Using the Medicare current beneficiary survey to conduct research on Medicare-eligible veterans

Yvonne Jonk, Heidi O'Connor, Tamara Schult, Andrea Cutting, Roger Feldman, Diane Cowper Ripley, Bryan Dowd

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The Medicare Current Beneficiary Survey (MCBS) is a longitudinal, multipurpose panel survey of a nationally representative sample of Medicare beneficiaries sponsored by the Centers for Medicare and Medicaid Services (CMS). The MCBS serves as a comprehensive data source on self-reported health and socioeconomic status, health insurance, healthcare utilization and costs, and patient satisfaction. CMS usesMedicare claims data to validate self-reported Medicare Fee-For-Service (FFS) utilization. Because the Veterans Health Administration (VHA) does not bill for services, CMS imputes VHA costs. This article addresses the quality of the MCBS dataset for conducting research on Medicare-eligible veterans by addressing the sample's representativeness, quality of self-reported data, and accuracy of imputed VHA cost estimates. We compared demographic data from the 1992 and 2001 National Survey of Veterans (NSV) with the MCBS 1992 and 2001 Cost and Use files. We compared self-reported VHA utilization and CMS's imputed costs with VHA administrative datasets. The VHA's Pharmacy Benefits Management (PBM) database is available from fiscal year (FY) 1999 onward, and the VHA Health Economics Resource Center's (HERC) Average Cost datasets are available from FY1998 onward. While the samples were comparable in terms of age, sex, and race, the MCBS respondents were in better health, less likely to be married, and more likely to be widowed than NSV respondents. MCBS underreporting rates were higher for VHA than Medicare outpatient events. Underreporting and differences between CMS's and HERC's costing methodologies contributed to lower MCBS versus VHA administrative person- and event- level costs. Alternatively, average annual VHA prescription costs per capita were higher in the MCBS than in the PBM data. Differences in socioeconomic characteristics of the NSV and MCBS samples may be attributable to differences in sampling methodologies. Higher underreporting rates for VHA versus Medicare FFS outpatient events are likely due to systemic differences between the VHA and private healthcaresectors. While VHA formulary discounts may not be reflectedin MCBS's VHA prescriptions costs, lower PBM prescriptions costs are also due to deficient indirect cost data. Since reliable VHA utilization and cost data existed in either FY1998 or FY1999 onward, study goals include estimating the relative share and/or cost of care provided by Medicare and the VHA. Researchers with access to VHA datasets should consider merging them into the MCBS and replacing self-reported utilization and CMS's imputed costs with VHA administrative data. This replacement would significantly improve the accuracy, quality, and usefulness of the MCBS dataset for policy research.

Original languageEnglish (US)
Pages (from-to)797-814
Number of pages18
JournalJournal of Rehabilitation Research and Development
Volume47
Issue number8
DOIs
StatePublished - Nov 24 2010

Fingerprint

Veterans Health
United States Department of Veterans Affairs
Veterans
Medicare
Research
Costs and Cost Analysis
Centers for Medicare and Medicaid Services (U.S.)
Health Care Costs
Prescriptions
Fee-for-Service Plans
Surveys and Questionnaires
Outpatients
Formularies
Widowhood

Keywords

  • Data quality
  • Database
  • Department of veterans affairs
  • Health insurance
  • Health services for the elderly
  • Healthcare costs
  • Healthcare surveys
  • Medicare
  • Medicare current beneficiary survey
  • Veterans
  • Veterans health administration

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Using the Medicare current beneficiary survey to conduct research on Medicare-eligible veterans. / Jonk, Yvonne; O'Connor, Heidi; Schult, Tamara; Cutting, Andrea; Feldman, Roger; Ripley, Diane Cowper; Dowd, Bryan.

In: Journal of Rehabilitation Research and Development, Vol. 47, No. 8, 24.11.2010, p. 797-814.

Research output: Contribution to journalArticle

Jonk, Yvonne ; O'Connor, Heidi ; Schult, Tamara ; Cutting, Andrea ; Feldman, Roger ; Ripley, Diane Cowper ; Dowd, Bryan. / Using the Medicare current beneficiary survey to conduct research on Medicare-eligible veterans. In: Journal of Rehabilitation Research and Development. 2010 ; Vol. 47, No. 8. pp. 797-814.
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