Projects

Medicare Advantage Encounter Data Integrity Protocol Management

2016-2020
Prepared For

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

Mathematica is assisting the Centers for Medicare & Medicaid Services (CMS) in developing a high quality encounter data system to support the ongoing administration of the Medicare Advantage program and to inform the design of future innovations, impact evaluations, and policy development.

Specifically, Mathematica is helping to update the Medicare Advantage Encounter Data (MA ED) Integrity Protocol, which provides Medicare Advantage Organizations with guidance on collecting and validating the accuracy and completeness of the encounters they submit; offering options to improve technical assistance to CMS contractors in implementing the protocol and document implementation progress; and if necessary, modifying the protocol to obtain more accurate and complete encounter data. 

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