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Validation of a Medicare Claims-based Algorithm for Identifying Freestanding Ambulatory Surgery Centers
John M Hollingsworth1, Rodney L Dunn, Anne M Suskind
1*Department of Urology, Dow Division of Health Services Research †Center for Health Outcomes & Policy, University of Michigan, Ann Arbor, MI.
Medical Care
|December 31, 2013
Summary
We developed an accurate claims-based algorithm to identify and track ambulatory surgery centers (ASCs) in Medicare data, essential for monitoring care quality as ASC utilization increases.
Area of Science:
- Health Services Research
- Health Informatics
- Medical Economics
Background:
- Ambulatory surgery centers (ASCs) are increasingly utilized for patient care.
- Accountability and monitoring of care quality in ASCs are crucial.
- Accurate identification of ASCs within healthcare data is necessary for such monitoring.
Purpose of the Study:
- To develop and validate a claims-based algorithm for identifying ambulatory surgery centers (ASCs).
- To enable accurate measurement and tracking of ASC-based care over time.
- To support accountability in ASCs and the surgeons who practice there.
Main Methods:
- Utilized a 20% sample of Medicare claims data from 2002-2008.
- Developed and refined three distinct definitions for identifying ASCs.
- Assessed algorithm performance against alternative data sources and established reference standards.
Main Results:
- The refined algorithm (Definition 3) demonstrated high agreement with State Ambulatory Surgery Databases (CCC=0.984).
- The algorithm achieved a positive predictive value of 99.0% for identifying healthcare markets with new ASCs.
- The algorithm accurately distinguished and tracked unique ASCs within Medicare claims data.
Conclusions:
- The developed claims-based algorithm is an accurate tool for identifying and monitoring ambulatory surgery centers (ASCs).
- This tool supports the essential need for accountability and quality assessment in ASCs.
- The algorithm facilitates research and policy-making related to the growing ASC sector.
