MarketScan Medicare Standard Edition Database

MarketScan is one of the largest and longest running proprietary US claims databases used for healthcare research. The data come from a selection of large employers, health plans, and government and public organizations. The database includes de-identified, patient-level longitudinal data for nearly 300 million unique patients, using data from several domains.

The Medicare Standard Edition Database is identical in structure to the Commercial Standard Edition Database but also includes data from Medicare-eligible retirees with employer-provided Medicare Supplemental and Medicare Advantage plans. Its inpatient and outpatient medical/surgical data are stored in the following tables:

• The Inpatient Admissions Table contains records that summarize information about a hospital admission, including all encounters or claims associated with the admission (e.g., from hospitals, physicians, surgeons, or independent laboratories), payment information, principal procedure and diagnosis, major diagnostic category (MDC), and diagnosis-related group (DRG).
• The Facility Header Table contains complete header information from facility claims. A Facility Header Record identifier (FACHDID) exists on both the Facility Header Table and the Inpatient Services and Outpatient Claims Tables to identify the individual service records that each header record comprises.
• The Inpatient Services Table contains the individual facility and professional encounters and services that the inpatient admission record comprises.
• The Outpatient Services Table contains encounters and claims for services that were rendered in a doctor’s office, hospital outpatient facility, emergency department, or other outpatient facility.
• The Outpatient Pharmaceutical Claims Table contains data from a large portion of the individuals represented in the medical/surgical and populations tables. Each record represents either a mail-order or retail program prescription drug claim.
• The Annual Enrollment Summary Table contains a single record per person per year. The annual summary contains monthly arrays of certain variables such as indicators of enrollment (yes/no), days enrolled, data type, and plan type in each month during the year. There also are variables indicating the number of months during the year with enrollment and the total annual enrollment days.
• The Enrollment Detail Table contains one record per person per month of enrollment for an individual enrollee regardless of whether any demographic values have changed from the previous month.