Affiliations: [a] Nathan Associates, Irvine, CA, USA | [b] U.S. Federal Trade Commission, NW, Washington, DC,
USA
Correspondence:
[*]
Corresponding author: Douglas A. Herman, Nathan
Associates, 2010 Main Street, Suite 700, Irvine, CA 92614, USA. Tel.: +1 949 474
4212; Fax: +1 949 474 4944; E-mail:
dherman@nathaninc.com
Abstract: This paper provides a guide to understanding physician claims data. Physician
claims data reflect the prices and quantity of procedures provided by physicians
and billed to insurers. These data are often used by policy analysts, legal
professionals, and academics to analyze price dynamics in markets for physician
specialties. Given recent legislation, such data will become ever more common
and accessible in the near future. The data are very complex, and there is
little in terms of publically available sources to explain how they convey
prices. Our goal is to aid the reader new to these data by providing a
substantive overview of them.
Keywords: Claims data, health care costs, electronic medical/health records, measuring health care price changes
