Given the primary role Medicaid and the Children’s Health Insurance Program (CHIP) serve as the backbone of the nation’s safety net health care system, the Centers for Medicare & Medicaid Services (CMS) has made significant investments in these programs’ information technology and data analytic infrastructure to improve access to high quality, timely Medicaid and CHIP data. The Transformed Medicaid Statistical Information System (T-MSIS) initiative transitioned state reporting to a timelier and expanded data set using a modernized technology platform to collect enhanced data from states. Because of the size and complexity of T-MSIS files and the frequency of updates, these raw data files are challenging to use for analytic purposes. Therefore, CMS created a series of data sets optimized for analytics, known as the T-MSIS Analytic Files (TAF) consisting of research identifiable files (RIF). TAF RIFs contain beneficiary-level data that are available with an approved Data Use Agreement.
CMS is releasing the preliminary TAF RIF for calendar year 2019. The preliminary TAF RIF includes TAF data that are not fully mature, as states continue to submit service use records. Preliminary TAF RIF and associated data quality information are produced once each month of the given data year meets a minimum of six months of runout; that is, once six months have passed from the initial state submission of each month’s data. The final TAF RIF is created when twelve months of runout have occurred. We expect the final 2019 TAF RIF to be available in summer 2021.
CMS, oversight entities, and researchers will use the TAF RIFs and associated data quality information for program monitoring, oversight, model evaluations, and answering questions regarding Medicaid and CHIP.
The TAF RIFs include annual files that contain demographic and eligibility information for all Medicaid and CHIP beneficiaries as well as claims files that contain service use and payment records. Data shared with researchers will not include beneficiary names, street addresses, or phone numbers, to protect beneficiary privacy, and proprietary managed care payment information will be redacted for external researchers. CMS is releasing five file types for calendar year 2019 at this time:
- Annual Demographics and Eligibility (DE) File
- Inpatient Hospital (IP) Claims File
- Long-Term Care (LT) Claims File
- Pharmacy (RX) Claims File
- Other Services (OT) Claims File
DQ Atlas, found here on Medicaid.gov, is an interactive, web-based tool that assists the user community in assessing the accuracy, reliability and usability of TAF. TAF data quality information is available to the public for calendar years 2014-2019. Not all topics in DQ Atlas are included for the preliminary 2019 data as some benchmark data is not yet available.
Preliminary Data Quality
While benchmark data for some topics are not available for the 2019 preliminary TAF RIF, and service use data are not yet fully mature, the available data quality assessments indicate a small improvement in data quality over the 2017 and 2018 TAF RIFs released in September. Most improved topics in 2019 compared to 2018 include Medicaid and CHIP enrollment and number of enrollment spans.
To support efforts to improve the quality and completeness of each state’s T-MSIS submissions, CMS has identified 32 T-MSIS Priority Items (TPIs) related to T-MSIS data quality, and states have made significant progress in addressing these items. Information on the number of open TPIs per state for the first 23 TPIs is in the state maps here. Moving forward, CMS will continue to work with the states to improve the quality of their data.
Accessing TAF RIF
All external researchers who want to obtain access to the TAF RIFs should contact the CMS Research Data Assistance Center (ResDAC). ResDAC staff will work with the researcher to assist with completing the forms needed for the request package. Researchers approved for access to the TAF will be required to sign a CMS data use agreement that contains strict beneficiary privacy and data security requirements. To learn more, visit the ResDAC website.
Final Data Release
CMS expects to release data quality information for the final 2019 data in spring 2021, ahead of the 2019 TAF RIF release in summer 2021. Additionally, CMS expects to release refreshed data for calendar years 2017 and 2018 to reflect improved state data quality in 2021.
Lastly, CMS expects to release for the first time in 2021 new annual files for calendar years 2014-2018 containing information on providers and managed care plans. Moving forward, these annual files will be included in all future TAF RIF releases.