title: Utilizing Medicare claims data for real‐time drug safety evaluations:is it feasible?
abstract: OBJECTIVE
  The Centers for Medicare & Medicaid Services claims comprise an administrative database of beneficiary-specific clinical information. This study evaluates the impacts of (i) claim information updates (claims adjudication) and (ii) delay in claim processing (claims delay) on real-time evaluation of health service and drug safety signals using the Medicare database.
  
  
  METHODS
  Using Medicare claims data accumulated through May 2009 on health services rendered in 2006 and drugs dispensed in 2007, this study measures the frequency with which clinical information changes in the database as a result of (i) claims adjudication and (ii) claims delay.
  
  
  RESULTS
  Over 85% of health services claims were processed within 8 weeks after the date of service, and 72% of drug claims were processed within 3 months after the dispense date. Clinical information changed for no more than 3% of unique claim groups in inpatient hospital, outpatient institutional, physician's office, and prescription drug Medicare claim settings.
  
  
  CONCLUSIONS
  Claims delay is consistent across time and is minimal. Claims adjudication does not substantially impact the content of clinical information in the Medicare claims database. Therefore, the Medicare claims database provides consistent information regarding health services and prescription drugs in a manner that is prompt enough to facilitate medical product safety evaluations in real time.
authors.affiliation: Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL, USA. Hartzema@ufl.edu
authors.forename: Abraham G
authors.initials: AG
authors.lastname: Hartzema
authors.forename: Judith A
authors.initials: JA
authors.lastname: Racoosin
authors.forename: Thomas E
authors.initials: TE
authors.lastname: MaCurdy
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Gibbs
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kelman
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions; D005240:Feasibility Studies; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D006278:Medicare; D011358:Product Surveillance, Postmarketing / Q000379:methods*; D013997:Time Factors; D014481:United States