SEER-CAHPS: Medicare Enrollment, Claims, and Assessment Data

Medicare is a federally funded program that provides health insurance for older adults ages 65 and older, persons with end-stage renal disease, and some individuals with disabilities. There are four components of Medicare coverage are described below:

  • Part A coverage includes hospital, skilled-nursing facility, hospice and some home health care. Almost all Medicare beneficiaries have Part A coverage.
  • Part B coverage covers physician and outpatient services. A majority of Part A beneficiaries elect to pay additional premiums for Part B coverage.
  • Part C coverage refers to Medicare Advantage enrollment (e.g., enrollment in Managed Care or an HMO).
  • Part D coverage, which provides prescription drug coverage for beneficiaries who purchase the benefit. Part D coverage began in 2006 and currently 60-70% of Medicare beneficiaries are enrolled.

Information about Medicare enrollment is available for all persons included in the SEER-CAHPS data resource (both persons with and without a cancer diagnosis).

Medicare claims (e.g., inpatient, outpatient bills) are available only for persons with FFS coverage (Parts A and B with no Part C coverage). Part D prescription encounter data is available for persons with Part D coverage who may be enrolled in an HMO or have FFS coverage.

For more information about Medicare data, please see the Research Data Assistance Center (ResDAC)External Web Site Policy website and the Chronic Conditions Warehouse (CCW)External Web Site Policy website.

Medicare Advantage versus Fee-For-Service

SEER-CAHPS includes both:

 
Medicare
Advantage
Fee-For-
Service
Types of Coverage
  • Part C coverage
  • Part A coverage
  • Part B coverage
Available Data
  • Medicare Enrollment History
  • Medicare Enrollment History
  • Home Health Agency
  • Hospice
  • Durable Medical Equipment
Prescription drug claims are available for those who elect to have Part D coverage
 

In order to include complete claims data in your analysis, individuals included in a cohort must have continuous Parts A and B coverage with no Part C coverage for the desired observation period.

Last Updated: 19 Apr, 2024