Dual Status Information for Medicaid and CHIP Beneficiaries by Month
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This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by dual eligibility status for Medicaid and Medicare (full dual eligibility, partial dual eligibility, or not dually eligible). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Dually Enrolled in Medicare. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.
Major Eligibility Group Information for Medicaid and CHIP Beneficiaries by Month
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This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Eligibility Group Code. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.
Acute Care Services Provided to the Medicaid and CHIP Population
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This data set includes monthly counts and rates (per 1,000 beneficiaries) of acute care services, including emergency department (ED) visits, inpatient stays, intensive care unit (ICU) stays, and ICU stays that include ventilator use, provided to Medicaid and CHIP beneficiaries, by state. Users can filter to acute care services for any reason, or acute care services for COVID-19. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating acute care services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Claims Volume - IP, Claims Volume - OT, Diagnosis Code - IP, Diagnosis Code - OT, Procedure Codes - OT Professional. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.
Medicaid and CHIP enrollees who received mental health or SUD services
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This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees who received mental health (MH) or substance use disorder (SUD) services, overall and by six subpopulation topics: age group, sex or gender identity, race and ethnicity, urban or rural residence, eligibility category, and primary language. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, ages 12 to 64 at the end of the calendar year, who were not dually eligible for Medicare and were continuously enrolled with comprehensive benefits for 12 months, with no more than one gap in enrollment exceeding 45 days. Enrollees who received services for both an MH condition and SUD in the year are counted toward both condition categories. Enrollees in Guam, American Samoa, the Northern Mariana Islands, and select states with TAF data quality issues are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the primary language subpopulation topic exclude select states with data quality issues with the primary language variable in TAF. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid and CHIP enrollees who received mental health or SUD services in 2020." Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a sex or gender identity subpopulation using their latest reported sex in the calendar year. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to an eligibility category subpopulation using their latest reported eligibility group code, CHIP code, and age in the calendar year. Enrollees are assigned to a primary language subpopulation based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.
Separate CHIP Enrollment by Month and State
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This dataset includes total enrollment in separate CHIP (S-CHIP) programs by month and state from April 2023 forward.,Sources: T-MSIS Analytic Files (TAF) and state-submitted enrollment totals. The data notes indicate when a state’s monthly total was a state-submitted value, rather than from T-MSIS. Methods: Enrollment includes individuals enrolled in S-CHIP at any point during the coverage month, excluding those enrolled in dental-only coverage. The S-CHIP enrollment in this report also excludes enrollees covered by Medicaid expansion CHIP, a program in which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act. If an individual is enrolled in both Medicaid or Medicaid-expansion CHIP and S-CHIP in a given month, TAF picks the program in which they were last enrolled. Unless S-CHIP enrollment counts are replaced with a state-submitted value, each state's monthly S-CHIP enrollment is equal to the number of unique people in TAF with a CHIP_CODE = 3 (S-CHIP) and ELGBLTY_GRP_CD not equal to ‘66’ (Children Eligible for Dental Only Supplemental Coverage). More information about TAF is available at https://www.medicaid.gov/medicaid/data-systems/macbis/medicaid-chip-research-files/transformed-medicaid-statistical-information-system-t-msis-analytic-files-taf/index.html.,
Race and ethnicity of the national Medicaid and CHIP population
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This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees by race and ethnicity overall and by three subpopulation topics: scope of Medicaid and CHIP benefits, age group, and eligibility category. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, and Puerto Rico who were enrolled for at least one day in the calendar year. Enrollees in Guam, American Samoa, the Northern Mariana Islands, and the U.S. Virgin Islands are not included. Results shown for the age group and eligibility category subpopulation topics only include enrollees with comprehensive Medicaid and CHIP benefits in the year. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on information shown in the brief: "Race and ethnicity of the national Medicaid and CHIP population in 2020." Enrollees are assigned to six race and ethnicity categories using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG). Enrollees are assigned to a child (ages 0-18) or adult (ages 19 and older) subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to the comprehensive benefits or limited benefits subpopulation according to the criteria in the "Identifying Beneficiaries with Full-Scope, Comprehensive, and Limited Benefits in the TAF" DQ Atlas brief. Enrollees are assigned to an eligibility category subpopulation using their latest reported eligibility group code, CHIP code, and age in the calendar year. Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.
Medicaid and CHIP Updated Renewal Outcomes
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State-reported data on Medicaid and CHIP eligibility renewals that reflect the outcomes of previously pending renewals three months after the renewal was due and also any corrections to the original renewal data submitted to CMS. See here for original renewal data. CMS renewal data specifications require states to update and submit to CMS their monthly renewal outcome metrics - metric 5 data and its submetrics (monthly metrics 5a, 5a(1), 5a(2), 5b, 5c, and 5d) - after the original monthly report submission. The “updated” renewal data reflect the outcomes of renewals previously reported as pending (monthly metric 5d of the original monthly report) as of three months after the renewal was due. For more information about this data set and considerations for users when reviewing, please see the Medicaid and CHIP Unwinding: Data Sources and Metrics Definitions Overview found here. Sources: (1) March 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on March 05, 2024, representing the updated disposition of renewals due in March 2023 as of June 2023. April 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on March 05, 2024, representing the updated disposition of renewals due in April 2023 as of July 2023. May 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on March 05, 2024, representing the updated disposition of renewals due in May 2023 as of August 2023. June 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on March 05, 2024, representing the updated disposition of renewals due in June 2023 as of September 2023. July 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on March 05, 2024, representing the updated disposition of renewals due in July 2023 as of October 2023. August 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on March 05, 2024, representing the updated disposition of renewals due in August 2023 as of November 2023. September 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on April 02, 2024, representing the updated disposition of renewals due in September 2023 as of December 2023. October 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on April 02, 2024, representing the updated disposition of renewals due in October 2023 as of January 2024. November 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on May 07, 2024, representing the updated disposition of renewals due in November 2023 as of February 2024. December 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on June 11, 2024, representing the updated disposition of renewals due in December 2023 as of March 2024. New Hampshire’s December 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on April 09, 2024, representing the updated disposition of renewals due in December 2023 as of March 2024. New York’s December 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report pulled on April 22, 2024, representing the updated disposition of renewals due in December 2023 as of March 2024. January 2024 state Medicaid and CHIP Renewal and Termination Data for t
Dental Services Provided to Medicaid and CHIP Beneficiaries Under Age 19
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This data set includes monthly counts and rates (per 1,000 beneficiaries) of dental services provided to Medicaid and CHIP beneficiaries under the age of 19 (as of the first day of the month), by state. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating dental services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Procedure Codes - OT Professional, Claims Volume - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.
Medicaid enrollees who qualify for benefits based on disability
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This data set includes annual counts and percentages of Medicaid enrollees who are eligible for benefits based on disability, overall; by reason for qualification of disability benefits; and by four subpopulation topics: age group, dual eligibility status, race and ethnicity, and managed care participation. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. The Children’s Health Insurance Program (CHIP) does not confer eligibility based on disability, so Medicaid expansion CHIP (M-CHIP) and separate CHIP (S-CHIP) enrollees are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the dual eligibility, race and ethnicity, and managed care participation subpopulation topics are restricted to working-age adults (ages 19 to 64) with comprehensive Medicaid benefits. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid enrollees who qualify for benefits based on disability in 2020." Enrollees are assigned to a disability category based on their latest reported eligibility group code and age in the calendar year. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a dual eligibility status subpopulation based on the dual eligibility code that applies to the majority of their enrolled-months during the year (Dual Eligibility Code). Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to a managed care participation subpopulation based on the managed care plan type code that applies to the majority of their enrolled-months during the year (Enrollment in CMC Plans). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.