SDR 02-237
 
 
VA Medicare Data Merge Initiative
Denise M. Hynes PhD MPH BSN
Edward Hines, Jr. VA Hospital
Hines, IL
Funding Period: October 2002 - September 2007

BACKGROUND/RATIONALE:
This five-year project, funded by the Under Secretary for Health & the HSR&D service, continues development of the linked VA-Medicare healthcare database for VHA users, enrollees and special populations also eligible for Medicare including 1999-2005 Medicare claims and enrollment files. The project also establishes VIReC as a data center for distribution of linked VA and Medicare datasets to researchers with approved research protocols.

OBJECTIVE(S):
Acquisition, maintenance, and distribution of VA and Medicare linked data, including development of linkage methodologies

METHODS:
VIReC worked with VHA and Office of Policy and Planning to establish a System of Records: "Consolidated Data Information System" - Jan, 2001, established a research data use agreement with CMS, and contributed to the development of a Memorandum of Understanding between VA and CMS for data sharing and use policies through 2007. VIReC convened a Technical Advisory Board (TAB) to make recommendations regarding access and data use priorities, and provide expertise about CMS data management, and a Data Request and Review Board to establish and implement a process for reviewing data requests. VIReC developed a sample frame methodology to produce a list of 6.4 million VHA users, enrollees and special populations for submission to CMS, established a linkage methodology based on criteria approved by the TAB, and created linked SAS files. VIReC continues to work with the Assistant Deputy Undersecretary for Health (ADUSH) Office to oversee and coordinate the research use of the Medicare data. VIReC serves on the oversight committee and meets annually with CMS together with ADUSH office.

FINDINGS/RESULTS:
Of 6.1 million identified veterans alive on 1/1/1999, 2.6 million (42.2%) were dually eligible for VA and Medicare in 1999, and 89.6% of those at least 65 years old were enrolled in Medicare. Of the 2.1 million veterans enrolled in Medicare Fee-For-Service, 21.9% used only VA services, 30.3% used only Medicare services, and 42.6% used both VA and Medicare services.

IMPACT:
Maintaining resources at VIReC to continue this project has assisted VA researchers in utilizing Medicare data in their research by centralizing and streamlining the CMS data request process, centralizing the technical resources for large data set management, reducing the cost of purchasing Medicare data for HSR&D funded research, and enriching the professional resources available across the country for understanding the best research uses of Medicare data.

PUBLICATIONS:

Reports

  1. Veterans Affairs Information Resource Center (VIReC) (VA Information Resource Center). Veterans' Enrollment, Access and Use of Medicare and VA Health Services: Report to the Under Secretary for Health, Department of Veterans Affairs. 2003 May .


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DRA: Health Services and Systems
DRE: Resource Use and Cost
Keywords: Research method, Utilization patterns, VA/non-VA comparisons
MeSH Terms: