CMS must ensure that all research requests for identifiable (RIF) data have IRB documentation to satisfy the requirements of the Common Rule and the Health Insurance Portability and Accountability Act (HIPAA). This article describes the...
The purpose of this article is to describe how to use the Medicare managed care enrollment information found in the Medicare Beneficiary Summary File (MBSF) Research Identifiable File (RIF) or Denominator in the Limited Data Set (LDS). Medicare managed care is sometimes also called Medicare Advantage, Medicare Part C or Medicare + Choice.
Medicare managed care enrollment has fluctuated over the years and is a frequently requested statistic. Often researchers are interested in penetration rates or the percentage of Medicare beneficiaries enrolled in a Medicare managed care plan. These plans are also referred to as Medicare Part C, Medicare Advantage (MA), or Medicare Health Maintenance Organizations (HMOs).
Occasionally researchers need to obtain identifiable data for MCBS participants, including claims data outside MCBS participation (i.e. before or after the individual participates in the MCBS). This article provides a brief overview of that process.
Researchers who are interested in studying inpatient utilization (e.g. hospital stays) have two options: the Inpatient claims file or the Medicare Provider Analysis and Review (MedPAR) file. It is important to note that the differences between the two files will vary depending on whether a researcher is interested in the Research Identifiable File (RIF) or Limited Data Set (LDS) versions of the two files.