Estimates of Medicare Costs for Cardiovascular Disease: Applying a Cost-Allocation Methodology to Medicare Claims Data
Gilman, B. (2005, December). Estimates of Medicare Costs for Cardiovascular Disease: Applying a Cost-Allocation Methodology to Medicare Claims Data. Presented at American Public Health Association Annual Meeting, Philadelphia, PA.
For individuals over the age of 64, Medicare claims provide the most comprehensive source of data on costs for medical services, particularly for chronic conditions such as cardiovascular disease with a relatively high prevalence among the elderly. The purpose of this study was to assess the economic burden imposed by selected cardiovascular diseases among the 65 and older population using Medicare claims. In particular, we analyzed the costs of medical services covered by Medicare associated with the treatment of ischemic heart disease and stroke. We extracted Medicare claims for the five major categories of services covered by Medicare: inpatient services, physician visits, outpatient services, home health care, and durable medical equipment. For each of the health conditions and medical service categories, claims were selected based on their reported diagnosis codes. The selected claims data were then used to estimate both the prevalence and the average cost of medical services for each condition. A major challenge using Medicare claims data to conduct cost-of-illness studies is deciding how to allocate claims-level costs (that are typically associated with multiple diagnoses) to specific conditions. The presentation will also identify the challenges of using Medicare claims to estimate the costs of Medicare-covered services associated with the treatment of cardiovascular disease among the elderly. We will discuss the structure and content of the Medicare claims databases and offer alternative approaches for assigning costs that may be associated with multiple diagnoses to specific diseases or conditions.