Overview
Given the primary role that Medicaid and the Children’s Health Insurance Program (CHIP) serve as the backbone of our nation’s safety net health care system, the Centers for Medicare & Medicaid Services (CMS) has made significant investments in these programs’ information technology and data analytic infrastructure to improve access to high-quality, timely Medicaid and CHIP data. The Transformed Medicaid Statistical Information System (T-MSIS) initiative transitioned state reporting to a timelier and expanded data set using a modernized technology platform to collect enhanced data from states. Because of the size and complexity of T-MSIS files and the frequency of updates, these raw data files are challenging to use for analytic purposes. Therefore, CMS created a series of data sets optimized for analytics, known as the T-MSIS Analytic Files (TAF) consisting of research identifiable files (RIF). TAF RIFs contain beneficiary-level data that are available with an approved Data Use Agreement.
Currently, TAF RIFs are available for calendar years 2014-2016 (released in November 2019), as well as 2017 and 2018 (released in September 2020). Today’s release refreshes the previously released 2014-2016 data to reflect improved state data quality for those years. Additionally, CMS is adding more years of data quality information to the Data Quality (DQ) Atlas tool. With today’s release, DQ Atlas will include data quality information reflecting the refreshed 2014-2016 data, as well as initial data quality information ahead of the expected December 2020 release for the preliminary 2019 TAF RIF.
What is included in this release and who will use it?
CMS is releasing refreshed data for the 2014-2016 TAF RIFs. CMS is also releasing data quality information in DQ Atlas to reflect this refreshed data as well as limited data quality information for 2019 pertaining to the upcoming preliminary 2019 TAF RIF. CMS, oversight entities, and researchers will use the TAF RIFs and associated data quality information for program monitoring, oversight, model evaluations, and answering questions regarding Medicaid and CHIP.
TAF RIFs
The TAF RIFs include annual files that contain demographic and eligibility information for all Medicaid and CHIP beneficiaries as well as claims files that contain service use and payment records. Data shared with researchers will not include beneficiary names, street addresses, or phone numbers, to protect beneficiary privacy, and proprietary managed care payment information will be redacted for external researchers. Five file types are being released for calendar years 2014, 2015, and 2016 at this time:
- Annual Demographics and Eligibility (DE) File
- Inpatient Hospital (IP) Claims File
- Long-Term Care (LT) Claims File
- Pharmacy (RX) Claims File
- Other Services (OT) Claims File
DQ Atlas
DQ Atlas, found here on Medicaid.gov, is an interactive, web-based tool that assists the user community in assessing the accuracy, reliability and usability of TAF. With today’s release, TAF data quality information is now available to the public for calendar years 2014-2018. Additionally, today’s release includes limited data quality information for the preliminary 2019 TAF RIF, to be released later this year. The preliminary TAF RIF includes TAF data that are not fully mature, as states continue to submit service use records. Not all topics in DQ Atlas are included for the preliminary 2019 data as some benchmark data is not yet available.
Has T-MSIS data quality improved?
State data quality has improved in the refreshed data. Most improved topics include total Medicaid and CHIP enrollment, eligibility group code, dual eligibility code, volume of claims, and inpatient stays. Arkansas is now included in the 2016 TAF RIF, and Puerto Rico is now included in both the 2015 and 2016 TAF RIFs. With the addition of data from these Medicaid agencies, the 2014-2016 TAF RIFs now contain data from every state and territory who submitted a complete year of data for that timeframe[1], reflecting increased state data quality.
While benchmark data for some topics are not available for the 2019 preliminary TAF RIF, and service use data are not yet fully mature, the available data quality assessments indicate a small improvement in data quality over the 2017 and 2018 TAF RIFs released in September. Most improved topics in 2019 compared to 2018 include Medicaid and CHIP enrollment and number of enrollment spans.
To support efforts to improve the quality and completeness of each state’s T-MSIS submissions, CMS has identified 32 T-MSIS Priority Items (TPIs) related to T-MSIS data quality, and states have made significant progress in addressing these items. Information on the number of open TPIs per state for the first 23 TPIs can be found in the state maps here. Moving forward, CMS will continue to work with the states to improve the quality of their data.
How do researchers and external partners obtain access to TAF RIF?
All external researchers who want to obtain access to the TAF RIFs should contact the CMS Research Data Assistance Center (ResDAC). ResDAC staff will work with the researcher to assist with completing the forms needed for the request package. Researchers who are approved for access to the TAF will be required to sign a CMS data use agreement that contains strict beneficiary privacy and data security requirements. Researchers who have previously received the 2014-2016 TAF RIFs have already been contacted and CMS is working with them directly regarding their access to the refreshed data. To learn more, visit the ResDAC website.
What’s next?
CMS expects to release preliminary 2019 TAF RIF in December 2020, with the final 2019 TAF RIF released in 2021 with accompanying data quality information. Next, CMS plans to rerun the 2017 and 2018 TAF RIFs in 2021 to reflect improved state data quality.
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[1] The U.S. Virgin Islands did not submit a complete year of data to T-MSIS until 2017.