Implementation of resource use measures in Medicare Advantage.

ABSTRACT:

Objective

To complement the previously illustrated method to measure resource use in Medicare Advantage (MA) using Encounter data and provide technical details and SAS code to validate Encounter data and implement resource use measures in MA.

Data sources

2015-2018 MA Encounter, Medicare Provider Analysis and Review (MedPAR), Healthcare Effectiveness Data and Information System (HEDIS), and Traditional Medicare (TM) claims data.

Study design

Secondary data analysis.

Data collection/extraction methods

We select MA contracts with high data completeness (≤10% missing hospital stays in Encounter data and ≤±10% difference in ambulatory and emergency department visits between Encounter and HEDIS data). We randomly sample TM beneficiaries with a similar geographic dis

SUBMITTER: Jung J 

PROVIDER: S-EPMC10501335 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature