Documentation for Medicaid Data

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Occasional Contributor SGK
Occasional Contributor
Posts: 8

Documentation for Medicaid Data

Hello,

I am working with raw Medicaid data, and I cannot find any documentation for the many datasets that I have access to. A variable dictionary or codebook with actual variable descriptions would be ideal but also anything  high-level that explains the difference between the various files would be helpful as well.

So this is not really a SAS question but I am hoping that someone out there who also works with this type of data might be able to point me in the right direction. Thanks in advance.

New Contributor
Posts: 2

Re: Documentation for Medicaid Data

When you say "raw" Medicaid data, do you mean MSIS? MAX? Files from a particular state's program? Medicaid data exists in a lot of different forms.

Link to high level info about Medicaid data from CMS:

Medicaid Data Sources - General Information - Centers for Medicare & Medicaid Services

Link to Medicaid Analytic Extract (MAX) data dictionaries:

Find a CMS Data File | ResDAC

Occasional Contributor SGK
Occasional Contributor
Posts: 8

Re: Documentation for Medicaid Data

I think I am talking about MSIS. Provider files, Encounter files, Enrollment, UB92 claims, etc. Not High-level. And yes, it is specific to a certain state but I am hoping that there must be similarities to the data structure across states.

Thanks!

New Contributor
Posts: 4

Re: Documentation for Medicaid Data

Usually the State IT people are the best source.  However, Old_Buccaneer has given you the best sources publically available.   If you have the data under a DUA, I would go back to the State.

New Contributor
Posts: 2

Re: Documentation for Medicaid Data

Our data warehouse doesn't deal with MSIS -- we have been using MAX data as produced by Mathematica since it started being available -- so I don't have a lot of ready info off the top of my head. However, I did find a reference to this in some of our QA documentation:

http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MSIS/downloads/msi...

It might give you a start on the claims and eligibility files. Provider files that have not been through the MAX process are state-specific and I don't really know anything about them; I would think the best course would be to approach the source of the files for whatever info they might have. TelligenOne is right -- for MSIS you need to talk to the people who are responsible for preparing the data for transmission to HHS. I sympathize because I know it's often difficult to locate the right person to talk to but once you find him or her they will steer you straight a lot faster than any of us will.

Occasional Contributor SGK
Occasional Contributor
Posts: 8

Re: Documentation for Medicaid Data

Well thank you both for weighing in. I'll keep trying to find the right person to ask.

Occasional Contributor
Posts: 5

Re: Documentation for Medicaid Data

Hi, what state are you talking about?  They are basically all different.  I have some experience with NC Medicaid data. 

N/A
Posts: 1

Re: Documentation for Medicaid Data

I worked with Medicaid data and used a book that contain all the diagnoses and remedy codes.  It was huge and very expensive.

New Contributor
Posts: 4

Re: Documentation for Medicaid Data

We just won a contract to manage the Mass P4P state program.  I am told it is mostly based on Medicaid.  I guess I will find out. I have been working with OK Medicaid data and the State people were necessary and helpful.  Have you tried the State websites? Usually in the health dept.

Occasional Contributor SGK
Occasional Contributor
Posts: 8

Re: Documentation for Medicaid Data

Well, I have been trying to find someone over at MassHealth (they do Medicaid in Massachusetts) to call or email but haven't found that person yet.

Occasional Contributor
Posts: 5

Re: Documentation for Medicaid Data

So you're a contractor working with Medicaid data?  And you're looking for a physical data model for the warehouse that you're working in?  In my experience (all in NC), you should just ask everybody you can think of until you find something.  Don't be bashful.  Be direct and respectful, and people will help if they can has been my experience.

One thing to do is find out who the fiscal agent (they may call it a third party administrator) is for the state, they're the folks that will be sending the data feeds that populate the warehouse.  If you can get in touch with them they might be able to get you some documentation.  It will depend also on how much ETL the state does when they get the data from the fiscal agent.  They may do a lot, which will make it harder to rely on the fiscal agent (although you said raw claims, so maybe not).

Occasional Contributor
Posts: 5

Re: Documentation for Medicaid Data

Also, I know a guy who used to work at MassHealth (I think, he definitely worked with medicaid, I just don't know if he was employed by them).  He didn't do data stuff, but he might know somebody good to talk to.  Want me to ask him?

Occasional Contributor SGK
Occasional Contributor
Posts: 8

Re: Documentation for Medicaid Data

Sure, that would be great. I'm not a contractor though, I'm an employee of Commonwealth Medicine through the University of Massachusetts Medical School.

Occasional Contributor
Posts: 5

Re: Documentation for Medicaid Data

Right on.  I'll ask him.  I don't know if he'll be able to help, but I'll get back to you either way.

Occasional Contributor
Posts: 5

Re: Documentation for Medicaid Data

My guy used to work at Commonwealth too it turns out.  He asked what center you work with.  You can email me at will dot funk at nctreasurer dot com if you want.

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