Assessing the Usability of 2011 Behavioral Health Organization Medicaid Encounter Data

This brief assesses the completeness and quality of encounter data for Medicaid managed care behavioral health organizations (BHOs) in 2011. It provides an update to a similar study conducted using MAX 2009 data. It describes state variation in the use of delivery systems, which benefits are covered, and the types of Medicaid beneficiaries enrolled in BHOs. Of the 15 states with BHOs in 2011, 13 had data available at the time we started the analysis in December 2015. We find that 10 of the 13 states with BHO programs had behavioral health encounter records available in MAX. Three states (Kansas, Massachusetts, and Utah) had outpatient and other services data deemed usable for all eligibility groups, whereas two others (Iowa and Washington) had outpatient data deemed usable for some but not all eligibility groups. Compared to 2009, more states submitted inpatient BHO encounter data in 2011. Although the data were high quality for all plans in all states, our analysis found the inpatient data were not complete for all eligibility groups in any state. The brief concludes with an assessment of the data’s overall usability for program monitoring and research, and notes some study limitations.