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. 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 ...

  3. 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 ...

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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 ...

  8. 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. ...

  9. Diagnosis and Procedure Coding Resources

    Background Understanding the appropriate procedure and diagnosis codes for a particular study question is an important part of analyzing Medicare data. These codes are very specific and can change from year to year as new codes are added and others are ...

  10. Long Term Care Hospitals in the Medicare Data

    Definition of a Long Term Care Hospital In short, a LTCH is “a hospital which has an average inpatient length of stay (as determined by the Secretary of Health and Human Services (the Secretary) of greater than 25 days.” 1 It is important to note that a ...

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