Providing Business Analytics and Data Quality Development for Medicaid and CHIP Business Information Solutions (MACBIS)

Prepared for
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services
Innovation graphic MACBIS

Medicaid and the Children’s Health Insurance Program (CHIP) are the largest sources of health coverage in the United States for low-income populations and people with disabilities. These critical safety net programs are growing in size and complexity. The Centers for Medicare & Medicaid Services is partnering with states to support innovations that will slow growth in program costs and increase the quality of care provided by these programs. The Medicaid and CHIP Business Information and Solutions initiative is building an infrastructure for robust data analytics, and integrating and aligning federal and state data sources, to support data-driven policy decisions about Medicaid and CHIP policy and programs.

The Mathematica team is focused on developing tools for advanced data quality detection and dissemination as well as the design and development of data products and analytic reports. Our advanced data quality detection tools, used to provide technical assistance to states with their Transformed Medicaid Statistical Information System (T-MSIS) file submissions, include dashboards, exploratory analytics, and custom reporting capabilities for self-service business decision making. To ensure our analytic work meets business needs, the team is conducting stakeholder engagement and training activities with CMS staff. Mathematica is also providing subject matter expertise on data design and management that supports the stakeholder community. We supported the development of research-optimized versions of the T-MSIS data, known as the T-MSIS Analytic Files (TAFs). Using our analytic capabilities, we are helping CMS test the possibilities of using T-MSIS data to replace a range of state reports, including reports for the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program and Medicaid and CHIP Core Measure Sets. In addition, Mathematica is supporting the data analytics for CMS’s Innovation Accelerator Program (IAP), developing methodologies and tools to support several IAP content areas, the Congressional-mandated Substance Use Disorder Data Book, and the design of the Medicaid and CHIP Scorecard.