HRS Medicare Claims and Summary Data

Overview

One of the main goals of the Health and Retirement Study is to understand the relationship between medical history and financial status, and how use of health care may change as people age. To assist in this effort, the HRS endeavors to obtain information about health care costs and diagnoses from Medicare records maintained by the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration). The HRS asks all respondents who are eligible for Medicare to provide their identification numbers; over 80% of them consent do so.

Summary of the Medicare Data Release Process

In order to use the Medicare records linked to HRS respondents, there are two linked approval processes that must be completed. As a first step, users should obtain approval from HRS for the use of restricted data (see below).As a second step, users should obtain a Data Use Agreement (DUA) from the Centers for Medicare & Medicaid Services (CMS), working through the Research Data Assistance Center (ResDAC). Formally, the request for a DUA from CMS must come from the program officer of the funding agency that supports your research.

Application Procedures

Negotiating a CMS Data Use Agreement

User applies to HRS for restricted data approval (see below). While application is under review by HRS, user completes a data request packet (New Use Request) for CMS. A complete description of the required documentation can be found at the ResDAC Requesting CMS's Identifiable Data Files (RIFs) - New Use Requests page: (http://www.resdac.umn.edu/Medicare/requesting_data_NewUse.asp) User receives PRELIMINARY approval from HRS. User finalizes CMS data request packet, incorporating data plan approved by HRS, and sends all paperwork, including HRS approval, to Acumen, LLC. Acumen verifies, completes, and sends the request to the funding agency Funding agency signs off on the request and forwards to CMS. CMS approves data request and notifies user, the Research Data Distribution Center (RDDC) at Acumen, and HRS. RDDC sends a CD containing the Medicare data files to user (encrypted). HRS provides user with ID cross-reference file (encrypted) that links respondents to the record set created by Acumen.

For users who desire more information, detailed descriptions of the data creation process and approval process are available. An overview of the procedures used by HRS to obtain permission from respondents to access Medicare records is available in PDF form.   A visual overview of the application process:

Negotiating an HRS Restricted Data Agreement

Eligibility rules and the procedures to be followed in negotiating a Restricted Data Agreement are described in detail on the Restricted Data section of the HRS Web site. In summary, a successful restricted data agreement requires:

1. Affiliation with an institution with an DHHS-certified Human Subjects Review Process, known as a Federal Wide Assurance
2. Current Receipt of Federal Research Funds
3. Written Research Proposal
4. Restricted Data Protection Plan
5. Human Subjects Review (either Full Board or Expedited)
6. Agreement for Use of Restricted Data from the Health and Retirement Study

Questions

Questions concerning HRS Restricted Datasets should be addressed as follows: