Jessica Beth Nysenbaum, Ellen Bouchery, Rosalie Malsberger Mathematica Policy Research—Health
Objective: To assess the availability, completeness, and quality of the Behavioral Health Organization (BHO) encounter data in MAX 2009. Data Source: The Medicaid Analytic Extract (MAX) 2009. Methods: We compared metrics of reporting completeness and quality for BHOs to similar metrics for six states that primarily cover MH and SA services on a FFS basis. For the IP file, number of encounters per 1,000 person months of enrollment were compared. In the OT file, we examined three completeness measures: the number of claims per PME, number of claims reported per BHO outpatient service user, and the number of OT claims per service user. Principal Findings: Out of the 15 states reporting enrollment in BHO plans in MAX 2009, 10 reported complete capitation data. IP encounter data were available in four states (Arizona, Colorado, Florida, and Iowa), compared well to FFS ranges, and appear usable for research. OT data are available for five states, but our analysis suggests data are only sufficiently complete for analysis in Arizona and Iowa. Conclusions: The initial assessment of the availability, completeness and quality of BHO encounter data in MAX 2009 suggests that only limited data are available and usable.
Keywords: behavioral health, managed care, MAX, Medicaid