The Medicaid and CHIP TAF (T-MSIS Analytic File) Long Term Care (LT) file contains records for institutional long term care provided by specific facilities identified by the Type of Service variable:

• Nursing Facility Services
• Mental Facility Services
• Independent (free-standing) Psychiatric Wings of Acute Care Hospitals
• Intermediate Care Facility (ICF) Services for Individuals With Intellectual Disabilities

The records in the LT TAF include fee-for-service (FFS) claims, managed care encounters and supplemental payments for Medicaid, Medicaid-expansion CHIP, and separate CHIP.

The Medicaid and CHIP TAF (T-MSIS Analytic File) Pharmacy (RX) file includes records of filled prescriptions. Records include fee-for-service (FFS) claims, managed care encounters and supplemental payments for Medicaid, Medicaid-expansion CHIP and separate CHIP.

The TAF APL file contains information about managed care organizations serving Medicaid enrollees. By linking the information in the APL to other TAFs, users can enhance their analyses focused on plans and providers. For example, users can describe their results by plan name. Users can also identify whether the plan serves Medicaid, CHIP, or both; whether the plan operates under a waiver or state plan authority; how the plan reimburses its providers; and whether the plan is for profit.

The TAF APR file contains information about providers of Medicaid services—both facilities and individual providers. By linking the information in the APR to other TAFs by provider ID, users can enhance their analyses focused of providers. For example, users can identify whether the provider is a facility, group or individual; whether the provider’s specialty is primary care, obstetrics, or something else; how the provider is affiliated with other providers in a group practice; where the provider is located; and many other characteristics.

Medicaid MAX (Medicaid Analytic Extract) Personal Summary (PS) file contains one record for every individual eligible for and enrolled in Medicaid for at least one month or who had a Medicaid-paid service within the file year.

The Medicaid MAX (Medicaid Analytic Extract) Inpatient (IP) file contains complete stay records for enrollees who had an inpatient hospital stay. Records include fee-for-service (FFS) claims and encounter records submitted for stays covered by Medicaid managed care.

Medicaid MAX (Medicaid Analytic Extract) Other Services (OT) file contains claim records for a variety of Medicaid services, including physician services, outpatient hospital institutional utilization, lab/X-ray, clinic services, home health, hospice and premium payments.

Medicaid MAX (Medicaid Analytic Extract) Long Term (LT) Care file contains claim records for institutional long term care provided at four specific facility identified by the MAX Type of Service:

• Nursing Facility Services
• Mental Hospital Services for the Aged
• Inpatient Psychiatric Facility Services for Individuals Under the Age Of 21
• Intermediate Care Facility (ICF) Services for Individuals With Intellectual Disabilities

Medicaid MAX (Medicaid Analytic Extract) Prescription Drug (RX) file includes records of filled prescriptions from fee-for-service (FFS) claims paid by Medicaid and encounter records for prescription drugs paid by a Medicaid managed care organization.

The Conditions segment of the MESF flags each Medicaid beneficiary for the presence of one of 27 specific chronic conditions or one of 35 other chronic or potentially disabling conditions.

The National Death Index segment of the MESF includes cause of death information from death certificates provided through linkage with the National Death Index (NDI) cause of death information.

The Long Term Care Minimum Data Set (MDS) is a health status screening and assessment tool used for all residents of long term care nursing facilities certified to participate in Medicare or Medicaid, regardless of payer. The assessment is also required for Medicare payment of skilled nursing facility stays. Assessment data for Skilled Nursing Swing Beds 3.0 is included in a separate file, MDS version 3.0 was implemented on October 1, 2010, replacing version 2.0.

The Home Health Outcome and Assessment Information Set (OASIS) contains data items developed to measure patient outcomes and for improve home health care. The OASIS assessments are required of all home health agencies certified to accept Medicare and Medicaid payments.

The Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) is collected on all Medicare patients who receive services from an inpatient rehabilitation unit or hospital. The data collected for IRF-PAI are used to measure quality of care.

The Long Term Care Minimum Data Set (MDS)-Swing Bed is a health status screening and assessment tool. It is required for Medicare payment of hospital-based skilled nursing care. Swing-bed providers are hospitals that can use their beds, as needed, to provide either acute or post-acute skilled nursing care.  The swing-bed assessment includes a subset of the skilled nursing facility (SNF) assessment items. The MDS 3.0 was implemented in October, 2010, replacing version 2.0.

The Long Term Care Minimum Data Set (MDS) is a health status screening and assessment tool used for all residents of long term care nursing facilities certified to participate in Medicare or Medicaid, regardless of payer. The assessment is also required for Medicare payment of skilled nursing facility stays. Assessment data for Skilled Nursing Swing Beds 2.0 is included in a separate file. Version 2.0 was replaced by MDS version 3.0 on October 1, 2010.

The Long Term Care Minimum Data Set (MDS)-Swing Bed is a health status screening and assessment tool. It is required for Medicare payment of hospital-based skilled nursing care. Swing-bed providers are hospitals that can use beds, as needed, to provide either acute or post-acute skilled nursing care.  The swing-bed assessment includes a subset of the skilled nursing facility (SNF) MDS items. MDS Swing Bed 2.0 was replaced by version 3.0 in October, 2010.

CMS administers several surveys to assess beneficiary experience with different types of health care. Some of these are CMS-only surveys. Others, those designated as CAHPS, have been approved by the AHRQ-overseen CAHPS consortium.

The Health and Retirement Study (HRS)-Medicare linked dataset includes HRS survey information linked to CMS claims and assessment data for the HRS study population. The HRS has been fielded since 1992 and surveys more than 30,000 people age 50 and older.

The Health and Retirement Study (HRS) is designed to:

• facilitate understanding of the relationship between medical history and financial status
• examine how use of health care may change as people age.

The longitudinal survey data is linked to CMS data to provide information on health care utilization and beneficiary assessment.

CMS is no longer distributing this file. See the NIA Data LINKAGE Program website to request this data.

The Medicare Health Outcomes Survey (HOS) collects patient-reported outcomes measures from beneficiaries enrolled in Medicare Advantage plans. The Medicare HOS program collects health status data for use in quality improvement activities, plan accountability documentation, and health improvement activities in a base survey and two year follow-up survey. The baseline sample size is 1,200.

The Healthcare Effectiveness Data and Information Set (HEDIS) Patient-Level Detail (PLD) files are a set of standardized healthcare quality measures designed to provide information for reliable comparison of health plan performance. The HEDIS PLD data are submitted annually by Medicare Advantage (MA) Organizations, Cost Plans, and Demonstration Plans and contribute to the assignment of CMS Star Ratings for MA plans.

The HEDIS Measures file is a person-level file that includes information about all HEDIS measures, except the Plan All-Cause Readmission measure, which is included in HEDIS File 2. It represents beneficiaries enrolled in each MA plan/contract during the year. The file contains indicator variables for whether the beneficiary met the denominator and numerator requirements for each of the HEDIS measures, as well as weights for some measures.

The HEDIS Medicare Advantage Plan All-Cause Readmissions (PCR) File (referred to as File 2 in the file name) is a patient-level file that contains all variables pertinent to the PCR measure. There is a separate record for each acute inpatient hospital discharge during the year.

The MD-PPAS file assigns Medicare providers to medical practices based on the tax identification numbers and elaborates on the Centers for Medicare & Medicaid Services (CMS) provider specialty classification. This provider-level dataset is built around two identifiers: the national provider identifier (NPI) and the tax identification number (TIN).

CMS has created a set of analytical files that contain data from the Medicare Shared Saving Program. There are two separate files in this data set:

• The Shared Savings Program Beneficiary-Level Research Identifiable File (RIF)
• The Shared Savings Program Provider-Level RIF