November 12, 2019

CMS on Thursday announced that the agency for the first time is releasing certain data on Medicaid and CHIP utilization and payments as part of an effort to improve health care.

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What is in the data?

The data is from the Transformed Medicaid Statistical Information System (T-MSIS), which is a joint effort by CMS and states intended to bolster oversight of Medicaid and CHIP programs. CMS has made the data available to researchers for the first time as part of its MyHealthEData initiative.

CMS released the information as a series of datasets that are optimized for analysis, known as T-MSIS Analytic Files (TAF). CMS said the TAFs are available in research-identifiable formats (RIFs), and the TAF RIFs contain demographic and eligibility data for all of the nearly 73 million beneficiaries enrolled in Medicaid and CHIP, as well as claims files that detail service-use and payment information.

CMS said it so far has released data on calendar years (CYs) 2014, 2015, and 2016, and plans to release TAF RIFs with data on CYs 2017 and 2018 sometime next year.

How can researchers use the data

According to CMS, researchers can use the data to examine how much states and the federal government are spending on Medicaid and CHIP, among other things. "These data provide key information, including information on utilization and spending under Medicaid managed care, and are needed to enable research and analysis to improve quality of care, assess beneficiary care costs, and enrollment and improve program integrity," CMS said.

The agency added, "Ongoing availability of T-MSIS data is essential to allow monitoring and oversight of Medicaid and CHIP programs, to enable evaluation of demonstrations under section 1115 of the Social Security Act, and to calculate quality measures and other metrics."

Researchers who wish to access the data must submit a request to CMS' Research Data Assistance Center and sign a use agreement intended to protect beneficiaries' data and privacy. CMS said, "Data shared with researchers will not include beneficiary names, addresses, or phone numbers, in order to protect beneficiary privacy, and proprietary managed care payment information will be redacted" (Slabodkin, Health Data Management, 11/11; Jason, EHRIntelligence, 11/7; Nyczepir, Fedscoop, 11/8; CMS release, 11/7).

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