Insurance-Related Differences in Chronic Conditions Data Warehouse Comorbidities of Medicare Beneficiaries
The prevalence of CCW-reported comorbidities differs significantly between TM-enrolled and MA-enrolled beneficiaries who underwent CABG. These differences can introduce substantial bias in risk-adjusted analyses that erroneously assume equivalent CCW-reported comorbidity documentation across insurance types. Medicare outcomes research that relies on CCW-reported comorbidity data without accounting for insurance-related differences may produce biased treatment-effect estimates, potentially misinforming clinical or policy decisions.
Authors
- Michael J. Mack (ORCID: https://orcid.org/0000-0002-3148-9158)
- Justin M. Schaffer (ORCID: https://orcid.org/0000-0002-5778-6249)
- John J. Squiers (ORCID: https://orcid.org/0000-0003-0608-9934)
- Jasjit K. Banwait (ORCID: https://orcid.org/0000-0002-1643-3375)
- Austin Kluis (ORCID: https://orcid.org/0000-0001-7452-8906)
- John Michael DiMaio (ORCID: https://orcid.org/0000-0002-6064-5869)
- Mario Gaudino (ORCID: https://orcid.org/0000-0003-4680-0815)
Institutions
- Heart Hospital Baylor Plano (US)
Publication Details
- Journal
- The American Journal of Managed Care
- Published
- 2025-11-14
- DOI
- https://doi.org/10.37765/ajmc.2025.89824
- Citations
- 2
- Primary Topic
- Chronic Disease Management Strategies
- Type
- article
- Field-Weighted Citation Impact
- 2.71