# MACStats data coverage and methods

Reviewed September 5, 2026.

The explorer uses MACStats' published categories and reports differences between category sums and reported totals. Source values, definitions, and workbook references remain available.

## What was verified

| Check | Result |
| --- | --- |
| Published-source inventory | 18 archived editions and 51 current exhibits; 8 current exhibits are PDF-only |
| Downloaded source files | All 61 Excel/ZIP files match their recorded SHA-256 checksums |
| Workbook coverage | 499 workbooks, 864 profiled worksheets, 783 retained tables, 67 series |
| Direct source-value audit | All 288,783 worksheet observations and 270 embedded-chart observations match their source values |
| All-vintage observations | 289,053, unchanged |
| Revised latest-vintage observations | 229,084; the earlier output contained 220,105 |
| Website snapshot | 84,726 rows, 19 datasets |
| Category explorer | 855 geography-year records covering FY2010–2024 |
| Calculations | Existing unit, period, PMPM, missing-value, and export-data checks pass; category reconciliation, roll-up, share, and PMPM tests pass |

The source inventory was checked against the current [MACStats archive](https://www.macpac.gov/publication/macstats-archive/) and [compiled exhibit list](https://www.macpac.gov/publication/macstats-compiled/). Source-file integrity checks refer to the downloaded snapshot; the review did not replace all source downloads with newly fetched copies.

## Corrections to the compilation

- **Dollar amounts and percentage shares:** Some exhibits give both under the same reconstructed header. Latest-vintage selection now includes source unit and data source in its identity, preserving those distinct observations.
- **Mixed units:** Explicit percentage formats and count/dollar columns take priority over a percentage-oriented exhibit title. Enrollment counts and dollar-denominated income tables are no longer classified as percentages merely because the title mentions percentages.
- **Period inference:** A year written as a row label is no longer automatically treated as a fiscal year. Calendar-year national health expenditure series retain calendar-year interpretation unless the historical source explicitly says otherwise.
- **Subtotal rows:** Recognized subtotals and percentage-of-total rows are excluded by the reporting-row flag. That flag remains a row filter, not a guarantee that all remaining columns or categories may be added together.
- **Source attribution:** Explicit source notes take priority over methodological comparisons that mention other datasets. For example, the benefit-category table identifies CMS-64 as its source even though its notes discuss differences from T-MSIS.
- **Territory labels:** The abbreviated Northern Mariana Islands label is recognized as a geography.

The revised pipeline and its regression checks are included in the source package. Raw source values, workbook references, worksheet names, and source cells remain available.

## Website data and PMPM

The Full tidy CSV button serves `macstats_tidy_reviewed.csv`, the dataset used by the main explorer.

State PMPM divides annual spending by same-state, same-fiscal-year FYE enrollment × 12. National PMPM divides summed spending by summed member months for the same matched states and D.C.

## Expenditure categories

The new section follows [MACStats Exhibit 17](https://www.macpac.gov/publication/total-medicaid-benefit-spending-by-state-and-category/) and its historical equivalents.

| Roll-up | Components |
| --- | --- |
| Fee for service | Hospital; physician; dental; other practitioner; clinic and health center; other acute; drugs; institutional LTSS; home- and community-based LTSS |
| Managed care and premium assistance | Published managed-care category, including its own rebate treatment |
| Medicare premiums and coinsurance | Published category |
| Collections | Published signed amounts, retained separately |

Users can switch between the roll-up and report detail; select a state, territory, or national total; view nominal dollars, shares excluding collections, or program PMPM; follow a category over time; and export the selected geography across all available years with sources and reconciliation differences.

Total benefit spending is not added as a category. Supplemental payments from other exhibits are not added again. Managed-care payments are not redistributed to fee-for-service categories. Shares use reported total benefit spending minus collections, matching the report's denominator. Negative values remain negative.

Automatic PMPM uses available state FYE data for FY2013–2014 and FY2018–2023. Missing matching enrollment remains unavailable. The national category PMPM uses one common set of jurisdictions across every category and the total. Dollar and share views instead use the reported U.S. row including territories.

The category extractor interprets 60 historical dashes as zero only where the workbook notes explicitly establish that meaning. Other ambiguous dashes remain unavailable. Historical labels and classification changes are retained: FY2011–2012 crosses changes affecting hospital, institutional LTSS, HCBS, other acute, and managed-care drug rebates. These are not constant-definition service trends.

## Published discrepancies retained

In the FY2024 source table:

| Geography | Reported benefit total | Sum of categories, including collections | Total less sum |
| --- | ---: | ---: | ---: |
| North Carolina | $28,887,230,741 | $28,720,948,949 | $166,281,792 |
| United States | $908,839,083,557.10 | $908,672,800,917.10 | $166,282,640 |

The explorer reports these differences without assigning them to a service. Other years can also have source rounding or small discrepancies. The source values and categories are from the [published FY2024 exhibit](https://www.macpac.gov/wp-content/uploads/2026/01/EXHIBIT-17.-Total-Medicaid-Benefit-Spending-by-State-and-Category-FY-2024.pdf) and its corresponding workbook.

## Limits of the review

This was a complete source-value and structural audit, with focused semantic checks and repairs. It does not certify every historical header, survey definition, period, population, or cross-year comparison as harmonized. Some older national health expenditure titles explicitly say FY despite the calendar-year nature of the broader series; those source labels are retained for review. Consult source notes before combining series or interpreting a trend across methodology changes.

The main website snapshot covers 19 datasets; the full reference package covers 67 series. The eight current PDF-only exhibits remain documented as unavailable in Excel. They are not silently fabricated or represented as newly extracted spreadsheet data.

Website verification used source inspection, JavaScript checks, local-asset and control-reference checks, and calculation tests. This buildless static project has no supported agent browser preview in this environment, so live browser interaction and visual rendering were not verified.
