The SEER and Medicare CAHPS Linked Dataset

Slide 1

The SEER and Medicare CAHPS Linked Dataset

Ron Hays, Ph.D.
Adjunct Researcher, RAND Corporation
Professor of Medicine, University of California, Los Angeles

Slide 2

SEER-CAHPS Sponsors

• Surveillance, Epidemiology and End Results (SEER) registries
• Centers for Medicare & Medicaid Services:
  • Sarah Gaillot and Liz Goldstein
• National Cancer Institute (NCI):
  • Neeraj Arora, Steven Clauser, Erin Kent
• Technical assistance:
  • Research Triangle Institute
  • Information Management Services, Inc.

Slide 3

SEER Registries

• Collect standardized clinical and demographic information for persons with newly diagnosed (incident) cancer in specific geographical areas.
• Began in 1973 and covers ~26% of U. S. population (http://seer.cancer.gov/registries/list.html):
  • States: California, Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Mexico, New Jersey, Utah
  • Metropolitan areas: Atlanta, Detroit, rural Georgia, Seattle-Puget Sound

Slide 4

SEER-CAHPS Data Sources

• CAHPS surveys fielded annually by CMS in all Medicare fee-for-service and Medicare Advantage plans from 1998-2013
• Clinical data from NCI’s SEER registries for CAHPS respondents who had cancer while living in a SEER region
• Medicare claims data for CAHPS FFS respondents who lived in a SEER region at the time of the survey

Slide 5

SEER-CAHPS Linkage: 1998-2013

Total Sample: 4,467,618

Cancer Cases: 231,089

Non-Cancer Cases: 4,236,529

Slide 6

SEER-CAHPS Linkage: 1998-2013

Total Sample: 4,467,618

Cancer Cases: 231,089

Non-Cancer Cases: 4,236,529:
In SEER Region: 816,155
Not in SEER: 3,420,374

Slide 7

SEER-CAHPS Linkage: 1998-2013 Surveys

Total Sample: 4,467,618

• Cancer Cases: 231,089:
  • FFS: 85,050
  • MA: 146,039
• Non-Cancer Cases: 4,236,529:
  • In SEER Region: 816,155
    • FFS: 294,489
    • MA: 521,666
  • Not in SEER: 3,420,374:
    • FFS: 1,402,275
    • MA: 2,018,099

Slide 8

CAHPS Survey Response Rates (1998-2010)

Year	Surveys distributed	Surveys completed	Response rate
1998	119,267	89,713	75%
1999	180,564	138,216	76%
2000	202,775	165,871	82%
2001	379,049	282,711	75%
2002	357,320	270,773	76%
2003	350,175	267,532	76%
2004	344,022	256,507	75%
2005	340,522	249,594	73%
2006	153,966	97,845	64%
2007	685,934	334,513	49%
2008	672,146	407,287	61%
2009	672,919	415,175	62%
2010	682,836	407,924	60%

 

Slide 9

Example NCI Research Questions

• Do perceptions of care differ among patients with versus without cancer?
• To what extent do cancer patients’ care experiences vary by race/ethnic subgroups?
  • Do these disparities vary by FFS or Managed Care?
• How are patient experiences with care associated with utilization of care for beneficiaries in FFS plans?

Slide 10

Data Available in 2006

• Rough cost estimate:
  • http://healthcaredelivery.cancer.gov/seer-mhos/obtain/cost.html

Images: Cartoons of a man carrying a wheelbarrow full of money, and another man wearing a billboard saying "Get Your Data Here!"

Slide 11

Further Information

• Chawla N, Urato M, Ambs A, et al. Unveiling SEER-CAHPS®: A new data resource for quality of care research. Journal of General Internal Medicine 2015;30:641-50.
• Erin Kent, PhD, Epidemiologist and Program Director in the Outcomes Research Branch at NCI:
  • http://healthcaredelivery.cancer.gov/about/staff/bios/kent.html
• ISOQOL Annual Conference, Breakfast Roundtables, October 23, 2015, 8 am-9 am:
  • http://www.isoqol.org/UserFiles/22ndAnnualConferenceFinalProgram.pdf

Slide 12

Thank you!

Ron D. Hays, Ph.D.
hays@rand.org or drhays@ucla.edu

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