MAX Provider Characteristics
What’s New in December 2012!
• A new report is now available titled “Medicaid Analytic Extract Provider Characteristics (MAXPC) Evaluation Report, 2009”. This report describes the design, content, and motivation for creating the MAXPC file. The report also examines the quality and completeness of each of the six types of provider IDs in each of the 51 states. The quality and completeness vary substantially by state and by type of provider ID. The report also identifies recommendations for CMS to help improve the quality of the provider IDs. The report is available through the links in the “Downloads” section.
What’s New in October 2012!
• A new issue brief is now available titled “Physician Service Use and Participation in Medicaid, 2009.” 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. It is available through the links in the “Downloads” section.
What's New in September 2012!
• MAXPC 2009 data are now available for all 51 Medicaid jurisdictions. The data and accompanying documentation are available through the links in the “Data Files” section below.
What’s New in April 2012!
• A new report is available that evaluates the MAX Provider Characteristics (MAXPC) data. In the report, we describe the motivation for creating the MAXPC file. We also describe its design and content and examine the quality and completeness of each of the six types of provider IDs in each of the 37 states. The quality and completeness varies substantially by state and by type of provider ID. Please see the “Downloads” section below.
What's New in March 2012!
MAXPC 2009 data are now available for 37 of the 51 Medicaid jurisdictions except the District of Columbia, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Hampshire, New York, North Dakota, Oklahoma, Pennsylvania, Utah, Washington and Wisconsin. These data are now available to all interested parties on this site. In the "Downloads" section under "MAXPC 2009 and Later", please see the zipped files for access to the data.
Description
There is currently considerable interest at CMS in examining health reform proposals, program integrity, and access-to-care issues among certain types of Medicaid providers. However, it has not been possible to easily conduct provider-based research activities because the provider identification numbers collected in MSIS data are largely unedited, undocumented, and state-specific. Starting in February 2009, states were required to include National Provider Identifiers (NPIs) on their MSIS claims. The main limitation of NPIs on claims for Medicaid services is that certain classes of nonmedical providers are not required to obtain an NPI. For example, adult day health care, case management, personal care, nonemergency transportation, and many other services are excluded from the NPI requirement. Because these so-called "wrap-around" (e.g., nonmedical) services can represent a significant part of the Medicaid package of services, and are of particular interest to policymakers, this "hole" in the assignment of the NPI can be problematic for provider-related research. Nonetheless, the availability of the NPI on MSIS claims makes the development of a uniform provider characteristics file more feasible.
Medicaid Analytic Extract Provider Characteristics (MAXPC) File, Implementation Report, 2006
The MAX Provider Characteristics (PC) File Implementation Report describes the design, implementation, and results of the MAXPC prototype, which was based on three states using provider data from 2006 and 2009.
Based on the findings of this report, CMS decided to begin producing MAXPC for MAX 2009 data. For more information about the 2009 MAXPC files, consult the production specifications and validation tables in the downloads below.
General Information
MAXPC documentation is provided for 2009 in the download files listed at the bottom of this page. The documentation includes these files:
1) MAXPC Data Dictionaries – The MAXPC data dictionary is available for 2009. Because the file layout and content can change from year to year, it is anticipated that new data dictionaries are prepared for each MAXPC year.
2) MAXPC SAS Load Statements – For users of the Statistical Analysis System - SAS, we have prepared a sample of the SAS load statements that can be used to load MAXPC data into a SAS program.
3) MAXPC Validation Table Specifications – Definitions of analytic measures found in the MAXPC validation tables.
4) MAXPC Validation Tables – The MAXPC validation tables provide a large number of statistics and frequencies on the MAXPC files. The tables can help researchers determine the extent to which a state's MAXPC file is suitable for their intended research.
5) MAXPC Anomaly Tables – The MAXPC provide documentation on data anomalies that were identified during the production of MAXPC.
Data Files
Downloads
- MAX Provider Charactistics (PC) File Implementation Report [PDF, 4MB]
- MAXPC General Information [ZIP, 4MB]
- MAXPC Evaluation Report, 2009 Final Report [ZIP, 1MB]
- Physician Service Use and Participation in Medicaid, 2009 [PDF, 697KB]
- Medicaid Analytic Extract Provider Characteristics (MAXPC) Evaluation Report, 2009 [PDF, 1MB]
- Page last Modified: 12/31/2012 10:08 AM
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