averages.

The CMS Chronic Conditions PUF represents 100% of the Medicare beneficiaries provided in the 100% Beneficiary Summary File for each reference year. The 100% Beneficiary Summary File is created annually and contains demographic, entitlement and enrollment data for beneficiaries who were: documented as being alive for some part of the reference year of the Beneficiary Summary File, are entitled to Medicare benefits during the reference year, and enrolled in Medicare Part A and/or Part B for at least one month in the reference year.

The CMS Chronic Conditions PUF provides various measures of utilization as averages for different groups of Medicare beneficiaries, or profiles. The 100% Beneficiary Summary File contains approximately 48 million beneficiaries, all of whom are represented in the PUF. As a result, the PUF provides utilization measures for Medicare beneficiaries who are enrolled in Fee-for-Service (FFS) plans. The averages are calculated for different types of Medicare beneficiaries by months of enrollment. Beneficiaries with 12 months of enrollment in FFS Part A or Part B are separated from beneficiaries with less than 12 months of enrollment.

In addition to the General documentation file, there are two documentation files for each Chronic Conditions PUF:

1. The data dictionary and codebook file contains information about each variable on the file and its values.
2. A data users document which gives the file layout for the downloadable CSV file, as well as SAS program code for creating a SAS dataset with variable formats.