By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    benefits of using protein powder to build muscles
    Protein Powder for Muscle Mass: Everything You Need to Know
    December 12, 2021
    changes brought on by blockchain in healthcare
    Technology In The Healthcare Industry
    March 28, 2022
    What Does Core Body Temperature Say About Health?
    August 17, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    FDA Approves Diabetes Pill
    May 2, 2011
    Patient Gets Drunk on Hand Sanitizer
    June 20, 2011
    Cultivating Health Improvement
    July 20, 2011
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Selecting Medicare Cohorts
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > eHealth > Selecting Medicare Cohorts
eHealth

Selecting Medicare Cohorts

JasonShafrin
Last updated: August 26, 2017 1:27 pm
JasonShafrin
Share
3 Min Read
SHARE

Medicare administrative data provides a rich source to conduct health services research. Researchers who wish to use this data, however, often have to restrict their sample population in order to have a similar types of patients and consistent data available. Today I review some popular methods to restrict Medicare samples for research use. Restrictions to consider for Medicare population:

  1. Continuously enrolled in Parts A and B. This is needed for data completeness
  2. Medicare Advantage Enrollment. Researchers may want to exclude beneficiaries who receive Medicare services through managed care, because they are currently not claim-level detail for MA-enrolled beneficiaries although this will change in 2012.
  3. U.S. Residence. Individuals residing outside the U.S. may receive their care through other countries’ medical systems and thus Medicare claims may not capture the full range of services they receive.
  4. The Working Aged. The working aged are individuals for whom a private group health insurance plan was the primary payer. Medicare may not have a complete set of claims for working aged beneficiaries.
  5. Hospice Beneficiaries. Managed care plans cover all Parts A & B services except for hospice. If one wants to predict Medicare Advantage spending, one would need to exclude hospice spending since hospices services are not covered by MA, only the Medicare FFS.
  6. ESRD Beneficiaries. Beneficiaries with End Stage Renal Disease (ESRD) are covered by Medicare through a specific carve out. Anyone with ESRD qualifies regardless of age. Thus, researchers may want to exclude/include these beneficiaries.
  7. Medicaid Status. Individuals who are dual eligible have much lower Medicare cost sharing and can also receive services covered by Medicaid.
  8. Disability Status. Some individuals qualify for Medicare prior to being 65 because they were disabled and qualify under the Supplemental Security Income program. A researcher could restrict the sample to: i) individuals eligible for Medicare under SSI who are less than 65, or ii) individuals who are eligible for Medicare because they are over 65, but who were already enrolled in Medicare when they were under 65 because of their disability status.
  9. Death. For researchers analyzing cost analysis, patients who die causes a problem. Patients who die are low cost; excluding these patients from the sample, however, may assign low-cost status to certain providers for whom a large number of patients die. Thus, one does not want to reward providers whose patients die at a high rate and identify them as low-cost providers.
TAGGED:medical researchMedicare
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Do You Grind Your Teeth at Night? Here’s How Night Guards and TMJ Treatments Can Help
Do You Grind Your Teeth at Night? Here’s How Night Guards and TMJ Treatments Can Help
Dental health
May 21, 2025
The Secret To A Confident Smile: Top Tips For Better Teeth
The Secret To A Confident Smile: Top Tips For Better Teeth
Dental health
May 21, 2025
Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025

You Might also Like

In Expanded Medical Systems, Video Bridges The Divide
eHealth

In Expanded Medical Systems, Video Bridges The Divide

April 7, 2018
social media healthcare
eHealthSocial Media

Five Uses of Social Media to Create Relationships with Your Patients

September 20, 2013

The Value of Healthcare Portals for Patient Engagement

February 10, 2015
internet of things
BusinesseHealthMedical RecordsPolicy & LawTechnology

Privacy and Security and the Internet of Things

February 4, 2015
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?