Redaction of Substance Abuse Claims in Medicare Research Files Affects Spending Outcomes for Nearly One in Five Beneficiaries with Serious Mental Illness.

ABSTRACT:

Objective

To assess the impact of substance abuse claims redaction on Medicare spending estimates for beneficiaries with serious mental illness.

Data sources

The 2012 claims and unredacted beneficiary-level Medicare spending totals from CMS's Chronic Conditions Warehouse.

Study design

We identified beneficiaries with claims affected by the redaction by comparing claims-based spending estimates to unredacted spending totals. Differences in characteristics of beneficiaries with and without redacted claims were examined in bivariate analyses.

Principal findings

Claims-based spending totals differed from unredacted totals for 19.7 percent of the cohort. Part A spending for those with redacted claims was underreported by 57.0 percent. Characteristics of beneficiarie

SUBMITTER: Roberto P 

PROVIDER: S-EPMC5441491 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature