[medreform] Re: mr. pell, a favor

  • From: "Pell, Michael" <mpell@xxxxxxxxxxxxxxxxxxx>
  • To: <medreform@xxxxxxxxxxxxx>
  • Date: Tue, 7 Jul 2009 10:47:03 -0400

David is going to be out of the office this afternoon, he claims on
business, so today is not real good for us. Any time tomorrow however
will be fantastic.


From: medreform-bounce@xxxxxxxxxxxxx
[mailto:medreform-bounce@xxxxxxxxxxxxx] On Behalf Of Tamman, Maurice
Sent: Tuesday, July 07, 2009 9:46 AM
To: 'medreform@xxxxxxxxxxxxx'
Subject: [medreform] Re: mr. pell, a favor

Can we chat today or tomorrow ... just to get caught up.



From: Tamman, Maurice 
Sent: Wednesday, July 01, 2009 4:54 PM
To: 'medreform@xxxxxxxxxxxxx'
Subject: RE: [medreform] Re: mr. pell, a favor


Question came up: 


Can the Medpar data tell us anything about how sick the patients are or
how many co-morbidities they have? I think this is sometimes referred to
as "case mix." Hospitals sometimes can say that their population is
"sicker" than another hospital's. Perhaps the only way to do it is
through diagnosis codes.  What about race by diagnostic code?



Maurice Tamman

News Editor, Wall Street Journal


914-482-8318 (mobile)

-----Original Message-----
From: medreform-bounce@xxxxxxxxxxxxx
[mailto:medreform-bounce@xxxxxxxxxxxxx] On Behalf Of Pell, Michael
Sent: Wednesday, July 01, 2009 12:52 PM
To: medreform@xxxxxxxxxxxxx
Subject: [medreform] Re: mr. pell, a favor




I hope this is not too much information, nor too brief. I hate it when
I'm too brief. The shame is unbearable.


At any rate...


1.) LDS MEDPAR Files 

The National MedPAR Files contain inpatient hospital final action stay
records. The Long Term Care Hospital (LTCH) MedPAR is a subset of the
National MedPAR and contains only long term care hospital discharges.
The Skilled Nursing Facility (SNF) MedPAR File contains SNF final action
stay records. 

Each MedPAR record represents a stay in an inpatient hospital or SNF. An
inpatient "stay" record summarizes all services rendered to a
beneficiary from the time of admission to a facility through discharge.
Each MedPAR record may represent one claim or multiple claims, depending
on the length of a beneficiary's stay and the amount of inpatient
services used throughout the stay. The lowest level of geographic
identification in the LDS MedPAR File is the state.

Data Available:

*         National MedPAR File available from 1997-2007 [pricing and
record layout
#TopOfPage> ] 

*         Long-Term Care Hospital (LTCH) Expanded Modified MedPAR
available from 2004-2006 [pricing and record layout

*         SNF MedPAR file is available from 2002-2006 [pricing and
record layout
DS.asp#TopOfPage> ] 

What this data can do:


Generally the MEDPAR data is used for comparing medical facilities. Each
record contains information about all the procedures of a single
beneficiary's stay in a medical facility. Obviously we could also make
comparisons by region and state as well. You can join the MEDPAR data to
the Hospital Provider ID file (attached) on the facility's unique
Medicare file number to find out the name of the facility, it's address,
and what city it's located in, basic information that could be helpful
for mapping purposes. There is also a "provider of services file" that
provides more detailed facility information, such as number of beds,
facility owner, and facility type. That data costs $100 per quarter, but
I think we'd only need the first quarter. The interesting thing about
that data is that we'd also be able to compare hospital owners. I have
not issued a FOIA for that file, but I will today. The weakness of this
data is that we can't use it to study things like reshospitalization
because it contains no unique patient ID number.


2.) The Standard Analytical Files

The Standard Analytical Files (SAFs) contain information collected by
Medicare to pay for health care services provided to a Medicare
beneficiary. SAFs are available for each institutional (inpatient,
outpatient, skilled nursing facility, hospice, or home health agency)
and non-institutional (physician and durable medical equipment
providers) claim type. The record unit of SAFs is the claim (some
episodes of care may have more than one claim). 

Data Available: SAFs are calendar year files and are available for the
years 1991 and forward. The most current file available is 2007.

*         Inpatient SAF [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#inpatient> ] 

*         Skilled Nursing Facility SAF [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#skilled> ] 

*         Outpatient SAF [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#outpatient> ] 

*         Home Health Agency SAF [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#HHA> ] 

*         Hospice SAF [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#hospice> ] 

*         Carrier SAF [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#carrier> ] 

*         Durable Medical Equipment [brief file description
<http://www.resdac.umn.edu/Medicare/file_descriptions.asp#dme> ]

What this data can do:


This data is broken down by claims, which means that a single hospital
visit could appear multiple times in this database, if a facility
submitted multiple claims. This might happen if a patient had a long
stay or had multiple procedures performed. Because this data has a
unique patient ID, you can use this to examine things like
rehospitalization and how Medicare recipients use the system. This does
contain some physician information, but I was advised not to use this
because it's unreliable.


If you have any follow up questions, please let me know and I'll get on





From: medreform-bounce@xxxxxxxxxxxxx
[mailto:medreform-bounce@xxxxxxxxxxxxx] On Behalf Of Tamman, Maurice
Sent: Wednesday, July 01, 2009 12:06 PM
To: medreform@xxxxxxxxxxxxx
Subject: [medreform] mr. pell, a favor

Can u give me a brief description of what is contained in each FOIAed
dataset and generally what they can be used for (strengths and






Maurice Tamman

News Editor, Wall Street Journal


914-482-8318 (mobile)


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