Introduction to CMS Data 02/28/2013 Presented by Erin Mann, ResDAC - - PowerPoint PPT Presentation

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Introduction to CMS Data 02/28/2013 Presented by Erin Mann, ResDAC - - PowerPoint PPT Presentation

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Introduction to CMS Data 02/28/2013 Presented by Erin Mann, ResDAC Technical Advisor About ResDAC Centers for Medicare and Medicaid (CMS) contractor Offer free assistance to researchers interested in using Medicare and Medicaid data for

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Introduction to CMS Data

02/28/2013

Presented by Erin Mann, ResDAC Technical Advisor

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About ResDAC

  • Centers for Medicare and Medicaid (CMS)

contractor

  • Offer free assistance to researchers interested in

using Medicare and Medicaid data for research

  • Staffed by a team of public health and health

services research specialists

  • Provide a range of services related to CMS data

˗ Assistance Desk ˗ Workshops and Outreach

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CMS Data – Where to Start?

  • Nearly 100 data files that can be requested or

downloaded

  • Many other resources on the CMS website

including summary statistics, reports, and payment system methodology files

  • Often difficult for both new and seasoned CMS

data users to know where to start

  • ResDAC is here

re to help. p.

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Overview of CMS Data Files

  • Goals for today

˗ Provide an overview of how data files are classified ˗ Requirements for release ˗ Examples of data files ˗ Information about accessing data files

  • More detailed information about data file

contents will be presented at later webinars

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CMS Data File Privacy Levels

  • All CMS data files are organized into three privacy

levels.

˗ Non-identifiable or Public Use (PUF) ˗ Limited Data Sets (LDS) ˗ Research Identifiable (RIF)

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Non-Identifiable Data

  • Also known as Public Use Files (PUFs)
  • Files have been edited and stripped of all

information that could be used to identify beneficiaries

  • The files contain aggregate level data on Medicare

beneficiary or provider utilization

  • Some files contain no utilization information, but

include characteristics about providers

What are non-identifiable files?

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Non-Identifiable Data

  • Provider of Services File

˗ Information about institutional providers ˗ Name, facility characteristics

  • Part B Summary Files

˗ Organized by procedure code ˗ Total procedures billed, payment amounts

  • Medicare Cost Reports

˗ Annual reports submitted to CMS ˗ Utilization statistics, costs, charges, financial information

What are examples of non-identifiable data?

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Non-Identifiable Data

  • Access will depend on the file, but data can either

be downloaded for free from the CMS website OR purchased and the data will be sent on hard media

  • Non-identifiable data can also be shared
  • No data use agreement is required

How can I access non-identifiable data?

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Limited Data Sets (LDS)

  • LDS data contain beneficiary level data
  • Files include protected health information, but

selected variables have been removed, encrypted, or ranged

˗ No zip code, only state or county ˗ No exact DOB, either age year of 5-year range ˗ No true physician identifiers; institutional facilities CAN be identified

  • Only available as standard extracts

˗ 5% random sample or 100% files (depends on file) ˗ Not possible to customize based on geography, diagnosis/procedures codes, or researcher-submitted identifiers (Medicare numbers, SSNs for known cohort)

What are LDS files?

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Limited Data Sets (LDS)

  • Standard Analytic Files (SAFs)

˗ Fee-for-service claims data ˗ Files organized by utilization type

  • Denominator File

˗ Demographic and enrollment information ˗ Often used with the SAFs

  • MedPAR

˗ Separate files for hospital, SNF, and LTCH ˗ Cannot be linked to the SAFs

  • Medicare Current Beneficiary Survey (MCBS)

What are examples of LDS files?

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Limited Data Sets (LDS)

  • Requestors must submit an application to

establish a Data Use Agreement (DUA)

˗ New Use – purchase the data new ˗ Reuse – request to use data already at your

  • rganization for a new purpose
  • Applications involve 4 documents
  • Requests typically take up to 8 weeks to process
  • Wide range of data uses

How can I access LDS files?

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Research Identifiable Files (RIF)

  • RIF data contain beneficiary level protected health

information

˗ Most RIF data files do not contain direct identifiers, but do include information such as zip code, date of birth, and exact dates of service

  • Data is at the beneficiary level
  • Standard extracts are available (5% random

sample), but custom cohorts (diabetics in Minnesota) are also possible

What are RIFs?

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Research Identifiable Files (RIF)

  • Medicare Data

˗ Fee-for-service claims data ˗ MedPAR ˗ Part D event data ˗ Assessment data ˗ Master Beneficiary Summary File

  • Medicaid Data

˗ MAX Files

What are examples of RIFs?

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Research Identifiable Files (RIF)

  • RIF data are only released for research studies
  • Requestors must submit an application to

establish a Data Use Agreement

˗ New Use – purchase the data new ˗ Reuse – request to use data already at your

  • rganization for a new study
  • Packets typically involve at least 8 documents and

documents are reviewed by ResDAC prior to submission to CMS

  • RIF requests are reviewed by the CMS Privacy

Board

How can I access RIF data?

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Summary of Privacy Level Differences

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RIF LDS Non-identifiable Beneficiary level data? Yes Yes No Data files customizable to specific cohort? Yes No No Linkable to non-CMS data at the beneficiary level? Yes No No Require Privacy Board Review? Yes No No Require a DUA Yes Yes No

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New File Series: DE-SynPUFs

  • Data Entrepreneurs' Synthetic Public Use Files
  • Series of linkable files that were released in February
  • File is classified as a PUF since the data is synthetic,

but created from LDS files

  • Purposes of the DE-SynPUF:

˗ Allow data entrepreneurs to develop and create software and applications ˗ Train researchers on data complexities prior to accessing actual CMS data ˗ Support data mining while preserving beneficiary privacy

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Resources for Help

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  • ResDAC Assistance Desk

˗ Email: resdac@umn.edu ˗ Phone: 1-888-973-7322 ˗ Web: http://www.resdac.org

  • ResDAC Website

˗ Search for files by Privacy Level ˗ Access request materials for RIF requests ˗ Browse ResDAC KnowledgeBase

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Resources for Help

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  • CMS Website
  • Good resource for Non-identifiable and LDS files
  • CMS.gov  Research, Statistics, Data and

Systems  Files for Order

  • ResDAC website is more appropriate for RIF data
  • CMS Data Navigator

˗ http://dnav.cms.gov ˗ Menu-driven search tool for locating CMS data and information resources

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Upcoming Webinars

  • 03/19 –Non-Identifiable Data
  • 04/04 –Cost Reports
  • 04/09 - DE-SynPUFs
  • 04/10 –Limited Data Sets
  • 04/25 –Research Identifiable Data
  • 05/02 – Utilization Data

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