Title: |
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Validating the Collection of Separately Billed Doctor Expenditures for Hospital Services: Results from the Medicare-MEPS Validation Study |
Description: |
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The Medicare-MEPS Validation Study uses Medicare claims for a subset of beneficiaries in the 2001-2003 MEPS Public Use Files to evaluate the quality of use and expenditure data collected in the MEPS. In this part of the study, we focus entirely on the quality of separately billed doctor (SBD) expenses associated with inpatient, emergency department, and outpatient department services. We first compare CMS claims data to MEPS estimates of SBD expenditures in aggregate for all hospital events identified by households and medical providers in the MEPS. The MEPS estimates of SBD expenditures are approximately 2-5 percent lower than the amounts reported on the Medicare Part B claims for reimbursement of physicians' services associated with hospital services for the matched subset of beneficiaries. We next compare facility and SBD expenditures for household-reported hospital events with an exact match to a CMS hospital claims record. These matched pair analyses also show SBD expenditures lining up well between MEPS and the CMS claims, particularly for hospital stays. Based on the aggregate and matched pair analyses, we conclude that the current SBD data collection process produces accurate information on expenditures for doctors who bill separately from hospitals for their services. Additional analyses suggest some potential for streamlining the SBD data collection process for certain types of outpatient department visits that infrequently have SBD expenses associated with them. |
Author(s): |
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Samuel Zuvekas and Gary Olin |
Agency: |
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Rockville (MD): Agency for Healthcare Research and Quality |
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