Chronic condition triads represent the combinations of three chronic conditions among Medicare beneficiaries who have at least three of the conditions. There are 969 triads. The 19 chronic conditions are identified through Medicare administrative claims. A Medicare beneficiary is considered to have a chronic condition if the Centers for Medicare and Medicaid Services (CMS) administrative data have a claim indicating that the beneficiary received a service or treatment for the specific condition. On October 1, 2016 the conversion from the 9th version of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to version 10 (ICD-10-CM) occurred.
Regardless of when a claim was submitted for payment, services that occurred prior to October 1, 2015, use ICD-9 codes. Also, exclude beneficiaries who were enrolled at any time in the year in Part A only or Part B only, since their utilization and spending cannot be compared directly to beneficiaries enrolled in both Part A and Part B. Beneficiaries who died during the year are included up to their date of death if they meet the other inclusion criteria. For chronic condition triads, the population is further restricted to beneficiaries who have at least three of the 19 conditions for the year 2016.