Analytic Guidance

This webcast reviews the access and use of Medicare data for research on emergency medicine, including strengths and limitations, examples, and relevant contextual information.

NOTE: As of 4/26/18, the Medicare Encounter data (Part C) are available beginning with calendar year 2015.

This presentation defines the different types of cost-to-charge ratios (CCRs), how to use these CCRs, and the locations of the CCRs in the data files.  The segment walks through an example of how to apply CCRs to adjust charges in order to arrive at an estimated "cost."

This presentation describes where to find the Medicare cost report downloads, what is contained within each data file, and the definitions used to create the download. This presentation includes a description of the resource documents that are essential in order to start using the data.

The Medicare cost reports can be downloaded from the CMS website.  CMS provides several documents to aid with the use of the cost reports. This presentation describes each resource and explains how to use each.  Also, it provides links to other important resource documents that will help researchers understand and use the Medicare cost reports.

For each of the CMS claim file types, the variables used in calculating costs for CMS covered services is reviewed. Calculations are defined by 1) what Medicare reimbursed; 2) the beneficiary's responsibility; 3) other primary payers, and then 4) total due to the provider. The presentation also includes issues to be considered when calculating costs.

Understanding of the CMS payment systems will assist the researcher in knowing how services are reiumbursed and what to expect in the data when costing services. This presentation will provide a historical review of CMS payment systems for all the claims data files, discuss details of calculating acute hospital MS-DRG payments, and review resources for determining 'cost' of services.

This presentation provides an overview of the types of economic evaluations in health care, the various economic perspectives studies can have, whose costs and benefits should be considered, and what measures of costs and effectiveness can be derived from Medicare datasets.

Specifically, objectives include: