Operators trying to determine which markets are under- or over-served can use Medicare data to make better development decisions, according to Arick Morton, CEO of NIC MAP Vision.
“When considering whether to build a new community, not being able to calibrate the need metric at the local level really frustrates the ability to get an accurate picture,” Morton said in an interview with NIC Chief Economist Beth Burnham Mace posted online by NIC. “And now, with Medicare claims data, we can see the rate of healthcare needs that allows us to calibrate utilization down to the market level.”
For example, Morton said, the Alzheimer’s Association publishes annual data on instances of dementia nationwide, but those numbers might not correspond to incidence in a particular market. By contrast, he said, Medicare’s Chronic Conditions Data Warehouse includes all claims in a master beneficiary file with basic demographic information about beneficiaries, which can be broken down by diagnosis. Operators also could find information via Medicare about readmission rates or dollars spent.
Although Medicare data historically have lagged, timeliness is improving, Morton said. Whereas Medicare Advantage files previously had delays of up to four to five years, most claims today are about 70% to 80% complete in 30 days once a beneficiary submits data.
“It is now possible to access Medicare claims data in a way that allows us to begin to build a full picture of how seniors are accessing healthcare, paving the way for us to finally understand how seniors housing and the healthcare system are serving seniors together,” Morton said.
Looking at the variability of chronic conditions across market areas and metros is useful, Morton emphasized. “It’s data that a lot of the market studies don’t consider, but it’s something stakeholders should know to make informed decisions,” he said.
