Medicaid Issue Briefs

What’s New in January 2013!

• A new issue brief is now available titled “Using the MAX-NHANES Merged Data to Evaluate the Association of Obesity and Medicaid Costs.”  This issue brief presents the results of the first study conducted using the newly 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.  This issue brief is available through the links in the “Downloads” section.

What’s New in December 2012!

• A new issue brief is now available titled “Assessing the Usability of Encounter Data for Enrollees in Comprehensive Managed Care Across MAX 2007–2009”.  This issue brief assesses the availability, completeness, and quality of encounter data in MAX 2007–2009.  The analysis builds on our 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 increase in reporting and usability makes the inclusion of encounter data in research studies a more viable option than in the past.  This issue brief is available through the links in the “Downloads” section.

• A new issue brief is now available titled “The Availability and Usability of Behavioral Health Organization (BHO) Encounter Data in MAX 2009”.  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.

What’s New in November 2012!

• A new issue brief is now available titled “CHIP Data in the Medicaid Statistical Information System (MSIS): Availability and Uses.”  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 that data, including to monitor program performance, evaluate policy options, and help implement provisions of the Affordable Care Act (ACA).  It is available through the links in the “Downloads” section.

• A new issue brief is now available titled “Best Practices for Linking Medicaid and Separate CHIP Eligibility Records.”  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.   It is available through the links in the “Downloads” section.

What’s New in October 2012!

• Two new issue briefs are now available.  The first is titled “Utilization of Dental Services among Medicaid Enrolled Children.”   It 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.  The second is titled “Utilization of Well-Child Care among Medicaid Enrolled Children.”  It 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. These issue briefs demonstrate the use of Mini-MAX (MAX sample data) for research and demonstrate that Mini-MAX can produce useful analyses for policy makers.  Please see the “Downloads” section below.  

• 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 July 2012!

• A new Issue Brief is now available, titled “Assessing the Usability of MAX 2008 Encounter Data for Enrollees in Comprehensive Managed Care.”  This issue brief provides an assessment of the selected other services (OT), inpatient (IP), and prescription drug (RX) encounter data for enrollees in comprehensive managed care during 2008. This issue brief summarizes the availability, completeness, quality and usability of the encounter data for comprehensive managed care enrollees by basis of eligibility (BOE) category as well as gives specific information by state. It also examines the changes in the IP and RX encounter data from 2007 to 2008.  The results are encouraging for researchers and policymakers. Most states that have comprehensive managed care plans are reporting IP, RX, and OT encounter data. Of those data, the majority are usable. The number of states submitting usable encounter data is increasing.  Please see the “Downloads” section below.  

• A new Issue Brief is now available, titled “Migration Patterns for Medicaid Enrollees, 2005-2007.”  This issue brief presents an analysis of the migration patterns of Medicaid enrollees by eligibility group and state over the period January 2005 through December 2007.  The analysis focuses on two major topic areas.  The first one is a national analysis of migration that examines the number of enrollees by the number of moves, the number of states to which enrollees moved and the number of moves associated with enrollment gaps of varying lengths.  The second one is a state analysis presented in two parts.  The first part includes in-migration, out-migration, net migration, along with a comparison to overall U.S. population migration.  The second part examines the number of enrollees who moved, the number of moves, and enrollment gaps for moves between pairs of states.  Please see the “Downloads” section below.  

What’s New in June 2012!

• A new Issue Brief is now available, titled “Medicaid Enrollment Gaps, 2005-2007.”  The Medicaid program provides health insurance coverage every year to more than 60 million Americans spanning all ages.  Eligibility is based on both categorical factors and income. Each can change, resulting in a potential loss of eligibility for an enrollee.  Prior research has established that the loss of Medicaid coverage, whether temporary or permanent, has consequences for both the individual and the community.  In this issue brief, which is based on a larger report, we use data from a source—Medicaid administrative records that have been unduplicated and linked over time—to investigate discontinuities in Medicaid enrollment by eligibility group over the period January 2005 through December 2007.  We focus on two areas:  (1) continuity of coverage and (2) the duration of enrollment gaps.  Please see the “Downloads” section below.  

What’s New in April 2012!

• A new Issue Brief is now available, titled “Movement of Children between Medicaid and CHIP, 2005 to 2007”.  The Children’s Health Insurance Program (CHIP) provides health insurance coverage to millions of children whose families are unable to obtain employer-sponsored insurance or purchase private non-group coverage but whose incomes are above the limits that would qualify their children for Medicaid.  Family incomes are fluid, however, and many children who receive coverage through CHIP were covered by Medicaid earlier or will shift their coverage to Medicaid later.  This issue brief uses data from a new source—Medicaid administrative records that have been unduplicated and linked over time—to examine the movement of children between Medicaid and CHIP from 2005 through 2007.  These findings provide perspective on potential transitions in coverage among low-income adults once the Affordable Care Act is fully implemented.  Please see the “Downloads” section below.

• A new Medicaid Issue Brief has been released, titled, "Prescription Drug Use and Cost Among Medicaid Beneficiaries with Disabilities and Chronic Illness."  With the shift of prescription drug coverage for Medicaid-Medicare dual eligibles to Medicare in 2006, Medicaid prescription drug spending is now highly concentrated among nondual Medicaid-only beneficiaries under age 65 with disabilities and chronic illnesses. They accounted for 62 percent of nondual Medicaid prescription drug spending in 2007, although representing just 12 percent of nondual Medicaid beneficiaries. They often have significant behavioral health needs and complex co-existing physical and behavioral health conditions. They represent about 12 percent of the Medicaid-covered residents of nursing facilities and increasingly are being included in capitated managed care programs.  This Issue Brief is available on the Mathematica Policy Research, Inc. website.  A link to that web page is located after the description section below.

• A new Issue Brief is now available, titled “Assessing the Usability of the MAX 2007 Inpatient and Prescription Encounter Data for Enrollees in Comprehensive Managed Care”.  As growing numbers of Medicaid enrollees receive health benefits through comprehensive managed care, the researchers and policymakers seeking to understand the service use of these enrollees must rely on encounter data that states receive from managed care plans.  Although encounter data provide insight into the service use of comprehensive managed care enrollees, not all states report encounter data, and little is known about the data’s usability.  This issue brief summarizes the availability, completeness, quality and usability of the MAX encounter data for comprehensive managed care enrollees in 2007 by basis of eligibility (BOE) category as well as gives specific information by state. The results are encouraging. Most states that have comprehensive managed care plans are reporting IP and RX encounter data. Of those data, the majority are usable. It is available through links in the “Downloads” section below.  

Description

During this time of rapid health reform, researchers and policymakers want access to the latest information on Medicaid enrollment, expenditures, and service use. They also want reports that are shorter, more focused, and more relevant to today's challenges facing the Medicaid program. CMS, in collaboration with Mathematica, has started the MAX Medicaid policy issue brief series, which highlights the essential role MAX data can play in analyzing the Medicaid program.

Medicaid Prescription Drug Issue Brief This link is to an Issue Brief, titled "Prescription Drug Use and Cost Among Medicaid Beneficiaries with Disabilities and Chronic Illnesses" based on an analysis of MAX data.