Matching MCBS and Medicare Data: The Best of Both Worlds

By Eppig, Franklin J.; Chulis, George S. | Health Care Financing Review, Spring 1996 | Go to article overview
Save to active project

Matching MCBS and Medicare Data: The Best of Both Worlds

Eppig, Franklin J., Chulis, George S., Health Care Financing Review


The MCBS is an ongoing household panel survey of approximately 12,000 elderly and disabled persons eligible for Medicare benefits.(1) Field work for the MCBS began in September 1991. To date, five MCBS Access-to-Care Public Use Files (PUFs) -- 1991 through 1994 -- have been produced and made available to the public. The Access-to-Care PUFs link survey data on access to and satisfaction with health care, supplementary health insurance, and health and disability status, which are typically collected in the fall round each year, to Medicare billing data that cover the entire calendar year.

These PUFs have been used extensively to analyze a variety of issues, including: access to health care (Physician Payment Review Commission, 1996; Rosenbach, Adamache, and Khandker, 1995); satisfaction with health care (Adler, 1995); premium payments for supplementary health insurance (Chulis, Eppig, and Poisal, 1995); the relationship between supplementary health insurance and Medicare spending (Chulis et al., 1993); risk adjusting per capita payments to Medicare health maintenance organizations HMOs) (Gruenberg, Kaganova, and Hornbrook, 1996); examining favorable HMO selection (Rodgers and Smith, 1996); and the characteristics of users of home health services (Mauser and Miller, 1994).

There are, however, some significant analytic limitations to the MCBS Access-to-Care PUFs. One limitation relates to the population covered. The Access-to-Care files represent the "always enrolled," that is, elderly and disabled Medicare beneficiaries entitled to Medicare for the entire calendar year. This enrollment concept excludes persons who come on the Medicare rolls during the year. More significantly, it excludes most persons who died during the year. Persons in this group have medical expenses that are considerably higher on average than surviving beneficiaries Lubitz and Riley, 1993).

Another limitation of the Access-to-Care PUFs is that they do not contain survey-reported use of health services and costs. The files do include use and payments for Medicare covered services from Medicare billing records. However, Medicare covers less than one-half of total health care expenditures for the elderly (Waldo et al., 1989). Two of the more financially significant health care services not covered by Medicare, and therefore not included in the Access-to-Care files, are outpatient prescription drugs and long-term facility care.

The 1992 MCBS Cost and Use PUF is designed to create a more complete user file, one that uses an "ever enrolled" population concept and that includes all survey-reported use and costs. The "ever enrolled" population includes use and costs for all Medicare beneficiaries in the program for any part of 1992, including those who joined the program during the year and those who died during the year. The Cost and Use file also includes survey reports for services not included in Medicare central billing files, including prescription drugs, long-term facility care, and Medicare services provided by HMOs. In addition, for Medicare covered services, the completeness and accuracy of services used, payments made, and sources of payment has been improved by an extensive operation to match and reconcile survey reports and Medicare bills. This article describes the methods used and the results from the matching and reconciliation process used to create the 1992 MCBS Cost and Use file.


There has been a continuing emphasis in government-sponsored research to find better ways to use government administrative records to verify and augment information reported on surveys (Okner, 1974; Jabine and Scheuren, 1984). The advantages of linking survey reports to administrative records include verifying the accuracy of survey reports, adding data that was not (or could not be) obtained in the survey, and reducing the reporting burden on respondents.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Matching MCBS and Medicare Data: The Best of Both Worlds


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?