Medicaid Issue Briefs

These Issue Briefs provide highlights of Medicaid program analysis made possible with the use of the MAX data.

Issue Briefs Include:

• “Trends and Patterns in the Use of Prescription Drugs Among Medicaid Beneficiaries: 1999 to 2009 (PDF).” This issue brief highlights the changes in volume of drugs used per person, changes in drug costs per person, and changes in the use of generic drugs between 1999 and 2009. The analysis focuses in particular on drug use and costs for beneficiaries with disabilities and chronic illnesses, whose drug use is much more extensive than that of children and nondisabled adults. It also focuses on some specific types of drugs that are especially costly for Medicaid: antipsychotics, antiasthmatics, ulcer drugs, antidiabetics, and antidepressants. 
• “Using the MAX-NHANES Merged Data to Evaluate the Association of Obesity and Medicaid Costs (PDF).” This issue brief presents the results of the first study conducted using the merged MAX-NHANES data. Using data from MAX-NHANES 1999-2004, we assessed the association of obesity on annual total fee-for-service Medicaid costs. While the estimated costs were higher for obese adults than non-obese adults, the differences in costs by obesity status were not significant at the 0.05 level. The results of the analysis demonstrate the hazard of using a small national survey (NHANES) with a state-based data system (MAX) to perform cost analyses, particularly when the range of realistic costs is large. 
• “Assessing the Usability of Encounter Data for Enrollees in Comprehensive Managed Care Across MAX 2007–2009 (PDF)”. This issue brief assesses the availability, completeness, and quality of encounter data in MAX 2007–2009. The analysis builds on previous reviews of MAX 2007 and 2008 encounter data by evaluating MAX 2009 physician, outpatient, and clinic services (OT), inpatient hospital services (IP), and prescription drug services (RX), and by assessing trends in the availability and usability of encounter data across the three year period. The analysis provides tools to assist researchers and policymakers in determining which states’ encounter data to analyze. 
• “The Availability and Usability of Behavioral Health Organization (BHO) Encounter Data in MAX 2009 (PDF)”. The purpose of this issue brief is to provide a detailed analysis of the behavioral health organization (BHO) encounter data in MAX 2009 and assess the viability of using these data for research and policy analysis. This issue brief is available through the links in the “Downloads” section.
• “CHIP Data in the Medicaid Statistical Information System (MSIS): Availability and Uses (PDF).” This issue brief discusses the increasing availability of Children’s Health Insurance Program (CHIP) data in the Medicaid Statistical Information System (MSIS) and potential uses for the data.  
• “Best Practices for Linking Medicaid and Separate CHIP Eligibility Records (PDF).” This issue brief provides guidance to states that have distinct eligibility determination systems for Medicaid and separate CHIP on how to link enrollment records across systems and report a unique, permanent identifier to MSIS. 
• “Utilization of Dental Services among Medicaid Enrolled Children (PDF).” This issue brief includes an estimate of current rates of utilization for dental services among Medicaid-enrolled children in nine states and then evaluates how a child’s personal and community characteristics impact the likelihood that they utilize dental services.
• “Utilization of Well-Child Care among Medicaid Enrolled Children (PDF).”  This issue brief includes an estimate of current rates of utilization for well-child care among Medicaid-enrolled children in nine states and then evaluates how a child’s personal and community characteristics impact the likelihood that they utilize well-child services. 
• “Physician Service Use and Participation in Medicaid, 2009 (PDF).” This issue brief presents an analysis of physician use and participation using the 2009 MAXPC data, Area Resource File (extracted from the American Medical Association master file), and National Plan and Provider Enumeration System data. The analysis focuses on four major topic areas: (1) the number of physicians serving Medicaid enrollees and average physician caseload, (2) the distribution of Medicaid physician caseload by physician, (3) enrollees served by in-state and out-of-state physicians, and (4) physician participation rates in Medicaid. 
• “Home- and Community-Based Service Use Among Medicare-Medicaid Enrollees with Functional Limitations, 2007–2008 (PDF).”  This issue brief presents the results of the first study conducted using data from MAX and the Medicare Current Beneficiary Survey (MCBS).  In the study, we assessed the use of home- and community-based services (HCBS) by the presence and level of functional limitations, as measured by limitations in activities of daily living (ADL).  We illustrated that these limitations appear to be common among Medicare-Medicaid enrollees and affect both the percentage of enrollees who use HCBS and the cost associated with that care.  
• “Guide to MAX Data (PDF).”  This issue brief provides an overview of the MAX data system, describes publicly available MAX data resources, and includes tips on using MAX data for research purposes.  
• “Assessing the Usability of Encounter Data for Enrollees in Comprehensive Managed Care 2010-2011 (PDF).”  This issue brief discusses the availability, completeness, and quality of encounter data for physician, clinic, and outpatient services (OT); inpatient hospital services (IP); and prescription drug services (RX) in the Medicaid Analytical eXtract (MAX) data, which are derived from MSIS. Knowing this information can help researchers and policymakers judge the usability of the 2010 and 2011 encounter data in MAX.