Health Information Technology (Hit) Medicare Databases

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Health Information Technology (HIT) Medicare databases are valuable tools to extract healthcare data because they store comprehensive sources of health information. Medicare collects information on all its beneficiaries and those providers that receive payments from Medicare. The data that Medicare collects can be used to identify the variations in cost, utilization and quality. Most Medicare beneficiaries are in traditional fee-for-service (FFS), therefore, spending per beneficiary should be the same throughout the country but, it is not. Numerous studies have shown there are differences in cost and the quality of health care with Medicare beneficiaries, with the biggest spending difference being post-acute services. As explained, by the …show more content…

HRR looks at where the beneficiary lives not where they get care. McCurdy explains, “HRR’s generally have populations that are large enough to generate stable averages for comparisons of cost and utilization, even for narrowly defined combinations of conditions and services”. The information that Medicare collects on its beneficiaries is broad and from a wide-range of sources, therefore, it is from multiple sources to compile and compare variations in healthcare. Therefore, I believe it to be a reliable and valid tool to detect small variations. Medicare has instituted policies to help regulate cost on these outliers which includes standardized payments, risk adjustments and bundle payments. CMS uses standardized payment rates to calculate its Medicare spending per beneficiary (MSPB) for the hospital value-based purchasing program (VBP). Medicare standardizes the allowed amount for the MSPB. This method looks at the different Fee for Service (FFS) payments and identifies the factors to adjust such as local wages, input prices and disproportionate share hospitals (DSH). Once you remove the differences this should help even out the geographic variability in payments and give a more accurate picture of how resources are used between providers and across the nation. Another way to control cost on outliers is to identify those patients that will use the most resources, this is known as

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