The Medicare–Medicaid Data Integration (MMDI) program has developed many tools designed to assist state Medicaid agencies (SMAs) with the acquisition, integration, and utilization of Medicare data.
COBA Mapping and Recommended Data Structures
This webinar provides an overview of the Coordination of Benefits Agreement (COBA) to the Chronic Conditions Warehouse (CCW) historic Parts A and B Mapping document, which the MMDI team developed to assist SMAs in understanding how COBA claims equate to and differ from the historic Parts A and B data received from the CCW.
Master Patient Index
The Master Patient Index (MPI) webinar was developed to provide SMAs with the rationale for implementing an MPI and introduces three methodologies a SMA could use to do so. By using an MPI, SMAs can link an enrollee across all data sources, providing a more holistic view of each individual. The webinar also discusses which identifiers a SMA could use to link an enrollee across data sources.
MMDI Medicare Database Staging Model
This webinar focuses on how SMAs can utilize the MMDI Medicare Database Staging Model (DSM). It introduces and explains the DSM concept and walks through, in detail, how to unpack, view, and generate the DSM. The DSM accounts for each Medicare data source and provides a loading strategy for each. The webinar also covers how utilizing the DSM is a helpful first step toward formulating a data integration plan and analyzing the data.
Final Action Indicator Process for Enhanced Coordination of Benefits Agreement (COBA) and Part D Prescription Drug Event (PDE) Data
The final action indicator webinar explains why SMAs need to apply a final action indicator to both the Part D PDE data and the Enhanced COBA data. It introduces the separate algorithms developed by the MMDI team and discusses how and when they should be applied. The webinar also details how to identify and flag the final version of an event or claim.
Using Integrated Medicare & Medicaid Data to Develop a Profile of the Dual Eligible Population
This webinar reviews the duals profile use case developed by the MMDI team. It examines the benefits to the SMAs in gaining a better understanding of their dual-eligible population, the data used to support this use case, a review of the variables used to identify dual status, considerations when using Medicare and Medicaid data, and the elements included in the duals profile use case.
Using a SAS Macro to Create Standardized Beneficiary Level of Demographic Indicators for Dual Eligible Population Analytics
SMAs that use the beneficiary and enrollment data in the MBSF for their analytics may encounter challenges in extrapolating quarterly and yearly variables from monthly MBSF variables. This webinar provides a basic orientation to the MBSF data and an overview of the Population Macro, a SAS tool developed by the MMDI team. The Population Macro is available to SMAs to standardize the process for creating a beneficiary-level demographic file, which is useful for performing analytics on dual-eligible populations.
Using Integrated Medicare & Medicaid Data to Profile Dual-Eligible Beneficiaries' Opioid Drug Use: Beneficiary and Provider Perspectives
Identifying opioid misuse in the dual-eligible population can help SMAs determine strategies for developing effective interventions and reducing opioid dependency among dual eligible beneficiaries. This webinar demonstrates how integrated Medicare and Medicaid data can be used to describe characteristics of opioid misuse among the dual-eligible population and identify potentially high-risk prescribing patterns among providers.
Using the CCW Algorithms with Integrated Data to Describe Chronic Conditions in the Dual Population
Understanding the prevalence and cost of chronic conditions is an important factor for SMAs to anticipate the health care needs of the dual-eligible population. This webinar provides an introduction and overview of the 62 CCW chronic conditions and describes examples where SMAs can benefit from using integrated Medicare and Medicaid claims to describe chronic conditions.
Methods for Linking Providers When Integrating Medicare and Medicaid Data
While linking providers was simplified by the adoption of the National Provider Identifier (NPI), it still requires some effort because other identifiers are also used and providers can submit claims under more than one identifier. This webinar provides SMAs with an overview of different methods for linking providers and describes the MMDI specifications for building a Master Provider Index (MPrI).
Provider Identification for Intelligent Assignment
Using data-driven decision logic based on utilization data will determine the best match between a beneficiary and health care providers or care coordinators. This webinar provides SMAs with methods for using Medicare data to match beneficiaries with primary care physicians (PCPs) or other key healthcare providers for intelligent assignment or attribution.
A crossover is a claim billed to multiple payers, such as to a primary payer (Medicare) and then to a secondary payer (Medicaid). This webinar is intended to provide SMAs with an introduction to crossover claims, including information on how they can identify crossover claims and organize data when there is both a Medicare and a Medicaid claim for the same service.
Developing Analytics with Medicare Data
This webinar was developed to describe how SMAs can leverage MMDI use cases and data integration tools to perform their own analytics using integrated Medicare and Medicaid data.
For more information about any of the tools, use cases, or webinars, please contact SDRC@EconometricaInc.com.