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Databases for Estimating Health Insurance Coverage for Children A Workshop Summary (2010) / Chapter Skim
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4 Administrative Databases
Pages 32-37

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From page 32...
... This chapter discusses the major sources of administrative data on children covered in public programs, assesses their strengths and weaknesses, and addresses steps being taken by the federal and state agencies responsible for collecting and compiling the data to improve their quality, timeliness, and representativeness over time. MAJOR ADMINISTRATIVE DATABASES The three major administrative databases maintained by the federal government are the CMS-64 Quarterly Expense Report to the Centers for Medicare & Medicaid Services (CMS)
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From page 33...
... The data files are subjected to quality assurance edits to ensure that the data are within acceptable error tolerances, and a distri butional review verifies the reasonableness of the data. Once accepted, valid tape files are created that serve as the historical source of detailed Medicaid eligibility and paid claims data maintained by CMS.
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From page 34...
... The data systems permit more detailed analysis of enrollment data. But there are issues with timeliness and completeness, which has driven organizations such as the Kaiser Family Foundation to collect Medicaid and CHIP administrative data directly from the states to track enrollment growth on the same time line as spending data from CMS become available, mostly because enrollment data lag spending data by at least a year.
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From page 35...
... STEPS BEING TAKEN TO IMPROVE THE ADMINISTRATIVE DATABASES David Baugh summarized the intensive program under way at CMS to rationalize and improve these administrative databases, particularly the MSIS data. These efforts, according to Rousseau, are bearing fruit, in that MSIS data quality continues to improve, with far fewer beneficiaries of unknown eligibility and far less spending on unknown services.
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From page 36...
... • Mature reporting system, tied to • Managed care spending not separated payment, helping to ensure data into services quality at both state and federal levels • Not intended for research; understanding trends often requires following up with states regarding their submissions (e.g., Arizona and Vermont) Medicaid Statistical Information System (MSIS)
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From page 37...
... Lastly, he reported that under the umbrella of the MAX expansion project, funded by ARRA, there is increased coordination between CMS and State Technical Advisory Groups to describe CHIPs, identify their issues, challenges, and concerns, and develop criteria for selecting volunteers. As part of this initiative, CMS is working to develop state-specific technical assistance plans in 10 to 15 pilot states, which include regular communications and working closely with data task teams, with the objective of improving MSIS reporting.
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Key Terms

  • administrative databases
  • enrollment data
  • msis data
  • health insurance
  • care spending

  • major administrative
  • spending data
  • state health
  • health programs
  • insurance coverage

  • data quality
  • data directly
  • data elements
  • medicaid expansion
  • quarterly expense

  • statistical enrollment
  • msis includes
  • public programs
  • expense report
  • specified data

  • data counts
  • chip administrative
  • data maintained
  • data resides
  • data complement

  • administrative records
  • medicaid spending
  • medicaid state
  • data serve
  • statistical data


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