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Linkage of Laboratory Results to Medicare Fee-for-Service Claims.

Publication ,  Journal Article
Hammill, BG; Curtis, LH; Qualls, LG; Hastings, SN; Wang, V; Maciejewski, ML
Published in: Med Care
November 2015

BACKGROUND: Medicare is the single largest purchaser of laboratory testing in the United States, yet test results associated with Medicare laboratory claims have historically not been available. OBJECTIVE: The purpose of this study was to describe both the linkage of laboratory results data to Medicare claims and the completeness of these results data. In a subgroup of beneficiaries initiating angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, we also demonstrate the generalizability of Medicare beneficiaries with laboratory values compared with those without laboratory values. We end with a discussion of the limitations and potential uses of these linked data. METHODS: We obtained information about laboratory orders and results for all Medicare fee-for-service beneficiaries in 10 eastern states who had outpatient laboratory tests conducted by a large national laboratory services vendor in 2011. Using a combination of direct identifiers and patient demographic characteristics, we linked patients in these laboratory data to Medicare beneficiaries, enabling us to associate test results with existing claims. RESULTS: Nearly all patients in the laboratory data were able to be linked to Medicare beneficiaries. There were over 2 million distinct beneficiaries with nearly 125 million specific test results in the laboratory data. For specific tests ordered in an outpatient or office setting in these 10 states, between 5% and 15% of them had linked laboratory data. Medicare beneficiaries initiating angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers who had laboratory results data had similar patient characteristics to those without results data. CONCLUSIONS: This novel linkage of laboratory results data to Medicare claims creates unprecedented opportunities for conducting comparative effectiveness research related to patient safety and quality.

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Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

November 2015

Volume

53

Issue

11

Start / End Page

974 / 979

Location

United States

Related Subject Headings

  • United States
  • Reimbursement Mechanisms
  • Quality Assurance, Health Care
  • Medicare
  • Male
  • Insurance Claim Reporting
  • Humans
  • Health Policy & Services
  • Female
  • Fee-for-Service Plans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hammill, B. G., Curtis, L. H., Qualls, L. G., Hastings, S. N., Wang, V., & Maciejewski, M. L. (2015). Linkage of Laboratory Results to Medicare Fee-for-Service Claims. Med Care, 53(11), 974–979. https://doi.org/10.1097/MLR.0000000000000420
Hammill, Bradley G., Lesley H. Curtis, Laura G. Qualls, Susan N. Hastings, Virginia Wang, and Matthew L. Maciejewski. “Linkage of Laboratory Results to Medicare Fee-for-Service Claims.Med Care 53, no. 11 (November 2015): 974–79. https://doi.org/10.1097/MLR.0000000000000420.
Hammill BG, Curtis LH, Qualls LG, Hastings SN, Wang V, Maciejewski ML. Linkage of Laboratory Results to Medicare Fee-for-Service Claims. Med Care. 2015 Nov;53(11):974–9.
Hammill, Bradley G., et al. “Linkage of Laboratory Results to Medicare Fee-for-Service Claims.Med Care, vol. 53, no. 11, Nov. 2015, pp. 974–79. Pubmed, doi:10.1097/MLR.0000000000000420.
Hammill BG, Curtis LH, Qualls LG, Hastings SN, Wang V, Maciejewski ML. Linkage of Laboratory Results to Medicare Fee-for-Service Claims. Med Care. 2015 Nov;53(11):974–979.

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

November 2015

Volume

53

Issue

11

Start / End Page

974 / 979

Location

United States

Related Subject Headings

  • United States
  • Reimbursement Mechanisms
  • Quality Assurance, Health Care
  • Medicare
  • Male
  • Insurance Claim Reporting
  • Humans
  • Health Policy & Services
  • Female
  • Fee-for-Service Plans