SDRC

State Data
Resource Center

Resources for States Integrating Medicare and Medicaid Data

Resources on Opioid Use Disorder Among Dually Eligible Beneficiaries (Posted 10/25/2018)
Beneficiaries dually eligible for Medicare and Medicaid may be particularly vulnerable to opioid addiction or misuse. In an October 2016 memo , the Centers for Medicare & Medicaid (CMS) estimated that these beneficiaries have significantly higher rates of co-occurring substance use disorders and chronic pain relative to Medicare-only beneficiaries or Medicaid-only adults with disabilities. Following are two new resources on opioid use disorder among dually eligible individuals.

Data Brief on National Trends in High-Dose Chronic Opioid Utilization Among Dually Eligible and Medicare-Only Beneficiaries (2006-2015)
This data brief provides a baseline understanding of high-dose chronic (HDC) prescription opioid use among dually eligible beneficiaries over the ten-year period from 2006 to 2015. The brief underscores that dually eligible individuals receive prescription opioids at higher rates than those with Medicare-only and that these differences are driven mainly by disability. For example, in 2015, while 10.4% of dually eligible and 4.9% of Medicare-only opioid using beneficiaries were prescribed opioids at the HDC level, among those qualifying for Medicare by disability, these rates were 13.4% and 14.7%, respectively. This data brief is available on our MMCO analytics webpage at https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Analytics.html .

New Opioid Use Indicators in the Chronic Condition Warehouse
CMS has created four new Chronic Condition Data Warehouse (CCW) indicators to promote research on opioid use disorder (OUD).

  1. An overarching indicator of OUD;
  2. Diagnosis and procedure-code bases for OUD;
  3. Opioid-related hospitalizations or emergency department visits; and
  4. Use of medication-assisted treatment (MAT).
The new indicators use algorithms by developed by experts and vetted during a public comment period. As with all other CCW indicators, the OUD-related indicators facilitate research as well as promote measurement quality and consistency. More information can be found at https://www.ccwdata.org/web/guest/condition-categories .

MMDI's "Profiling the Provider Role in Opioid Prescribing Among Dual Eligible Beneficiaries – Full Use Case" is Now Available (Posted 03/05/2018)
Research shows that excessive and inappropriate prescribing of opioids is a widespread problem among providers and is largely responsible for the observed trends in opioid misuse. This use case will provide guidance to assist SMAs on how to leverage Medicare data to profile providers who prescribe opioids to dual eligibles. This will enhance SMAs' abilities to identify opportunities to implement efforts resulting in safer prescribing analgesic opioids.

  • Profiling the Provider Role in Opioid Prescribing Among Dual Eligibles
  • MMDI’s "Profiling Potential Opioid Misuse Among Dual Eligible Beneficiaries – Full Use Case" is Now Available (Posted 03/05/2018)
    Prescription opioid misuse has emerged as a growing epidemic. To address prescription opioid misuse among dual eligibles, SMAs must understand prescription filling patterns and factors associated with opioid misuse within this population. This use case shows SMAs how to use Part D Prescription Drug Event (PDE) data, with other Medicare and Medicaid data sources, to examine opioid prescription fills among dual-eligible beneficiaries.

  • Profiling Substance Use Disorder and Potential Opioid Misuse Among Dual Eligibles
  • SDRC Tip Sheet – Public Use Files (Posted 01/26/2018)
    A new SDRC Tip Sheet has been added under the Data Dictionaries and File Layouts section. This tip sheet lists free, publicly available data resources from CMS (i.e., Public Use Files or "PUFs") for state Medicaid agencies to better understand Medicare enrollee experiences in their state and nationally.

    CMS-MMCO Announcing Changes to SDRC Support (Posted 09/27/2017)
    The Medicare-Medicaid Coordination Office (MMCO) is pleased to announce the State Data Resource Center (SDRC) contract has been awarded to Econometrica, Inc. Econometrica, along with their subcontractor Acumen LLC, will continue to offer the same level of excellent support to state Medicaid agencies for care coordination and program integrity initiatives that has been provided since 2012. Both contractors will work together to ensure that this transition is as smooth as possible for state Medicaid agencies and their downstream users.

    As of today, you can reach the new SDRC Team by:
    Email: sdrc@EconometricaInc.com
    Phone: (877) 657-9889

    New Historic Part A/B Data Dictionary Available (Posted 03/02/2017)
    The historic Part A/B data distributor, GDIT, announced the RIF claims layout was updated to Version K last weekend. The new layout can be downloaded from the Chronic Condition Warehouse (CCW) website . Under Medicare Claims, select Medicare Fee-For-Service Claims – Version K.

    Cybersecurity Initiative - CMS Beneficiary Data Protection (Posted 08/06/2015)
    The mission of the CMS Cybersecurity Initiative includes the protection of the personal information of the millions of people CMS serves. This includes the protection of the data CMS shares with state Medicaid agencies for the purpose of coordinating care for Medicare-Medicaid Enrollees as well as Program Integrity efforts. As part of this effort, which will strengthen the safeguards in place to protect Medicare data received from CMS, the Medicare-Medicaid Coordination Office (MMCO) requests that state Medicaid agencies review and possibly take action on the following requirements:

    1. All data management plans are up-to-date and include up to date protocols for securing data received from CMS.
    2. All downstream users and data custodians have signed the appropriate Data Use Agreement (DUA) attachment forms (DUA addenda and Attachment A), Conflict of Interest Letters (Part D data only), or have an up to date COBA Agreement listing all users of the data. Remember, the data cannot be released prior to the appropriate documents being on file and being signed at the State level.
    3. All approved planned data uses are current and all Medicare data requested addresses those planned uses.
    4. Data that is no longer useful or that are no longer scheduled for planned data uses should be disposed of and a Certificate of Disposition (COD) filed with the CMS Privacy Office.
    5. Please review the steps for reporting loss of data and consequences of breaches that are described in the Information Exchange Agreement (IEA) (please see Section IV (loss) and Section IX, part E (breach) of the IEA).
    If you have any questions or concerns, please contact the State Data Resource Center (SDRC)Team by phone at (877)-657-9889 or by email at sdrc@EconometricaInc.com.

    Webinars

    The State Data Resource Center (SDRC) offers a range of data support services to state Medicaid agencies—from understanding the Medicare data request process to handling and using received data. As a part of these services, SDRC leads a series of project-related training webinars over the course of the year. A description of past webinars is also available.

    Public Data Visualization Tools – Tuesday, October 30, 2018 - 3-4pm ET
    The State Data Resource Center (SDRC) and the Center for Program Integrity (CPI) will explore how state Medicaid agencies can utilize public data within data visualization tools with other Medicare data types to initiate anti-fraud, waste, and abuse programs for their dual-eligible cohorts. In particular, CPI will review the different features of the "Market Saturation and Utilization Data Tool," a resource developed by CMS in conjunction with IBM for program integrity purposes, while SDRC will explain the Centers for Disease Control and Prevention's (CDC) "Stats of the States." A brief Q&A session will follow the presentation.

    Overview of New RIF files and Using Medicare Data in Wisconsin's Long-Term Care (LTC) Scorecard – Tuesday, August 21, 2018
    This webinar included two parts. In part one, the SDRC team provided an overview, description, and potential uses of the two (2) new Research Identifiable Files (RIFs) available via SDRC: MedPAR and MESF. In part two, Wisconsin provided an overview of how they have used Medicare COBA data for quality measurement in their Long-Term Care (LTC) Scorecard. This included an overview of the LTC Scorecard, items that use Medicare data, and challenges, solutions, and possible improvements to the use of this data.

    Part D PDE Data and the Opioid Epidemic – August 30 and September 21, 2017
    The State Data Resource Center (SDRC) and its data experts explored how state Medicaid agencies can utilize Part D Prescription Drug Event (PDE) data to combat the opioid epidemic. From the early 1990s to the early 2010s, the number of opioid prescriptions in the United States has more than doubled, while the number of opioid-related overdose deaths has more than tripled during the 2000s and 2010s. SDRC illustrated which Part D PDE elements can maximize state Medicaid agencies’ efforts to implement opioid-related care coordination and program integrity initiatives.

    Additional Opioid Analysis Resources:

    For more information on attending webinars and other support services available to state Medicaid agencies, please contact the SDRC Team by phone at (877)-657-9889 or by email at sdrc@EconometricaInc.com.