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Medicaid and CHIP CAA Reporting Metrics
State-reported data on Medicaid and CHIP eligibility renewals conducted during the reporting period and call center operations Sources: (1) March and April 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of June 13, 2023. Florida's March and April 2023 Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of June 05, 2023. May 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of July 12, 2023. Florida's May 2023 Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of July 03, 2023. June 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of August 16, 2023. Florida's June 2023 Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of July 31, 2023. July 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of September 12, 2023. August 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of October 23, 2023. September 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of November 07, 2023. Delaware’s September state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of November 28, 2023. October 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of December 05, 2023. November 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of January 05, 2024. December 2023 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of February 08, 2024. January 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of March 05, 2024. February 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of April 02, 2024. The total number of Medicaid and CHIP beneficiaries for whom a renewal was initiated in the reporting month (metric 4) for Idaho and Nebraska as of April 12, 2024. March 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of May 07, 2024. April 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of June 11, 2024. May 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of July 02, 2024. June 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of August 06, 2024. July 2024 state Medicaid and CHIP Renewal and Termination Data for the Unwinding Data Report as of September 09, 2024. (2) Call Center Data from the Medicaid and CHIP Eligibility and Enrollment Performance Indicator Data as of September 10, 2024. Notes: For all states, data may be affected by mitigation strategies in place, such as those related to ex parte functionality. Georgia reported data for individuals who continue to be eligible following a change in circumstances and were granted a new 12-month eligibility period during the April - July 2024 reporting periods, along with data on individuals due for renewal in these months. South Dakota did not initiate or complete renewals in the March - July 2024 reporting period due to a mitigation strategy for ex parte functionality. South Dakota did not initiate renewals in the February 2024 reporting period due to a mitigation strategy for ex parte functionality. Due to temporary renewal process changes, most renewals due in Iowa, including ex parte renewals, were not completed by the end of the reporting month for the December 2023 - February 2024 reporting periods. Hawaii and Vermont experienced a natural disaster, and the number of renewals initiated and completed in the reporting period were impacted due to the disaster response efforts in the month of August 2023. South Carolina does not have renewal outcomes to report
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State Medicaid and CHIP Eligibility Processing Data
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All states (including the District of Columbia) provide data to the Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment metrics. These data reflect state-reported information on Medicaid and CHIP eligibility renewals initiated and scheduled for completion during the reporting period. In addition to reporting the outcomes of renewals at the end of each reporting period, states also provide an update on renewals that were reported pending as of the end of a reporting period. For more information on these data, see Sections II and III of the Eligibility Processing Data Report specifications. Notes: Georgia reported data for individuals who continue to be eligible following a change in circumstances and were granted a new 12-month eligibility period during the reporting period, along with data on individuals due for renewal in the month. North Carolina reports renewal outcomes for only initiated renewals scheduled for completion in the report month, and as such, the data do not reflect renewals that should have been completed in the reporting period that the state was unable to initiate by the end of the report month.
State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data-test
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CHIP Applications, Eligibility Determinations, and Enrollment Data
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All states (including the District of Columbia) are required to provide data to The Centers for Medicare & Medicaid Services (CMS) on a range of indicators related to key application, eligibility, and enrollment processes within the state Medicaid and Children’s Health Insurance Programs (CHIP). These data reflect enrollment activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, as well as state program performance.
State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data
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All states (including the District of Columbia) are required to provide data to The Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) indicators related to key application, eligibility, enrollment and call center processes. These data reflect enrollment activity for all populations receiving comprehensive Medicaid and CHIP benefits in all states, as well as state program performance. States submit this data via the Performance Indicator dataset. Further information about this dataset is available at: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/performance-indicator-technical-assistance/index.html.
Major Eligibility Group Information for Medicaid and CHIP Beneficiaries by Year
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This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each major eligibility group over the year (duplicated count); (2) the number of beneficiaries enrolled in each major eligibility group as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment in each major eligibility group. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year 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.
Benefit Package for Medicaid and CHIP Beneficiaries by Year
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This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by benefit package (full-scope, comprehensive, limited, or unknown). There are three metrics presented: (1) the number of beneficiaries ever enrolled with each benefit package over the year (duplicated count); (2) the number of beneficiaries enrolled with each benefit package as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment with each benefit package. 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 Restricted Benefits 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. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.
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.,
Managed Care Information for Medicaid and CHIP Beneficiaries by Year
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This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each managed care plan type over the year (duplicated count); (2) the number of beneficiaries enrolled in each managed care plan type as of an individual’s last month of enrollment (duplicated count); and (3) average monthly enrollment in each managed care plan type. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some cells have a value of “DS”. Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. 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.
Program 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 program type (Medicaid or CHIP). 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 topics Medicaid-only Enrollment and M-CHIP and S-CHIP Enrollment. 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.
Dual Status Information for Medicaid and CHIP Beneficiaries by Year
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This data set presents annual 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). There are three metrics presented: (1) the number of beneficiaries ever dually eligible for Medicaid and Medicare over the year (duplicated count); (2) the number of beneficiaries dually eligible for Medicaid and Medicare as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly eligibility for Medicaid and Medicare. 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.
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