Chronic Conditions Data Warehouse

The following poster session utilizing data from the Chronic Conditions Warehouse were presented at AcademyHealth's 2017 Annual Research Meeting (ARM):

• Agreement of Enrollment and Services Items in the OASIS-C1 with Medicare Claims and Enrollment Data, 2015

The purpose of this study was to contribute knowledge to the validity of OASIS-C1 data by quantifying the agreement between the demographic, enrollment, prior and post services items on the OASIS-C1 assessment with Medicare claims and enrollment data.

The following poster sessions utilizing data from the Chronic Conditions Warehouse were presented at AcademyHealth's 2016 Annual Research Meeting (ARM).

Fractures among the elderly are serious health problems that occur frequently, are expensive to treat, and may result in significant disability and increased risk of mortality. Overall mortality rates among the elderly with hip fractures has been estimated, but less is known about the risk of mortality following fractures of varying severity. Hip fractures are an especially common, severe and expensive fracture type among the elderly. The main objectives of this study were to quantify mortality rates and determine factors impacting mortality following a fracture among nursing home residents.

• Survival Analysis of Nursing Home Residents with a Fracture in 2012

On October 1, 2015 the conversion from the 9th version of the International Classification of Diseases (ICD-9-CM) to version 10 (ICD-10-CM) occurred. The ICD-10-CM has more than 70,000 unique codes compared to approximately 14,000 ICD-9-CM codes, which allows for more detail surrounding diagnoses. The objectives of this study are to: 1) validate that Medicare claims were received in the CCW after the ICD-10-CM conversion without disruption; 2) describe the changes in the CCW algorithms to identify three chronic conditions (Acute Myocardial Infarction [AMI], Asthma and Hip/Pelvic Fractures); and 3) quantify the impact on the prevalence rates of these conditions after the conversion to ICD-10-CM codes.

• The Impact of the ICD-9-CM to ICD-10-CM Conversion to Identify Chronic Conditions in Administrative Claims

Breast cancer (BC) is the second most common cancer among US women. The study objective was to examine the pattern of BC-related surgical, radiation and drug treatment up to two years post diagnosis among a cohort of Medicare females with incident BC derived from Medicare claims in 2011.

• Treatment Patterns for Female Breast Cancer Patients Enrolled in Medicare

The following poster sessions utilizing data from the Chronic Conditions Warehouse were presented at AcademyHealth's 2015 Annual Research Meeting (ARM):

• Avoidance of Double Counting Services in a Medicare-Medicaid Dually Enrolled Population

The objectives were to: 1) describe the percent of fee-for-service (FFS) Medicare claims identified in the Medicaid claims data and considered a single service in the Medicare-Medicaid dual population; 2) quantify the impact on utilization counts after accounting for overlapping claims; and 3) examine different types of service and geographic variation in overlapping claims.

• Medicare and Medicaid Drug Expenditures for Medicare and Medicaid Dual Eligible Enrollees

MMLEADS is a suite of analytic files designed to serve as a tool for research of Medicare and Medicaid enrollees in addition to individuals who only receive Medicare coverage and/or individuals who only receive Medicaid coverage. It allows for investigation of eligibility, enrollment, cost and utilization, and 49 common health conditions for individuals enrolled in Medicare and/or Medicaid. Cost and utilization has been summarized into therapeutic classes within Medicare Part D and Medicaid drug categories. The objectives of this study were: 1) to identify a population with high drug costs and 2) to characterize the drug use in terms of specific therapeutic classes of medications.

• Rates of Outpatient Emergency Department Visits for Low Severity Conditions among Medicare Beneficiaries

Emergency Departments (EDs) are important gateways to health care in the United States and providers of services to all persons regardless of insurance or ability to pay. From 2001 to 2008, the number of ED visits increased by 1.9% per year, a rate 60% faster than population growth. The main goal of this study was to understand geographic patterns and identify important factors in the rate of low severity ED visits among Medicare beneficiaries at the hospital referral regions (HRRs) level. Understanding driving factors of ED visits for low severity conditions among Medicare beneficiaries may alleviate ED crowding and improve quality of care in US emergency departments.

• Real-Time Reporting – An Evaluation of Approaches to Prediction of Mature Monthly Metrics

The Centers for Medicaid & Medicare Services (CMS) Chronic Condition Warehouse (CCW) is used as the data source for several CMS real-time re-porting initiatives. Measures of quality, cost and utilization are computed based on all claims for a given month. Unfortunately, due to the nature of receiving, processing and finalizing claims data, the mature monthly metric value may not be observed until a number of months after the service month. The non-mature monthly metric value that we observe in more recent months is an error-prone estimate of the mature monthly metric value. The primary research objective here was to characterize the relationship between observed and mature monthly metric values, and to evaluate approaches to predict mature values prior to maturity.

• Utilization of Benzodiazepines and Barbiturates after Medicare Part D Coverage

Benzodiazepines (BZD) and barbiturates (BARB) were excluded from Medicare Part D covered drugs from 2006 to 2012. Starting in 2013, the Part D program began to cover BZD for all Part D medically accepted indications and BARB when used in the treatment of epilepsy, cancer or chronic health disorders. The study objective was to examine the cost and use of these drugs in Medicare beneficiaries since most of these drugs are included by Beers' criteria as potentially inappropriate drugs in older adults.