Medicare

Medicare is a health insurance program, administered by the United States government, for people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other special criteria like the End Stage Renal Disease program (ESRD).

Inpatient Rehab Facility-Patient Assessment Instrument

The Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) is collected on all Medicare patients who receive services from an inpatient rehabilitation unit or hospital. The data collected for IRF-PAI are used to measure quality of care.

What does this file include? (variable highlights)

  • Pre-hospitalization living situation
  • Co-morbid conditions
  • Communication status
  • Functional status

Opportunities and Challenges when Using Medicare Advantage Encounter Data

Date Recorded

This video is one segment in a series of videos from ResDAC’s Introduction to the Use of the Medicare Encounter Data for Research.

This presentation highlights the strengths and limitations of Medicare Advantage Encounter data, highlighting which are unique to encounter data and which belong to all administrative data analysis. Dr. Huckfeldt also presents an example of a method for overcoming one limitation - the lack of MA encounter payment information - using FFS prices. Considerations when analyzing the data are also discussed. 

Working with the Carrier and Outpatient Files: Overview and Examples

Date Recorded

This video is one segment in a series of videos from ResDAC’s Introduction to the Use of the Medicare Encounter Data for Research.

This presentation describes the steps taken to compare the Encounter data with HEDIS data for two measures: ambulatory outpatient visits and emergency department visits. Dr. Huckfeldt also presents a research example investigating the association of enrollment in full-risk primary organization with use of outpatient and emergency visits, including his lessons learned.

Encounter Data Structure

Date Recorded

This video is one segment in a series of videos from ResDAC’s Introduction to the Use of the Medicare Encounter Data for Research.

This presentation describes the complex structure of the Medicare Advantage encounter data files available for request. Topics include: