U.S. flag

An official website of the United States government

Transformed Medicaid Statistical Information System (T-MSIS)

Find T-MSIS information to support your role. Whether you’re submitting Medicaid or CHIP data, analyzing that data, searching for a way to obtain data, or reviewing T-MSIS Data Quality, you'll find additional resources here. 


Enriching Beneficiary Care Through Data

T-MSIS collects Medicaid and Children's Health Insurance Program (CHIP) data from U.S. states, territories, and the District of Columbia into the largest national resource of beneficiary information.  This data is crucial for research and policy on Medicaid and CHIP and helping the Centers for Medicare & Medicaid Services (CMS) conduct program oversight, administration, and integrity.

To meet the reporting needs of states and CMS stakeholders, T-MSIS features an operations dashboard for state and territory use to validate a timely, accurate, and complete data set.


Innovation Models

The CMS Innovation Center references T-MSIS data in measures behind innovative payment and service delivery models at the state level – through the Accountable Health Communities model for addressing health-related social needs of beneficiaries and the Financial Alignment Initiatives models aimed at better aligning the financing of Medicare and Medicaid programs for dually eligible individuals.

 

Center for Program Integrity (CPI)- T-MSIS Usage 

CPI has been analyzing T-MSIS data to identify emerging vulnerabilities in seven subject areas, such as opioid overuse and COVID19 related testing. These analyses identified anomalies in 33 states and territories. Additionally, the Healthcare Fraud Prevention Partnership Trusted Third Party has 44 state T-MSIS data feeds in place for identifying and reducing FWA across the healthcare sector (as of June 2022).

Ways to Engage with T-MSIS

Explore data sources, research products, and support materials available to everyone.

  • T-MSIS Data Dictionary documents requirements for mapping system data to T-MSIS record layouts.  The dictionary helps states submit accurate files to CMS each month.
  • T-MSIS Coding Blog clarifies technical instructions on CMS reporting requirements and expectations.  Browse previous coding memos for the latest T-MSIS coding guidance.
  • CMS GitHub thresholds file provides a full list of data quality measures run on each state's monthly T-MSIS submission, including a subset used in the current assessment.  Access to the data quality measures code and technical documentation is also available in the GitHub.
  • T-MSIS Analytic Files (TAF) provide a research-optimized version of T-MSIS data, tailored to the needs of the Medicaid and CHIP data user community.  Learn more about TAF, how to obtain access, and related resources, such as the Data Quality Atlas or the CCW.
  • Dive into T-MSIS and TAF Data Quality (PDF, 119.84 KB).


Tracking State Data Quality Progress

See how CMS is partnering with states to ensure delivery of timely, accurate and complete data.  The Outcomes Based Assessment (OBA) map and file submission status below are as of 8/26/2022.  CMS currently uses OBA for assessing and prioritizing T-MSIS data quality. 

Learn more about OBA

Notes on Outcomes Based Assessment Methodology

  • Outcomes Based Assessment, or OBA, is an improved assessment framework to review T-MSIS data quality. OBA will assess states on over 500 high and critical priority DQ checks. These individual checks will include mostly the same checks that were used as a part of the prior TPI assessment methodology. However, rather than “TPI categories”, the checks will be grouped into intuitive categories based on file and topic area. These categories are:
    • Beneficiary demographics, beneficiary eligibility, and program participation in the TMSIS Eligibility file
    • Expenditures, utilization, and provider information in all four T-MSIS claims files (i.e., Inpatient, Long-term Care, Other, and Prescription)
    • Provider characteristics, provider enrollment, and provider identifiers in the T-MSIS Provider file
    • Managed care reporting in the T-MSIS Managed Care file
  • OBA uses three criteria to review states' data quality: OBA reviews issues considered Critical Priority, issues considered High Priority, and a subset of high priority issues tagged in the Expenditures category. States must meet or exceed the target for all three criteria.
    • 1 - Critical priority issues may render the T-MSIS data unusable, impact the integrity of the files, or impact the creation of the T-MSIS Analytic File (TAF) (target: 100%)
    • 2 - High priority issues are related to T-MSIS reporting accuracy and completeness that may impact the usability and usefulness of the data for program monitoring and research purposes (target 99%).
    • 3 - Expenditures has been identified by CMS as an important priority area of focus for data quality. For this reason, expenditures related issues are assessed as their own criteria (target 95%).
  • OBA mapping of measures/rules can be found on the CMS GitHub repository (Threshold file).

Note:

  • The reporting period is not the same for each state.  See map notes for details.
  • States can check the T-MSIS Operations Dashboard for their most up-to-date data.

T-MSIS Data Quality Progress for Outcomes Based Assessment (OBA)

The success of T-MSIS hinges on the reliability of Medicaid and CHIP data for making informed decisions. States can check for and address T-MSIS data submission errors or data quality concerns through the Operations Dashboard available on the CMS Enterprise Portal. CMS additionally provides States with data quality technical assistance to monitor and address specific data quality issues.

The map below displays each state and territory’s T-MSIS reporting data quality assessment using the Outcomes Based Assessment (OBA) methodology. The numbers presented on the map indicate the number of OBA criteria that have not been met, out of three total assessment criteria. States must meet data quality targets for (1) critical priority, (2) high priority, and (3) expenditures, in order to be assessed as meeting data quality expectations under the OBA methodology.

Image
oba

T-MSIS Data Quality Progress for Outcomes Based Assessment (OBA) as of 08/26/2022

31 states and 2 territories met the targets for critical priority, high priority, and expenditures data content category

10 states passed on the critical priority criterion but did not meet at least one of the targets for the high priority and/or expenditures data content category

10 states did not meet the target for critical priority criterion

3 territories do not yet submit T-MSIS data

Notes on Map for Outcomes Based Assessment
  • If a state fails one or more of the three OBA criteria, the failed criteria will be included in the count of failed OBA criteria reflected on the map.
  • Pennsylvania only includes T-MSIS data submitted by the state Medicaid agency. T-MSIS data submitted separately by the state’s S-CHIP program are not included.
  • This map identifies the status of state activities in addressing T-MSIS data quality areas currently prioritized by CMS. The map is reflective of potential data quality issues identified using the OBA methodology and is not a representation of all T-MSIS data quality issues.
  • Timely, accurate, and complete T-MSIS data submission continues to be a CMS priority and is even more critical to national analyses of Medicaid and CHIP services, activities, and expenditures. While states are strongly encouraged to continue to improve data quality, CMS does not plan to use state data quality assessment results as the basis to initiate state compliance actions during or immediately following the COVID-19 public health emergency.
  • The T-MSIS DQ Map will be updated on the last week of the month.
  • The following states were updated with data from the May 2022 reporting period: Rhode Island, South Dakota.
  • The following states were updated with data from the June 2022 reporting period: Alabama, Alaska, California, Colorado, Florida, Hawaii, Idaho, Illinois, Indiana, Kentucky, Maryland, Michigan, Missouri, Montana, Nebraska, Nevada, New Hampshire, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Vermont, Virginia, Washington, West Virginia, Wisconsin.
  • The following states were updated with data from the July 2022 reporting period: Arizona, Arkansas, Connecticut, Delaware, District of Columbia, Georgia, Iowa, Kansas, Louisiana, Maine, Massachusetts, Minnesota, Mississippi, New Jersey, New Mexico, North Dakota, Oklahoma, Oregon, Puerto Rico, South Carolina, Utah, Virgin Islands, Wyoming.

T-MSIS State File Submission Status

Overall Progress as of August 26, 2022

54 Reporting Entities are in Production and Submitting Monthly

100% are current, meaning files for a reporting period are submitted before the end of the subsequent month

All states which submit data to T-MSIS are current. States fall out of currency when data submissions are behind by two or more months.

This number includes:

  • 50 U.S. states
  • District of Columbia
  • 1 entity: PA-CHIP
  • 2 territories: Puerto Rico & Virgin Islands

A reporting entity is defined as a Medicaid/CHIP agency.

Progress Notes (as of August 26, 2022):
  • 1 territory (Guam) is working to begin submitting data to T-MSIS
  • 2 territories (American Samoa and Northern Mariana Islands) do not participate in T-MSIS
  • PA CHIP is the only entity submitting T-MSIS data separately from the PA Medicaid agency submission.

Medicaid & CHIP Scorecard

The scorecard is another resource on state reporting progress on T-MSIS. Updated annually, it was launched by CMS to improve transparency and accountability about Medicaid and CHIP's administration and outcomes. See this year's version.


More About T-MSIS

History

Learn more about the change from MSIS to T-MSIS and steps CMS has taken to work with states to improve data quality and outcomes:

T-MSIS evolved from the older Medicaid Statistical Information System; Virginia was the first state to go-live in T-MSIS, in May 2015.

Secure Data

T-MSIS uses cloud infrastructure services for advanced data processing, security, and storage. CMS continually works to enhance T-MSIS in accordance with the U.S. federal government's Digital Services Playbook. New product features are delivered in a rapid, iterative, and secure manner using agile development and DevSecOps practices.

Resources inside CMS

  • Integrated Data Repository (IDR) integrates a range of data sources and ancillary data to support analytics across CMS. IDR houses the raw T-MSIS data. Visit this page to learn about data access and training.
  • DataConnect is a collaboration center with a range of products and services to support CMCS Medicaid and CHIP data needs. It is a single source of truth that unifies Medicaid and CHIP data and provides a centralized system for performing analysis.