Data Analytics

For many states, a critical barrier to achieving Medicaid delivery system reform is data analytic capacity. Within the functional area of data analytics, the Medicaid IAP seeks to offer targeted technical support and solutions to Medicaid agencies in building and strengthening their data analytic capacity as they design and implement delivery system reforms. In addition, IAP seeks to develop standard solutions using common data sets for states’ use in delivering improved care and driving smarter spending.

Data Analytics Technical Support

To assist Medicaid agencies in moving towards their Medicaid delivery system reform goals, IAP is offering targeted technical support to states around a variety of data analytic activities. Selected states are assigned a dedicated IAP Data Analytic (DA) team that provides customized one-on-one data analytics support in one or more of the following areas:

  • Designing an analytic strategy
  • Improving programmatic decision-making
  • Building and executing statistical models
  • Planning non-Medicare data integration
  • Developing transfer protocols for sharing data

Starting in April 2017 selected states and territories Alabama, Guam, Mississippi, Nebraska, New Hampshire, New Jersey, North Dakota, Commonwealth of the Northern Mariana Islands, Pennsylvania, Washington, and West Virginia participated in the support opportunity for a 12 month period.

Additional information can be found in the Information Session Slides.

Medicare-Medicaid Data Integration (MMDI) Technical Support

CMS recognizes that existing Medicare-Medicaid enrollee data collection and reporting systems are fragmented, making it difficult for states to coordinate care at time of delivery, or to monitor and evaluate the effectiveness of new programs for dually- eligible beneficiaries.

Under MMDI, IAP has worked with five states (Alabama, District of Columbia, Pennsylvania, New Hampshire, New Jersey) since October 2015 providing one-on-one technical support to address the overarching challenge of acquiring and successfully integrating Medicare and Medicaid data from multiple sources. Selected states have been assigned a dedicated state team lead supported by a team of experts, programmers, and analysts. 

In addition to the one-on-one technical support, work is underway to develop use cases and webinars for participating states on Medicare and Medicaid data integration topics such as:

  • Webinars
    • Database Staging Model
    • Duals Profile
    • COBA Mapping
    • COBA & Part D Final Action
    • Master Patient Index
  • Technical Specifications
    • Database Staging Model
    • COBA Mapping Spreadsheets
    • COBA Final Action Algorithm/Specification
  • Use Cases
    • Using Integrated Data to Develop Risk Scores and Chronic Condition Information for Dual Eligibles
    • Using Integrated Medicare & Medicaid Data to Develop a Profile of the Dual Eligible Population

Data Analytics Tool Development

IAP is developing a series of toolkits related to the four IAP program areas, as well as maternal and infant health. The goal of these toolkits is to provide transparent, straightforward, and adaptable data analytic solutions that states can easily implement in their local environments. Primarily the toolkits will assist states with: 

  • Population identification
  • Assessing the care provided

All of these IAP data analytic tools will be mapped to T-MSIS. These tools also signal our ongoing effort to maximize the resources we share with states; as states submit their data to CMS, we will dedicate ongoing resources to making data usable for analytic purposes.

To learn more about Medicaid’s Data and Systems work, including T-MSIS, please visit this webpage.

National Dissemination

In addition to the one-on-one technical support, use cases and webinars will be developed to share solutions and information on issues that impact all states, such as such as improving data visualization and imputing missing sociodemographic information for research purposes.

States interested in future IAP Data Analytic support opportunities should continue to check the webpage as well as send questions via e-mail with the subject line "Data Analytics" to the IAP mailbox: MedicaidIAP@cms.hhs.gov.