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Measuring Health Care Utilization in Medicare Advantage Encounter Data: Methods, Estimates, and Considerations for Research
Authors: --- --- --- --- --- et al.
Year: 2019 Publisher: Santa Monica, Calif. RAND Corporation

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Abstract

This report describes analytical methodologies, estimates, and technical considerations related to the measurement of health care utilization in Medicare Part C encounter data (ED) submitted by organizations offering Medicare Advantage plans to Medicare beneficiaries. The primary aim of the report is to provide technical details for researchers on the structure and scope of ED and on the methodological steps and analytical decisions necessary to assess utilization of health care services using ED. The authors identify key considerations related to enrollment, differences in ED and Medicare claims data, and decisions that researchers must make about data field selection. From 2015 to 2016, there was a slight decrease in inpatient hospital stays (from 0.231 to 0.225 per enrollee) and a slight increase in professional visits (from 21.095 to 21.292 per enrollee). Outpatient facility visits, emergency department visits, and other outpatient facility visits increased slightly.

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An Evaluation of the Military OneSource Call Center in Select Groups of Callers: Call Quality, Call Outcomes, and Caller Satisfaction
Authors: --- --- --- --- --- et al.
Year: 2021 Publisher: Santa Monica, Calif. RAND Corporation

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Military OneSource operates a call center for military personnel and their family members, as well as those who have recently left the military. The goals of the center, which is directed by Military Community and Family Policy (MC&FP), are to directly provide resources for families and to provide referrals to a variety of support and health services. In this report, the authors describe their evaluation of Military OneSource call quality, call outcomes, and caller satisfaction within select groups of callers: junior enlisted personnel and their family members, those seeking relationship counseling, and transitioning service members (retired or honorably discharged). Their evaluation consists of two separate studies: Study 1 involved reviewing and rating audio recordings of calls for quality, outcomes, and satisfaction. Study 2 consisted of telephone interviews with a separate sample of callers in which the callers were asked directly about their experiences in communicating with the Military OneSource triage consultants who handle the calls; whether and how they were referred to resources; and, if so, their satisfaction with those resources. Overall, the Military OneSource calls were rated of high quality with regard to communication style, and they were successful in referring callers to appropriate resources. Similarly, most interviewees expressed satisfaction with their experience in communicating with Military OneSource triage consultants and reported that they were referred to resources and services that met their needs. These interviewees offered limited suggestions for changes to the referral process.

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