Introduction to the Use of Medicare Encounter Data for Research

Claims for a Medicare beneficiary enrolled in Medicare Advantage (also known as “Part C”) are paid through private health insurance companies. The Centers for Medicare and Medicaid Services (CMS) has recently released healthcare utilization data (or “encounter data”) for Medicare beneficiaries enrolled in these plans to researchers.

This one-day workshop is a primer designed to provide researchers with an overview of the Medicare Advantage program, a comparison of the encounter data and FFS claims data, and strategies for using the encounter data in combination with FFS data.

Workshop Date:

June 6, 2025 to June 6, 2025

ResDAC Faculty:

Agenda:

Sample Agenda 2022.pdf

Location:

Minneapolis, MN (In-person)

Cost:

Free

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Why You Should Attend this Workshop

For those familiar with Medicare fee-for-service (FFS) claims data, previous assumptions researchers held while working with FFS claims data may not apply to encounter data. This workshop will walk through important similarities and differences between claims data and encounter data.

Many of the workshop elements will be easier to assimilate by participants familiar with using Medicare fee-for-service (FFS) or other claims data for research; however, previous experience with Medicare data is not required. This workshop will not include interactive exercises.

Educational Objectives

Gain background knowledge about the Medicare Advantage program relevant to understanding the underlying population (denominator) and how it compares to FFS Medicare.
Gain background knowledge about how the processing and construction of Medicare Advantage encounter data research files impacts use, particularly when compared to FFS claims.
Understand the differences between encounter/Part C data and FFS claims data, the fields contained within each, and the inference that can be gained from each type of data when used together or for comparison.
Be equipped with strategies for assessing the impact of various analytic decisions on findings from studies using Medicare Advantage encounter data.

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