Comparison Results | RestoredCDC.org

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    About the Vision and Eye Health Surveillance System (VEHSS) VEHSS Data Explorer Links Data Sources Reports and Publications VEHSS Modeled Estimates Case Definitions VEHSS Partners Glossary View All
May 15, 2024
  About the Data: MarketScan
          Key points
            * MarketScan® Commercial Claims and Encounters (CCAE) data include information from commercial medical insurance claims.
            * Sample: convenience sample of privately insured patients.
            * Sample size: approximately 43.6 million persons.
            * VEHSS topics: Vision Problems and Blindness, Vision Care Services, Age-related Macular Degeneration (AMD), Cataract, Diabetic Retinopathy (DR), Glaucoma, Other Eye Disorders.
        Where the data comes from
        Where the data come from
          Access the data‎
          Access the data
              Explore MarketScan summary data in the VEHSS application. Directly access and download the summary data in the data portal.
        The MarketScan Commercial Claims and Encounters (CCAE) data is produced by IBM. CCAE data contain a convenience sample of insurance claims information from persons with employer-sponsored insurance and their dependents, including 43.6 million person-years of data in 20161.
        Several types of insurance plans are included in the CCAE including fee-for-service, partial capitation, and full capitation. Benefit designs of persons insured include preferred and exclusive provider organizations, point-of-service plans, indemnity plans, health maintenance organizations (HMOs), and consumer-directed health plans (CDHPs).
        Encounter-level data include diagnoses and procedures, insurer, and insurer and patient paid amounts from outpatient, inpatient, pharmacy, laboratory, and dental claims. Services can be linked by unique patient ID to patient characteristics as measured and included in a separate patient enrollment file. Because patient characteristics are dependent on information included in enrollment forms, some demographic variables (in particular race/ethnicity) are limited. MarketScan does not include vision insurance claims that are not covered by the patient's primary insurer.
          Analysis overview
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        The VEHSS team calculated prevalence of diagnosed eye and vision disorders and prevalence of receipt of covered eye care services in MarketScan® claims based on the presence of ICD-9 and ICD-10 diagnosis codes and CPT procedure codes on any patient claim during the year of observation.
        VEHSS reports summary prevalence and counts for the topics and categories listed, by the geographic levels and stratification factors listed below:
            Expand All
              Included VEHSS topics – categories
                    * Vision Problems and Blindness – Diagnosed Vision Disorders
                    * Vision Care Services – Eye Exams
                    * Vision Care Services – Imaging or Diagnostic Tests
                    * Vision Care Services – Screening Services
                    * Vision Care Services – Glasses or Contacts
                    * Age-related Macular Degeneration (AMD) Prevalence
                    * Age-related Macular Degeneration (AMD) Treatment
                    * Cataract Prevalence
                    * Cataract Treatment
                    * Diabetic Retinopathy (DR) Prevalence
                    * Diabetic Retinopathy (DR) Treatment
                    * Glaucoma Prevalence
                    * Glaucoma Treatment
                    * Other Eye Disorders – Prevalence
              Available geographic levels
                    * National and state*
                  *South Carolina has been suppressed in state-level results.
          Data definitions
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              Included stratification factors (state and national estimates)
                          Age Group
                        * All ages
                        * 0-17
                        * 18-39
                        * 40-64
                        * 65-84*
                          Gender
 
                          Sex
                        * Both sexes
                        * Male
                        * Female
                          Race/Ethnicity
                        * Not available
                          Risk Factors
                        * Diabetes–yes and no
                        * Hypertension–yes and no
                  *Ages 85+ suppressed due to small sample size.
                  A detailed description of the analytical steps is described in the report "VEHSS Claims & Registry Data Analysis Plan."
                  Full analysis documentation is included in the "VEHSS MarketScan® Data Report."
              Potential limitations
                  Although the MarketScan CCAE is a very large convenience sample, it is not nationally representative. Additionally, differences in patient characteristics and representation of plan and benefit type between it and the universe of all privately insured individuals has not been assessed. With those limitations in mind, because of its large sample, information from the MarketScan CCAE is likely related to what would be found in the full population of those privately insured. However, users of the data should be cautioned that the CCAE information is not representative, and results derived from it may differ substantially from what would be found using a representative sample of privately insured persons. Differences between the MarketScan sample and the population of all privately insured individuals are likely most extreme at the state level, especially in some smaller states where limited insurers participate in the system.
                  Additional limitations of the of the VEHSS analysis of MarketScan commercial insurance data include:
                    * Commercial insurance claims are intended for billing purposes only. Diagnosis information included on claims is intended to justify payment. Therefore, diagnosis data on claims may suffer from bias or limited detail.
                    * Commercial insurance does not cover all health care services, and coverage differs by patient, plan, and insurer. Commercial insurance patients may utilize these services using a different payer, and thus these services are not captured in commercial insurance data.
                    * Patients may be insured by multiple insurers. Thus, even normally covered ophthalmology services may not be indicated in commercial insurance data if services were reimbursed by another payer.
        On This Page
            * Where the data comes from
            * Where the data come from
            * Analysis overview
            * Data definitions
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            * Data Sources
            * About the Data: IRIS® Registry
            * About the Data: Medicare
            * About the Data: Medicaid
            * About the Data: Managed Vision Care
            * About the Data: Military Health System (MHS)
          View All Vision and Eye Health Surveillance System
    About the Data: Managed Vision Care
  May 15, 2024
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          Content Source:
        National Center for Chronic Disease Prevention and Health Promotion
        References
         1. Truven Health Analytics https://truvenhealth.com/portals/0/assets/2017_MarketScan_Databases_Health_Services_Researchers.pdf
      Related Pages
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        * Data Sources
        * About the Data: IRIS® Registry
        * About the Data: Medicare
        * About the Data: Medicaid
        * About the Data: Managed Vision Care
        * About the Data: Military Health System (MHS)
      View All Vision and Eye Health Surveillance System
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    Vision and Eye Health Surveillance System
    VEHSS uses new and existing data sources to provide information on vision loss, eye disorders, and eye care services in the United States.
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          * About the Vision and Eye Health Surveillance System (VEHSS)
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          * VEHSS Modeled Estimates
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