Identifying cohabiting couples in administrative data: evidence from Medicare address data
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Identifying cohabiting couples in administrative data: evidence from Medicare address data Sasmira Matta1,2 · Joanne W. Hsu3 · Theodore J. Iwashyna4,5 · Micah Y. Baum6 · Kenneth M. Langa5,7 · Lauren Hersch Nicholas6,8 Received: 11 June 2020 / Revised: 1 October 2020 / Accepted: 28 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Marital status is recognized as an important social determinant of health, income, and social support, but is rarely available in administrative data. We assessed the feasibility of using exact address data and zip code history to identify cohabiting couples using the 2018 Medicare Vital Status file and ZIP codes in the 2011–2014 Master Beneficiary Summary Files. Medicare beneficiaries meeting our algorithm displayed characteristics consistent with assortative mating and resembled known married couples in the Health and Retirement Study linked to Medicare claims. Address information represents a promising strategy for identifying cohabiting couples in administrative data including healthcare claims and other data types. Keywords Marriage · Cohabitation · Address · Couples
1 Introduction Marital status is widely recognized as an important social determinant of health (National Academies of Sciences 2017; Wood et al. 2007). Compared to the unmarried or widowed, members of married couples live longer, exhibit better physical and mental health, and receive less expensive and more efficient health care (Calvillo-King et al. 2013; National Academies of Sciences 2017; Waite and Gallagher 2000; Wood et al. 2007; Wu et al. 2008; Young et al. 1998). As the Centers for Medicare and Medicaid Services (CMS) increasingly move towards paying for outcomes, the availability of a partner (potential caregiver) has emerged as an important variable for risk adjustment (National Academies of Sciences 2017). Despite the numerous health and economic benefits of marriage, administrative data rarely includes marital status. Health services researchers have had a long-standing interest in identifying married couples using administrative data (Allison and Christakis 2006; Christakis and Allison 2006, 2009; Christakis and Iwashyna 1998; Christakis et al. 2002; Elwert and Christakis 2006, 2008a, 2008b; Gilden et al. 2017; Iwashyna and Christakis 2003; Iwashyna et al. * Lauren Hersch Nicholas [email protected] Extended author information available on the last page of the article
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Health Services and Outcomes Research Methodology
1998, 2002; Jin and Chrisatakis 2009; Smith and Christakis 2009; Subramanian et al. 2008; Zivin and Christakis 2007). Health Insurance Claim numbers (HIC), which are frequently derived from Social Security Numbers, were previously used to identify couples in Medicare claims data (Iwashyna et al. 1998). Unfortunately, this method is no longer as useful because fewer couples claim benefits using a single partner’s earnings history and CMS no longer release HICs. Ascertaining marital status without appropriate legal d
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