{
 "id": "cms:5f9f1216-6fd9-455d-bfbc-0efade687a4e",
 "slug": "county-level-aggregate-expenditure-and-risk-score-data-on-assignable-beneficiaries",
 "source": "data.cms.gov",
 "title": "County-level Aggregate Expenditure and Risk Score Data on Assignable Beneficiaries",
 "summary": "The Shared Savings Program County-level Aggregate Expenditure and Risk Score Data on Assignable Beneficiaries Public Use File (PUF) for the Medicare Shared Savings Program (Shared Savings Program) provides aggregate...",
 "description": "The Shared Savings Program County-level Aggregate Expenditure and Risk Score Data on Assignable Beneficiaries Public Use File (PUF) for the Medicare Shared Savings Program (Shared Savings Program) provides aggregate data consisting of per capita Parts A and B FFS expenditures, average CMS-HCC prospective risk scores and total person-years for Shared Savings Program assignable beneficiaries by Medicare enrollment type (End Stage Renal Disease (ESRD), disabled, aged/dual eligible, aged/non-dual eligible). DISCLAIMER: This information is current as of the last update. Changes to Shared Savings Program Accountable Care Organization (ACO) information occur periodically. Each Shared Savings Program ACO has the most up-to-date information about their organization. Consider contacting the Shared Savings Program ACO for the latest information. Contact information is available in the ACO PUF and the ACO Participants PUF.",
 "aliases": [],
 "keywords": [
  "Counties",
  "Medicare",
  "Original Medicare",
  "Value-Based Care",
  "Coordinated Care",
  "Financials",
  "Payment Models",
  "Accountable Care Organizations"
 ],
 "themes": [
  "Medicare"
 ],
 "topics": [
  "spending-utilization",
  "quality",
  "aco-value-based"
 ],
 "category": "medicare-shared-savings-program",
 "publisher": "Office of Enterprise Data and Analytics (OEDA)",
 "contact": "SharedSavingsProgram@cms.hhs.gov",
 "landing_url": "https://data.cms.gov/medicare-shared-savings-program/county-level-aggregate-expenditure-and-risk-score-data-on-assignable-beneficiaries",
 "csv_url": "https://data.cms.gov/sites/default/files/2026-07/90ab6d99-1e6f-46af-9a88-dbbaf1fa7505/FFS_Data_for_SSP_CRB_PUF_2025_01_01_Cal_Year_Assignable_2025_2026_Starters.csv",
 "api_url": "https://data.cms.gov/data-api/v1/dataset/5f9f1216-6fd9-455d-bfbc-0efade687a4e/data",
 "api_kind": "cms-data-api",
 "preview_url": "https://data.cms.gov/data-api/v1/dataset/5f9f1216-6fd9-455d-bfbc-0efade687a4e/data?size=10",
 "dictionary_url": "https://data.cms.gov/resources/county-level-aggregate-expenditure-and-risk-score-data-on-assignable-beneficiaries-data-dictionary-0",
 "dictionary_kind": "page",
 "methodology_urls": [
  "https://data.cms.gov/resources/county-level-aggregate-expenditure-and-risk-score-data-on-assignable-beneficiaries-methodology"
 ],
 "state_column": "STATE_NAME",
 "row_count": 3226,
 "posted": "2026-07-14",
 "modified": "2026-07-14",
 "period_start": "2019-01-01",
 "period_end": "2025-12-31",
 "latest_period": "2025-01-01 to 2025-12-31",
 "cadence": "annually",
 "next_update": null,
 "versions": [
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  },
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   "posted": "2026-07-14",
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   "posted": "2026-07-14",
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  },
  {
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   "uuid": "0cff0290-90f1-4e8a-b8cd-d09d9da60ebb",
   "posted": "2026-07-14",
   "period_start": "2021-01-01",
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  },
  {
   "label": "2020-01-04",
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   "posted": "2026-07-14",
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   "period_end": "2020-12-31"
  },
  {
   "label": "2019-01-04",
   "uuid": "1878d362-3fc0-4463-948c-9229c1344667",
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 ],
 "columns": [
  {
   "name": "YEAR",
   "label": "Year",
   "type": "number",
   "meaning": "Calendar year for which assignable beneficiaries are determined and per capita expenditures, average risk scores, and person-years are calculated.",
   "source": "cms-dictionary"
  },
  {
   "name": "STATE_NAME",
   "label": "State name",
   "type": "string",
   "meaning": "State name.",
   "source": "cms-dictionary"
  },
  {
   "name": "COUNTY_NAME",
   "label": "County name",
   "type": "string",
   "meaning": "County name.",
   "source": "cms-dictionary"
  },
  {
   "name": "STATE_ID",
   "label": "State ID",
   "type": "string",
   "meaning": "SSA state code. Note that this code should always include two numeric characters, though leading zeros may be dropped when opening the files in some programs (e.g. a value of “01” may appear as “1”).",
   "source": "cms-dictionary"
  },
  {
   "name": "COUNTY_ID",
   "label": "County ID",
   "type": "string",
   "meaning": "SSA county code. Note that this code should always include three numeric characters, though leading zeros may be dropped when opening the files in some programs (e.g. a value of “001” may appear as “1”).",
   "source": "cms-dictionary"
  },
  {
   "name": "PER_CAPITA_EXP_ESRD",
   "label": "Per capita ESRD expenditures",
   "type": "number",
   "meaning": "Annualized, truncated, weighted mean total expenditures per ESRD assignable beneficiary person year in the county. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_RISK_SCORE_ESRD",
   "label": "Average ESRD CMS HCC risk score",
   "type": "number",
   "meaning": "Final, mean prospective CMS-HCC risk score for assignable beneficiaries in ESRD enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable ESRD population equals 1.0. See parameters sheet for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_DEMOG_SCORE_ESRD",
   "label": "Average ESRD Demographic Risk Score",
   "type": "number",
   "meaning": "Final, mean demographic risk score for assignable beneficiaries in ESRD enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable ESRD population equals 1.0. See parameters sheet for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PERSON_YEARS_ESRD",
   "label": "ESRD person-years",
   "type": "number",
   "meaning": "Number of assignable beneficiaries with ESRD enrollment type in the county, adjusted for the total number of months that each beneficiary was classified as ESRD and was enrolled in Part A and Part B and was not enrolled in a Medicare Group Health Plan. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PER_CAPITA_EXP_DIS",
   "label": "Per capita DISABLED expenditures",
   "type": "number",
   "meaning": "Annualized, truncated, weighted mean total expenditures per DISABLED assignable beneficiary person year in the county. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_RISK_SCORE_DIS",
   "label": "Average DISABLED CMS HCC risk score",
   "type": "number",
   "meaning": "Final, mean prospective CMS-HCC risk score for assignable beneficiaries in DISABLED enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable DISABLED population equals 1.0. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_DEMOG_SCORE_DIS",
   "label": "Average DISABLED Demographic Risk Score",
   "type": "number",
   "meaning": "Final, mean demographic risk score for assignable beneficiaries in DISABLED enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable DISABLED population equals 1.0. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PERSON_YEARS_DIS",
   "label": "DISABLED person-years",
   "type": "number",
   "meaning": "Number of assignable beneficiaries with DISABLED enrollment type in the county, adjusted for the total number of months that each beneficiary was classified as DISABLED and was enrolled in Part A and Part B and was not enrolled in a Medicare Group Health Plan. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PER_CAPITA_EXP_AGDU",
   "label": "Per capita AGED/DUAL expenditures",
   "type": "number",
   "meaning": "Annualized, truncated, weighted mean total expenditures per AGED/DUAL assignable beneficiary person year in the county. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_RISK_SCORE_AGDU",
   "label": "Average AGED/DUAL CMS HCC risk score",
   "type": "number",
   "meaning": "Final, mean prospective CMS-HCC risk score for assignable beneficiaries in AGED/DUAL enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable AGED/DUAL population equals 1.0. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_DEMOG_SCORE_AGDU",
   "label": "Average AGED/DUAL Demographic Risk Score",
   "type": "number",
   "meaning": "Final, mean demographic risk score for assignable beneficiaries in AGED/DUAL enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable AGED/DUAL population equals 1.0. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PERSON_YEARS_AGDU",
   "label": "AGED/DUAL person-years",
   "type": "number",
   "meaning": "Number of assignable beneficiaries with AGED/DUAL enrollment type in the county, adjusted for the total number of months that each beneficiary was classified as AGED/DUAL and was enrolled in Part A and Part B and was not enrolled in a Medicare Group Health Plan. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PER_CAPITA_EXP_AGND",
   "label": "Per capita AGED/NON-DUAL expenditures",
   "type": "number",
   "meaning": "Annualized, truncated, weighted mean total expenditures per AGED/NON-DUAL assignable beneficiary person year in the county. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_RISK_SCORE_AGND",
   "label": "Average AGED/NON-DUAL CMS HCC risk score",
   "type": "number",
   "meaning": "Final, mean prospective CMS-HCC risk score for assignable beneficiaries in AGED/NON-DUAL enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable AGED/NON-DUAL population equals 1.0. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "AVG_DEMOG_SCORE_AGND",
   "label": "Average AGED/NON-DUAL Demographic Risk Score",
   "type": "number",
   "meaning": "Final, mean demographic risk score for assignable beneficiaries in AGED/NON-DUAL enrollment type in the county, based on the applicable risk adjustment model for that year, renormalized so that the mean national FFS risk score for the assignable AGED/NON-DUAL population equals 1.0. See parameters and notes for further details.",
   "source": "cms-dictionary"
  },
  {
   "name": "PERSON_YEARS_AGND",
   "label": "AGED/NON-DUAL person-years",
   "type": "number",
   "meaning": "Number of assignable beneficiaries with AGED/NON-DUAL enrollment type in the county, adjusted for the total number of months that each beneficiary was classified as AGED/DUAL and was enrolled in Part A and Part B and was not enrolled in a Medicare Group Health Plan. See parameters and notes for further details.",
   "source": "cms-dictionary"
  }
 ],
 "caveats": [],
 "curated": false,
 "license": "https://www.usa.gov/government-works",
 "detail_key": "d0919fbf-3841-46c7-bb87-1ff50bd8b734|2026-07-14",
 "checked": "2026-10-25",
 "source_name": "data.cms.gov"
}