Projects
Providing Data Analytics and Data Quality Support for Medicaid and CHIP Business and Information Solutions
2015-2026
Project Overview
Objective
To meet the analytical needs of CMS, Mathematica supports the T-MSIS and Performance Indicator data products and analyzes and disseminates data about Medicaid and CHIP that enable CMS monitoring and oversight, policy implementation, and technical assistance activities.
Project Motivation
By improving the quality of the Federal Medicaid and CHIP administrative data and developing analytical tools, CMS can more easily use data to strengthen the health care system for Medicaid and CHIP enrollees.
Partners in Progress
IBM
Prepared For
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Data and Systems Group (DSG)
After helping the Centers for Medicare & Medicaid Services (CMS) stand up the new national data system for Medicaid and CHIP, known as the Transformed Medicaid Statistical Information System (T-MSIS), Mathematica’s Medicaid and CHIP Business Information Solution (MACBIS) team has worked with CMS to strengthen and use T-MSIS and Performance Indicator data to inform important program and policy decisions.
Under this contract, Mathematica develops tools for advanced data quality detection and dissemination as well as data products and analytic reports. We produce the research-optimized version of the T-MSIS data, known as the T-MSIS Analytic Files (TAFs), and end user materials. We also improve the quality of T-MSIS and Performance Indicator (PI) data through direct technical assistance to states and maintenance of self-service data quality monitoring tools.
We support the Center for Medicaid and CHIP Services (CMCS) use of TAF data by producing many analytic products and reports across business owners, such as the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program; the Medicaid and CHIP Core Measure Sets; and the Medicaid and CHIP Scorecard. The team has produced congressionally-mandated reports on substance use disorders (known as the Substance Use Disorder Data Book) and the Medicaid non-emergency medical transportation benefit.
During the COVID public health emergency, Mathematica helped CMCS monitor the impacts of COVID-19 among Medicaid and CHIP beneficiaries by developing a data visualization tool that tracked COVID-19-related conditions, enrollment, and service utilization on a month-by-month basis. We leveraged this experience to develop quality measures and co-create with CMCS a comprehensive dashboard relating to access and health-related social needs.
We also provide support to end users of the data through a support desk and the maintenance of tools, such as TAF DQ Atlas and PI dashboard.
Project Impact
Through leading edge technology, analytic solutions, and a deep understanding of Medicaid and CHIP, Mathematica’s MACBIS team has provided reliable and useful data, tools, and technical assistance that has helped CMS and states make timely, data-informed decisions about waivers, program integrity, demonstrations, risk assessment, and quality of care.
Evidence & Insights From This Project
Publication
Non-Emergency Medical Transportation in Medicaid, 2018–2021
This Report to Congress presents an analysis of Medicaid beneficiaries’ use of Non-Emergency Medical Transportation (NEMT).
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