Healthcare — medical services
Physician (CMS Physician Fee Schedule CPTs) + hospital outpatient (CMS OPPS APC rates) + dental & vision (MEPS survey-weighted out-of-pocket), Carli-averaged. PFS/OPPS are administered Medicare prices — a documented proxy that understates private prices.
Sources
Precedence ladder for healthcare — medical services. Lower precedence wins where multiple sources cover the same period. The engine walks the ladder per period with chain-link rescale at source transitions.
| Precedence | Source | Series ID | Cadence | Geography |
|---|---|---|---|---|
| 0 | CMS Physician Fee Schedule | cms_pfs_99213_non_facility | annual | national |
| 0 | CMS Physician Fee Schedule | cms_pfs_99214_non_facility | annual | national |
| 0 | CMS Physician Fee Schedule | cms_pfs_99203_non_facility | annual | national |
| 0 | CMS Physician Fee Schedule | cms_pfs_99283_facility | annual | national |
| 0 | CMS Physician Fee Schedule | cms_pfs_93000_non_facility | annual | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_45378_colonoscopy | — | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_66984_cataract | — | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_43239_egd_biopsy | — | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_70553_mri_brain | — | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_93306_echo | — | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_99284_ed_visit | — | national |
| 0 | CMS Hospital Outpatient PPS (Addendum B) | cms_opps_64483_epidural | — | national |
| 0 | AHRQ Medical Expenditure Panel Survey (MEPS-HC) | meps_dental_visit | — | national |
| 0 | AHRQ Medical Expenditure Panel Survey (MEPS-HC) | meps_vision_eyewear | — | national |
Weight across archetypes
How healthcare — medical services is weighted in each of the 10 published archetypes. Sorted by weight, highest first. National Average is the headline citation surface.
| Archetype | Weight | Action |
|---|---|---|
| Retiree | 5.5422% | View archetype → |
| Income — Second Quintile | 2.9947% | View archetype → |
| Income — Lowest Quintile | 2.9322% | View archetype → |
| Homeowner | 2.8634% | View archetype → |
| National Average | 2.4980% | View archetype → |
| Income — Middle Quintile | 2.4785% | View archetype → |
| Income — Fourth Quintile | 2.4699% | View archetype → |
| Income — Highest Quintile | 2.3226% | View archetype → |
| Working Parent | 1.8609% | View archetype → |
| Renter | 1.6174% | View archetype → |
Substitution history
Substitution log entries that touched this stratum. Each entry
bumps the basket version and is reproducible from observations
tagged with their basket_version.
2026-06-29 — Healthcare out-of-pocket split into rx_drugs + medical_services
Version: methodology 2.0.5 → 2.1.0
What changed. The single healthcare_oop stratum (5 generic drugs + 2 physician CPT codes) was split into rx_drugs (12 generic prescription molecules at NADAC acquisition cost) and medical_services (physician CMS PFS + hospital outpatient CMS OPPS + dental and vision from MEPS survey-weighted out-of-pocket). The prior weight was divided by the CEX-2000 out-of-pocket shares — drugs 38.4%, medical services 61.6% — preserving each archetype's total exactly. Strata count 15 → 16.
Why. The old stratum was both too narrow and conceptually wrong. The fixed good for a drug is the therapeutic MOLECULE: an FDA-bioequivalent generic is the same good, not a cheaper substitute, so tracking molecules at prevailing generic prices is correct — and it means 2000's drugs honestly DEFLATE (−3.7%/yr) as generics matured. (An earlier brand-only basket was built and rejected: it measured the price a brand-loyalist would pay for a label, which no household experiences.) The real defect was breadth — dental, vision, broad physician and hospital care were all missing, and those inflate (+3.0%/yr).
Effect on headline. National Average headline 3.56 → 3.59%/yr; Retiree 3.31 → 3.39%/yr. Two limits are disclosed rather than engineered away: CMS PFS/OPPS are administered Medicare prices, so medical_services is a floor relative to private prices; and a fixed-2000 basket structurally cannot contain drugs that did not exist in 2000 (biologics, GLP-1s), so rx_drugs shows 2000's drugs getting cheaper while real pharmacy spending rose. That gap is the fixed-basket premise's limit, carried by the chained companion.
Methodology
See the basket page for all 17 strata and the per-stratum source map. The methodology page covers the load-bearing pillars including the rules around source-precedence ladders, chain-link splicing at source transitions, and the no-fabricated-data invariant.