Medicare addresses snow birds

Upgrades to a Medicare database soon will make life easier for senior citizens who get sick when they are away from home.

Beginning next month, a renovated database will enable health care providers to check the insurance coverage of any patient from anywhere in the country, letting them confirm addresses, demographic information and entitlement information.

One of the new features of the database will enable beneficiaries to give the addresses where they live part of the year. That will make life easier for the millions of senior citizens called "snow birds" who spend part of the year in warm locales such as Florida before returning to their northern homes after the winter.

The overall database overhaul aims to provide the Centers for Medicare and Medicaid Services (CMS) with a single, authoritative database of comprehensive data on people enrolled in Medicare. It does not include their medical records.

"Our system was aging and creaking," said Gary Christoph, chief information officer for CMS, which runs the health insurance programs for the elderly and poor. "It was the standard legacy system, and the demands were increasing 40 percent. We were getting to the point that a daily run would take 26 hours."

At a cost of about $6 million, CMS rewrote the database, pulled out old language and put in more modern terms, Christoph said.

The procedure is "long overdue," according to Bruce Vladeck, who ran the Health Care Financing Administration -- the predecessor to CMS -- during the Clinton administration.

"There were critical functions that have been impossible to track because the kind of data identified was not kept in a commonly accessible database," Vladeck said. "It made everybody crazy."

Among the problems, he said, was keeping track of a beneficiary's Medicare coverage and private insurance responsibilities as well as being able to cross-check dual eligibility of a person entitled to both Medicare and Medicaid

"This is an attempt to use modern technology to merge data from several existing databases so that certain routine administrative functions can be performed without special data match runs all the time," said Vladeck, who is now director of the Institute for Medicare Practice at the Mount Sinai School of Medicine in New York City.

Health care providers will not have direct access to the information. They will be able to send e-mails to Medicare seeking confirmation of specific coverage.

"This system was designed to have one place that the managed care system could access information derived from several places," Christoph said.


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