Processing and validation of inpatient Medicare Advantage data for use in hospital outcome measures.

ABSTRACT:

Objective

To determine the feasibility of integrating Medicare Advantage (MA) admissions into the Centers for Medicare & Medicaid Services (CMS) hospital outcome measures through combining Medicare Advantage Organization (MAO) encounter- and hospital-submitted inpatient claims.

Data sources and study setting

Beneficiary enrollment data and inpatient claims from the Integrated Data Repository for 2018 Medicare discharges.

Study design

We examined timeliness of MA claims, compared diagnosis and procedure codes for admissions with claims submitted both by the hospital and the MAO (overlapping claims), and compared demographic characteristics and principal diagnosis codes for admissions with overlapping claims versus admissions with a single claim.

Data collection/extr

SUBMITTER: Kyanko KA 

PROVIDER: S-EPMC11622257 | biostudies-literature | 2024 Dec

REPOSITORIES: biostudies-literature