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Medicare Advantage & Part DSource-backed product
Medicare Advantage Plan Payments & Bids
The money side of Medicare Advantage: what Medicare pays each plan per member, plan risk scores and rebates, and how efficiently plans spend premium dollars on care versus admin and profit. Used to understand plan revenue and margins.
What Vlada adds: Preserves the publisher data, normalizes schema eras and identifiers, and connects the product to compatible healthcare entities with measured join coverage.
- rows
- 387.7K
- rows
- datasets
- 4
- datasets
- cadence
- annual
- cadence
- coverage
- 2006-2024
- coverage
Publishers: Centers for Medicare & Medicaid Services
What's inside
MA plan payment — county rollup
CMS county-level summary of MA Part C payments and risk: average PMPM federal payment, average risk score, and average rebate dollars, broken out by county, plan type, and SNP type.
grain: One row per (payment_year, ssa_county_code, plan_type, snp_plan_type). 140,291 rows, 2015-2024.
232.4K rows
MA plan payment — Part D (plan x year)
CMS Part D plan-payment reference: per plan+year averages of the federal subsidies CMS pays each MA-PD / standalone PDP (avg_direct_subsidy, avg_reinsurance, avg_low_income_cost_sharing) plus the plan's average Part D risk score (avg_part_d_risk_score).
grain: One row per (payment_year, contract_id, plan_id). 48,455 rows, 2015-2024.
84.5K rows
MA plan payment — Part C (contract x plan x year)
CMS Part C plan-payment summary: per MA contract+plan+year, the average risk-adjusted A/B payment per member per month (avg_ab_pmpm_payment), the average enrollee risk score (avg_part_c_risk_score), and the average rebate PMPM (avg_rebate_pmpm_payment).
grain: One row per (payment_year, contract_id, plan_id). 40,014 rows, 2015-2024.
65.9K rows
MA / Part-D Medical Loss Ratio (MLR)
The contract-level efficiency / profitability lens: adjusted_mlr (share of revenue spent on care + quality improvement vs admin/profit), remittance_amount (owed to CMS for missing the 0.85 floor), and in detailed years total_revenue, total_claims, member_months, the MLR numerator/denominator, and an incurred-claims split by supplemental benefit.
grain: One row per (contract_id, contract_year). CMS MA/Part-D Medical Loss Ratio Public Use File, 4,984 rows across 2014-2023. Contract-level (no plan grain).
5.0K rows