Self-proclaimed health policy nerds across the country are rejoicing after the federal government released a new set of Medicaid and Children’s Health Insurance Program (CHIP) data files that have been inaccessible for years.
A government data dump rarely makes headlines, but this one has policy analysts and researchers abuzz.
Medicaid and CHIP cover more than 72 million people, providing free or low-cost health coverage to low-income individuals, families, children, pregnant women, the elderly, and people with disabilities. But because Medicaid programs are run by states and each state’s program looks different, the data they collected varied, too. The lack of standardized data from state to state (not to mention historically lax standards for data quality, completeness, and timeliness) made it difficult to study this growing demographic and measure the effectiveness of the programs aimed at improving care and reducing costs.
Recognizing the critical importance of having reliable data about the Medicaid program, the U.S. Centers for Medicare & Medicaid Services (CMS) launched a new system in 2015 called the Transformed Medicaid Statistical Information System (T‑MSIS) to enable more complete and timely analysis of Medicaid and CHIP. Since then, CMS has been working to onboard states into the data system while also working to improve the data quality.
During this yearslong transition, CMS paused the release of new Medicaid data, creating a logjam in data analysis.
“The absence of data has delayed critically important research about the health of tens of millions of people,” said Arielle Mir, Vice President of Complex Care at Arnold Ventures. Mir’s focus at Arnold Ventures is to improve care coordination for people with complex medical, behavioral and social needs.
“This includes data needed for policy analysis and program evaluation. From an oversight perspective, this means policymakers have not had clear line of sight into the third largest mandatory program in the federal budget,” she said.
The absence of data has delayed critically important research about the health of tens of millions of people.Arielle Mir Vice President of Complex Care at Arnold Ventures
Now that the data has been released, researchers can begin requesting extracts of the data, which spans from 2014 – 16, and resume much-needed investigations into policies and programs that affect the care of individuals with some of the most critical and complex health needs. This is especially important for a population of people who get health coverage through both Medicare and Medicaid, a demographic often referred to in policy circles as “dual eligibles.”
“Dual eligible beneficiaries have some of the most significant health care needs of any population in the country,” Mir said. “It’s always hard to be a patient that needs different health care providers to talk to one another, and care coordination is made even harder by having to navigate the two programs. High needs and poor coordination result in significant use of last resort care settings, such as hospitals and nursing homes.”
Over the last five years, programs have sought to improve care for dual eligibles by integrating Medicare and Medicaid financing and care delivery. However, none of the evaluations have had the Medicaid data they needed to understand those programs’ impact on Medicaid spending and utilization of services Medicaid covers, like long-term care.
“Bringing Medicaid data into these evaluations is essential and long overdue,” Mir said.
Some lawmakers, oversight agencies, and the research community have expressed some trepidation due to early analyses by the U.S. Government Accountability Office (GAO) and the U.S. Department of Health and Human Services Office of the Inspector General (OIG) that indicate that issues remain regarding data quality and completeness. While the challenges may complicate data analysis, they shouldn’t deter efforts, Mir said.
“This data release has the opportunity to help CMS and the states improve the quality of the data by crowdsourcing the identification of gaps and limitations,” Mir said. “As researchers interested in evidence-based solutions, we need data to build the evidence. We applaud CMS for releasing this data and look forward to supporting its greater exploration and analysis so that evidence can be used to improve care for millions of people.”