Data on Health and Well-being of American Indians, Alaska Natives, and Other Native Americans. Medicare Utilization  Standard Analytic Files (SAFs)

12/01/2006

Sponsor: U.S. Department of Health and Human Services (DHHS)/Centers for Medicare and Medicaid Services (CMS)
Description: The Standard Analytical Files (SAFs) comprise seven data sets containing detailed claims information about health care services rendered to Medicare beneficiaries in fee-for-service Medicare. SAFs are available for each institutional (inpatient, outpatient, skilled nursing facility, hospice, or home health agency) and non-institutional (physician and durable medical equipment providers) claim types. Data are organized at the claim level and include basic beneficiary demographic information, date of service, diagnosis and procedure code, provider number, and reimbursement amount.
Relevant Policy Issues: Disease-specific Measurements, Health Disparities, and Factors Contributing to Measured Health Disparities.
Data Type(s): Program claims data
Unit of Analysis: Final action claims, which are associated with an individual.
Identification of AI/AN/NA: Race is provided by the Social Security Administration and is found within the Denominator file. CMS receives a quarterly update file from Indian Health Services on individuals deemed by IHS to be Native American and uses it to update the race code found in the Denominator file. The information from the IHS will override any other code which may have been on file.

The following categories are used in the SAFs:

  • White
  • Black
  • Other
  • Asian
  • Hispanic
  • North American Native
  • Unknown
AI/AN/NA Population in Data Set: Population size is not available in documentation, however, the data reflect all Medicare beneficiaries and therefore should have more than adequate sample size to address research needs.
Geographic Scope: The geographic scope of the SAFs is national. Zip code is the lowest level of geographic detail available in the file.
Date or Frequency: Data are submitted continually from the Fiscal Intermediary (FI) and Carriers to CMS, but SAFs are produced by calendar year, available from 1991 through the present, with 2004 data the most recently available.
Data Collection Methodology: Providers submit claims to the FI or Carrier for processing and payment. The FI or Carrier forwards all claims to CMS. CMS creates the SAFs six months following the end of the calendar year.
Participation: Mandatory
Strengths: This data source offers a near-census (does not include the small number of beneficiaries enrolled in managed care organizations) of utilization, expenditure and diagnosis data for Medicare beneficiaries.

CMS updates race information based on a quarterly update file from Indian Health Services identifying individuals deemed by IHS to be Native American.

Limitations: Only very broad racial categories are available (White, Black, Hispanic, Asian, Other, North American Native). Claims data are very difficult to work with and also consist of very large files, often millions of records large, and therefore are not a suitable resource for the average researcher with limited programming skills.
Other: In addition to the data sets profiled in this catalog, a full listing of all available CMS data sets is presented at this website: http://www.cms.hhs.gov/FilesForOrderGenInfo/
Access Requirements and Use Restrictions: The data request process involves multiple components including a proposal of how the data will be used, evidence of funding for the research, data use agreement, Institutional Review Board clearance/waiver, and some administrative forms. There is a cost associated with use of this data set. Researchers will need to contact ResDAC in order to receive pricing information. The steps and forms are described in detail at the following website: http://www.resdac.umn.edu/medicare/requesting_data.asp.
Contact Information: The University of Minnesota, CMS contractor for managing and supporting CMS data, can be contacted via the Internet at: https://resdac.oit.umn.edu/
Via e-mail: resdac@umn.edu
Via telephone: (888) 973-7322

Please see this website for a further description of the SAFs: http://www.resdac.umn.edu/Medicare/data_file_descriptions.asp#rif

Data Dictionaries are available at: http://www.resdac.umn.edu/ddvh/index.asp#RIF

 

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