What does the Centers for Medicare and Medicaid Services do?

Updates published annually

The Centers for Medicare and Medicaid Services (CMS) is a subdivision of the Department of Health and Human Services responsible for administering the nation’s major healthcare programs including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The agency ensures that beneficiaries have access to high-quality healthcare services while also working to improve the efficiency and effectiveness of healthcare delivery. It was established in 1965.

In FY 2024,

$1.52T

was spent by the Centers for Medicare and Medicaid Services

In FY 2024,

88.6%

of Dept. of Health and Human Services spending was by the Centers for Medicare and Medicaid Services

How much does the Centers for Medicare and Medicaid Services spend?

The Centers for Medicare and Medicaid Services spent a net total of $1.52 trillion in fiscal year (FY) 2024. This was 88.6% of the $1.72 trillion spent by the Department of Health and Human Services, which itself was 25.4% of all federal spending. The CMS ranked first among HHS subdivisions in net spending.

Net spending is the difference between agency spending and any financial accounts generating funds from the agency’s own activities, like fees or rent. When these funds offset all spending, net spending appears negative. Some agencies tend to operate with positive net spending while others will register negative net spending sometimes or often.

The Centers for Medicare and Medicaid Services ranked first among Department of Health and Human Services divisions in net spending in 2024.

HHS net spending by division, FY 2024

Like the overall federal budget, agency spending may shift over time due to population growth, changes in policy and programs, and emerging problems to address. Adjusting for inflation, the Centers for Medicare and Medicaid Services’ federal spending has increased from $179.8 billion in 1980 to $1.52 trillion in 2024.

The Centers for Medicare and Medicaid Services’s federal spending in FY 2024 was higher than in FY 1980.

Yearly federal net spending by CMS, adjusted for inflation (2024 dollars), FYs 1980–2024

Since 1980, the Centers for Medicare and Medicaid Services' spending has increased 747.4%, while overall spending has increased 193.7%.

As a percentage of the overall federal budget, a positive number means agency net spending made up some positive share of total federal spending; a negative number means that net generated funds offset a portion of total spending. CMS spending grew more than overall federal spending since 1980, which means that its share of the federal budget increased. In 2024, CMS accounted for 22.5% of overall federal spending.

Major legislation, internal or global economic conditions, and acute events like the COVID-19 pandemic can affect spending year to year. For example, the federal budget fluctuated during the pandemic, rising from $5.3 trillion (in 2023 dollars) in 2019 to $7.7 trillion in 2020 and $7.8 trillion in 2021.

The Centers for Medicare and Medicaid Services’s share of federal spending in FY 2024 was higher than in FY 1980.

Net spending by CMS as a share of federal spending, FYs 1980–2024

Most federal spending can be categorized as direct or indirect. Direct spending refers to money the federal government spends on budget items such as federal programs, employee salaries, and debt interest. Indirect spending refers to federal transfers to state and local governments.

In FY 2024, the Centers for Medicare and Medicaid Services transferred 41.9% of its total spending to states and local governments.

The chart below outlines all net CMS spending.

How did the Centers for Medicare and Medicaid Services spend its budget in 2024?

Federal government net spending isolated to CMS, FY 2024

How many people work for the Centers for Medicare and Medicaid Services?

Some 6,557 of the 2.31 million total civilian federal employees work for the Centers for Medicare and Medicaid Services as of September 2024. This is 34.2% more people than the division staffed in 2010.

The number of federal employees working for the Centers for Medicare and Medicaid Services has increased 34.2% since 2010.

Number of federal employees working for CMS, September 2010–2024

The Centers for Medicare and Medicaid Services accounts for 0.3% of the overall federal workforce. As the number of federal employees has changed, so too has the way the workforce is organized, with resources allocated to agencies depending on government priorities. The division constituted a larger share of the overall federal workforce in September 2024 compared to 2010 (0.2%).

While the number of employees on an agency’s payroll contributes to that agency’s expenditures, some agencies have relatively few employees compared to their budget or vice versa, giving them an outsized share of either the budget or the workforce. According to the most recent data, the Centers for Medicare and Medicaid Services' share of the workforce (0.3%) is smaller than its share of the budget (22.5%).

Who leads the Centers for Medicare and Medicaid Services?

The CMS is led by an administrator. This individual is nominated by the President of the United States and requires confirmation by the Senate. The CMS administrator reports to the Secretary of Health and Human Services. There is no fixed term for this position.

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Methodology

USAFacts standardizes data, in areas such as time and demographics, to make it easier to understand and compare.

Page sources

USAFacts endeavors to share the most up-to-date information available. We sourced the data on this page directly from government agencies; however, the intervals at which agencies publish updated data vary.

Office of Personnel Management
FedScope
Office of Management and Budget and US Department of the Treasury
Budget of the US Government and Monthly Treasury Statement