About This Book

      Purpose

      This book teaches you how to access Medicare data and, more importantly, how to apply this data to your research. Knowing how to use Medicare data to answer common research and business questions is a critical skill for many SAS users. Due to its complexity, Medicare data requires specific programming knowledge in order to be applied accurately. Programmers need to understand the Medicare program to properly interpret and use its data. With this book, you’ll learn the entire process of programming with Medicare data—from obtaining access to data; to measuring cost, utilization, and quality; to overcoming common challenges. Each chapter includes exercises that challenge you to apply learned concepts to real-world programming tasks.

      Is This Book for You?

      This book is a must for anyone interested in programming with Medicare data in SAS. This includes students, professional researchers, and employees in the federal and state governments. SAS® Programming with Medicare Administrative Data offers beginners a programming project template to follow from beginning to end. It also includes more complex questions and discussions that are appropriate for advanced users.

      Prerequisites

      This book has no prerequisites, and is designed for SAS users at all levels, as well as readers with varying levels of knowledge of the Medicare program and Medicare data. Those readers with experience in SAS, but with no background in healthcare or Medicare data, could focus more on Chapter 1 through Chapter 5. In these chapters, we learn about the Medicare program, how the Medicare program drives the content of the data, and the acquisition of Medicare administrative claims and enrollment data. Those readers with knowledge of the Medicare program, but not Medicare data or SAS, could focus more on Chapter 3, where we discuss Medicare data, as well as Chapter 6 through Chapter 10, where we develop the majority of SAS code.

      Scope of This Book

      The main topics covered in the book include:

      • An introduction to the Medicare program;

      • A detailed introduction to Medicare data;

      • A discussion of how to plan a research programming project;

      • Methods to obtain Medicare data;

      • Instructions for programming with Medicare data to measure utilization, cost, and quality;

      • A demonstration of how to present findings;

      • A helpful explanation of how to sunset a research programming project

      Because this book is foundational, it does not cover more complex manipulations or analyses, such as risk adjustment or payment standardization algorithms. It does, however, provide the reader with ample background information to tackle these topics independently.

      About the Examples

      Software Used to Develop the Book's Content

      SAS 9.3

      Example Code and Data

      You can access the example code and data for this book by linking to its author page at http://support.sas.com/publishing/authors/gillingham.html. For an alphabetical listing of all books for which example code and data is available, see http://support.sas.com/bookcode. Select a title to display the book’s example code.

      If you are unable to access the code through the website, e-mail [email protected].

      Output and Graphics Used in This Book

      The output in this book was generated using ODS.

      Exercise Solutions

      You can access the exercise solutions for this book by linking to its author page at http://support.sas.com/publishing/authors/gillingham.html.

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      We look forward to hearing from you. We invite questions, comments, and concerns. If you want to contact us about a specific book, please include the book title in your correspondence to [email protected].

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      About The Author

      Matthew Gillingham is the director of health research systems at Mathematica Policy Research. His career in health care data analytics began with analyzing commercial claims and enrollment data. For more than ten years, he has used SAS to build software that analyzes administrative health care and Medicare administrative data. Specifically, Gillingham directs systems research and development work that uses large Medicare claims and enrollment data files to monitor and report on health care quality and utilization for the Centers for Medicare & Medicaid Services. In addition, he provides technical assistance and quality assurance on projects that use Medicare data to create analytic files for program evaluation, monitoring, and other research purposes.

      Learn more about this author by visiting his author page at http://support.sas.com/publishing/authors/gillingham.html. There, you can download free chapters, access example code and data, read the latest reviews, get updates, and more.

      Acknowledgments

      Writing this book became more of a lifestyle choice than a project (kind of like owning a boat, but without the enjoyment of being on a boat!). What’s more, this “lifestyle choice” was not just my own. Family, friends, and coworkers provided support and patient encouragement as they endured my long hours, late nights, and busy weekends with grace.

      I would like to thank my employer, Mathematica Policy Research, as well as my colleagues. I consider myself truly blessed to work at Mathematica, a company that values the highest standards of quality, unwavering objectivity, and compassionate collegiality. My years at Mathematica have been filled with opportunities to perform interesting and relevant work, interact with

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