ResConnect

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  1. Difference between Proposed and Final Rule Files

    A number of CMS Limited Data Set (LDS) files are released first as a Proposed Rule file and then as a Final Rule file. These files include the MedPAR, Hospital Outpatient Prospective Payment System (OPPS), Hospital Outpatient Prospective Payment System ...

  2. Differences between the Cost and Use and Access to Care Modules

    Background The Medicare Current Beneficiary Survey (MCBS) is released as two modules. Researchers can choose to request one or both of the modules depending on their research needs. The modules can be linked using the BASEID variable. The two modules are ...

  3. How to Open the Hospital Service Area File in Excel

    The Hospital Service Area File is one of the few CMS non-identifiable files that can be opened in Microsoft Excel.  However, the file is sent as a.txt file and not as a.xls file. Users will need to use the text import wizard tool and provide Excel with ...

  4. Medicare Ambulatory Surgical Centers (ASCs) in the Claims Data

    Medicare defines an Ambulatory Surgical Center (ASC) as a distinct entity that operates exclusively for the purpose of furnishing outpatient surgical services to patients. The ASC must have an agreement with CMS that was obtained in accordance with 42 CFR ...

  5. Differences between the Inpatient and MedPAR Files

    Background 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 ...

  6. Linking the Medicare Current Beneficiary Survey (MCBS) to Identifiable Data

    Background Both modules of the Medicare Current Beneficiary Survey (MCBS) come standard with Medicare claims data. The claims data included with the MCBS are for beneficiaries found in the module requested and are claims for the year of the file. ...

  7. MAX Provider Charisteristics File (MAXPC): Linking to Medicare Provider Numbers

    MAX data files include state provider identification codes that are state-specific. No central repository exists that would allow institutional providers, physicians or other professionals to be identified. Beginning with the MAX 2009 files, the NPI ...

  8. Sources for Managed Care Enrollment and Penetration Rates

    Background 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 that are enrolled in a Medicare managed ...

  9. Medicare Managed Care Enrollees and the Medicare Utilization Files

    Medicare Managed Care Plans Medicare managed care began in 1985 and it has evolved from the traditional Health Maintenance Organization plans to additional managed care plans offered under Medicare Part C. The structure and payment rules for each type of ...

  10. CMS Research Identifiable Files Request Process and Timeline

    The attached flowchart illustrates the various steps of the CMS identifiable data request packet process. The process involves several organizations, including the researchers, the Research Data Assistance Center (ResDAC), CMS, and the data distributor. ...

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