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Article type: Research Article
Authors: Herman, Douglas A.a; * | Ulrick, Shawn W.b
Affiliations: [a] Nathan Associates, Irvine, CA, USA | [b] U.S. Federal Trade Commission, NW, Washington, DC, USA
Correspondence: [*] Corresponding author: Douglas A. Herman, Nathan Associates, 2010 Main Street, Suite 700, Irvine, CA 92614, USA. Tel.: +1 949 474 4212; Fax: +1 949 474 4944; E-mail: [email protected]
Abstract: This paper provides a guide to understanding physician claims data. Physician claims data reflect the prices and quantity of procedures provided by physicians and billed to insurers. These data are often used by policy analysts, legal professionals, and academics to analyze price dynamics in markets for physician specialties. Given recent legislation, such data will become ever more common and accessible in the near future. The data are very complex, and there is little in terms of publically available sources to explain how they convey prices. Our goal is to aid the reader new to these data by providing a substantive overview of them.
Keywords: Claims data, health care costs, electronic medical/health records, measuring health care price changes
DOI: 10.3233/JEM-2012-0356
Journal: Journal of Economic and Social Measurement, vol. 37, no. 3, pp. 197-224, 2012
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