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This variable is contained in the following files:
Master Beneficiary Summary File (MBSF) Base A/B/C/D V2 Accountable Health Communities (AHC) Model Oncology Care Model (OCM) Current Clinical Status File Oncology Care Model (OCM) Clinical and Staging File Oncology Care Model (OCM) Medicare Bayesian Improved Surname Geocoding (MBISG) Acute Hospital Care at Home (AHCAH) - Patient Acute Hospital Care at Home (AHCAH) - Hospital Inpatient Rehab Facility-Patient Assessment Instrument TAF Demographic and Eligibility File Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Alignment Files Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Provider List File Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Practice List File Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Visit File Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Beneficiary Demographic File Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Final Clinical File Million Hearts® Cardiovascular Disease Risk Reduction (Million Hearts®) Model Raw Clinical File Million Hearts® Cardiovascular Disease Risk Reduction Model CMMI Model Data Sharing (CMDS) Beneficiary File CMMI Model Data Sharing (CMDS) Provider File CMMI Model Data Sharing (CMDS) Entity File CMMI Model Data Sharing (CMDS) Model Participation Data Initiative Healthcare Effectiveness Data and Information Set (HEDIS) File 2: Plan All-Cause Readmission (PCR) Measure Healthcare Effectiveness Data and Information Set (HEDIS) File 1: Measures File (does not include Plan All-Cause Readmission measure) MBSF 30 CCW Chronic Conditions Next Generation ACO Model Provider RIF Next Generation ACO Model Beneficiary RIF Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) 3.0 TAF Annual Managed Care Plan (APL) TAF Annual Provider (APR) Comprehensive ESRD Care (CEC) Model - Provider Comprehensive ESRD Care (CEC) Model - Beneficiary Home Health Outcome and Assessment Information Set (OASIS) Long Term Care Minimum Data Set (MDS) 2.0 Plan Characteristics File Long Term Care Minimum Data Set (MDS) 3.0 Long Term Care Minimum Data Set (MDS) - Swing-Bed 3.0 MAX Personal Summary File Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) 2.0 TAF Pharmacy File TAF Other Services File TAF Long Term Care File TAF Inpatient File Skilled Nursing Facility (Encounter) Outpatient (Encounter) Inpatient (Encounter) Home Health Agency (Encounter) Durable Medical Equipment (Encounter) Carrier (Encounter) Risk Score Files Value Modifier Practice-Level File Value Modifier Beneficiary-Level File Medicare Shared Savings Program Accountable Care Organizations (ACO) Beneficiary-level RIF Medicare Shared Savings Program Accountable Care Organizations (ACO) Provider-level RIF Pioneer Accountable Care Organization (ACO) Medicare Data on Provider Practice and Specialty (MD-PPAS) Healthcare Effectiveness Data and Information Set (HEDIS) Long Term Care Minimum Data Set (MDS) - Swing-Bed 2.0 Consumer Assessment of Healthcare Providers & Systems RIF National Health and Aging Trends Study (NHATS) - Medicare Linked Data Health and Retirement Survey - Medicare Linked Data Health Outcomes Survey RIF Medicaid Enrollee Supplemental File (MESF): National Death Index (NDI) Segment Medicaid Enrollee Supplemental File (MESF): Conditions Segment MBSF Other Chronic or Potentially Disabling Conditions MBSF National Death Index (NDI) MBSF Cost and Use MBSF 27 CCW Chronic Conditions MBSF Base A/B/C/D MAX Long Term Care File MAX Inpatient File MAX Other Services File MAX Prescription Drug File Value Modifier NPI Practice-Level File Part D Medication Therapy Management Data File Part D Plan Election Type Beneficiary Summary File Part D Event (PDE) File Part D Formulary File Part D Pharmacy Characteristics File Part D Prescriber Characteristics File Part D Drug Characteristics File Carrier (Fee-for-Service) Durable Medical Equipment (Fee-for-Service) Home Health Agency (Fee-for-Service) Hospice (Fee-for-Service) Inpatient (Fee-for-Service) Outpatient (Fee-for-Service) Skilled Nursing Facility (Fee-for-Service) Medicare Provider Analysis and Review (MedPAR)
SAS Name
BENE_HMO_CVRAGE_TOT_MONS
Months of Medicare Advantage (HMO) coverage.
Values: 0-12
Source: CMS Common Medicare Environment (CME)
This variable counts the number of months during the year that the beneficiary received their Part A and Part B benefits through a managed care plan (i.e., a Medicare Advantage [MA] plan) instead of the traditional fee-for-service (FFS) program. Any month where the HMO indicator variable (HMO_IND_XX) is anything other than a 0 (not a member of an HMO, and this value includes beneficiaries who are not Medicare enrolled for the month) or a 4 (FFS participant in a case or disease management demonstration project) is counted as an MA month.
Use caution interpreting this field since months that are not counted as HMO months for this variable include months of fee-for-service (FFS) coverage and months the beneficiary is not enrolled in Medicare. In other words — do not assume that every month during the year is either an HMO month or FFS month.