Updated research request forms and data security approval requirement effective 4/24/23
Data File Search
These data files may be used as ‘finder files’ in combination with other requested Chronic Conditions Warehouse (CCW) files to isolate results to include (or not include as desired) entities, providers and or beneficiaries participating in specific models.
Each model has a set of up to three (3) files, one per participant type:
Entity file
Provider file
Beneficiary file
Data for each model will be updated the first month of each calendar quarter, unless the model has ended. Models which have ended are…
Program:
Medicare
What does this file include? (variable highlights)
Model-Assigned Practice ID
Practice Billing TIN
Practice Location
Comma-Separated Lists of Affiliated Practice NPIs and CCNs (Facility Numbers)
A record represents a single physician practice (billing TIN).
The practice TIN can be linked to other Medicare data that contains TINs.
The Model-Assigned Practice ID can be used to link all Million Hearts® data files for provider-oriented analytics. It does not link to other CCW provider data.
Program:
Medicare
The Million Hearts® Cardiovascular Disease Risk Reduction Model used data-driven predictive modeling approaches to generate individualized risk scores and mitigation plans for eligible Medicare fee-for-service beneficiaries.
The data from the trial is released as a suite of seventeen linked data files. The data include detailed information about the beneficiaries, physician practices, specific providers and clinic visits. The files do not contain names, street addresses or contact information. However, they…
Program:
Medicare
What does this file include? (variable highlights)
Beneficiary ID
Model-Assigned Patient ID
Patient Date of Birth
Patient Gender
Patient Race
Patient Ethnicity
A record represents a single beneficiary. Some beneficiaries may have more than one record if more than one organization tried to enroll them in the trial.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary files (demographic, visit, and alignment), but cannot link to other CCW non-Million Hearts® files…
Program:
Medicare
What does this file include? (variable highlights)
Model ID (in which the Provider participates)
Entity ID (with which the Provider is associated)
National Provider Identifier (NPI)
Tax Identification Number (TIN)
CMS Certification Number (CCN)
Provider Start Date
Provider End Date
Provider Participation Type Code
The Entity ID is the only key field needed to link a Provider to their Entity.
The NPI, TIN, and/or CCN can be used to link to claims and other relevant CCW data.
A Provider may have an…
Program:
Medicare
What does this file include? (variable highlights)
NPI of the Participating Provider
Provider First and Last Name
Model-Assigned Practice ID the provider is associated with
Practice Name
Practice TIN
A record represents a provider (NPI) who is enrolled in the registry.
The Model-Assigned Practice ID can be used to link all Million Hearts® data files for provider-oriented analytics. It does not link to other CCW provider data.
Program:
Medicare
What does this file include? (variable highlights)
Beneficiary ID
Model-Assigned Practice ID
Model-Assigned Patient ID
Provider NPI
Activity Date
Activity End Date
Provider NPI
Clinical Service Procedure Code
Clinical Service Procedure Modifier
Service Units
A record represents one clinical data element per beneficiary. Beneficiaries that have multiple clinical data elements will have multiple records.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary…
Program:
Medicare
What does this file include? (variable highlights)
Model-Assigned Practice ID
Model-Assigned Patient ID
Visit Date
Baseline CVD Risk Score
CVD Risk Score at the time of the visit
Baseline risk group (low, medium, high)
A record represents a patient at the time of a particular visit, and includes information such as visit date, baseline risk score, visit risk score, and baseline group.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary files (demographic, visit…
Program:
Medicare
What does this file include? (variable highlights)
Model ID (with which the Beneficiary is associated)
Entity ID (with which the Beneficiary is associated)
CCW Beneficiary ID
Beneficiary Start Date
Beneficiary End Date
Voluntary Alignment Indicator
The Entity ID is the only key field needed to link a Beneficiary to their Entity.
The Beneficiary file also contains the CCW Beneficiary ID that can be used to link to claims and other relevant CCW data.
A Beneficiary may have an End Date of 12/31/9999,…
Program:
Medicare
What does this file include? (variable highlights)
Model-Assigned Practice ID
Practice Name
Practice TIN
Unique Model-Assigned Patient ID
Aligned Flag
Eligible Flag
Patient Status Change Reason Code
A record represents the eligibility and alignment status of a beneficiary.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary files (demographic, visit, and alignment), but cannot link to other CCW non-Million Hearts® files.
The Model-Assigned Practice ID can be…
Program:
Medicare
What is a clinical data element? Data fields that can be collected, utilized, or stored in various application systems.
What does this file include? (variable highlights)
Beneficiary ID
Model-Assigned Practice ID
Model-Assigned Patient ID
Provider NPI
Activity Date
Activity End Date
Provider NPI
Clinical Service Procedure Code
Clinical Service Procedure Modifier
Service Units
A record represents one clinical data element per beneficiary. Beneficiaries that have multiple clinical data elements will…
Program:
Medicare
What does this file include? (variable highlights)
Beneficiary ID (allows linkage to other files)
ACO Name
Monthly assignment status information
Date of Birth
Date of Death
Special considerations
This file can be linked to any other CMS file that includes the Bene ID
Beneficiaries can be linked to their assigned providers by linking the ACO_ID in the provider file to the ACO_NUM in the beneficiary file
Questions regarding the Next Generation ACO Model can be directed to NextGenerationACOModel@cms.hhs.gov
Program:
Medicare
What does this file include? (variable highlights)
ACO identifier
Performance year
Organization Name
CMS organization identifiers including Tax Identification Number, CMS Certification Number (CCN)
Provider type description
Special considerations
This file can be linked to any other CMS file that contains the ORG_TIN, ORG_NPI or ORG_CCN
Providers can be linked to their assigned beneficiaries by linking the ACO_ID in the provider file to the ACO_NUM in the beneficiary file
Questions regarding the Next…
Program:
Medicare