Intermediate

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."

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.