Updated research request forms and data security approval requirement effective 4/24/23
Data File Search
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 IDModel-Assigned Patient IDPatient Date of BirthPatient GenderPatient RacePatient EthnicityA 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.The…
Program:
Medicare
The AHCAH dataset contains two files, a Hospital file and a Patient file, which are both provided for a research request (i.e., cannot be requested separately). The Patient file contains a record for each AHCAH admission for the patient, and includes other beneficiary-specific data such as the beneficiary’s program eligibility status (Medicare, Medicaid, Dual) and the state Medicaid identifier, if applicable. The file also contains the facility submission date for the data represented in the file record. The…
Program:
Medicare, Medicaid
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 DateProvider End DateProvider Participation Type CodeThe 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 End Date of 12/31/9999…
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
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 fileProvider fileBeneficiary fileData for each model will be updated the first month of each calendar quarter, unless the model has ended. Models which have ended are identified…
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
The MBISG algorithm was developed by CMS to augment existing race and ethnicity data from the Social Security Administration and produce more accurate indirect estimates of the race and ethnicity of the Medicare beneficiary population. The MBISG data includes a set of probabilities that the beneficiary is a member of six racial and ethnic groups: American Indian or Alaska Native (AI/AN), Asian American and Native Hawaiian or Other Pacific Islander (AA and NHPI), Black, Hispanic, Multiracial, or White. MBISG…
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 IDBeneficiary Start DateBeneficiary End DateVoluntary Alignment IndicatorThe 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, which indicates that…
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
The AHCAH dataset contains two files, a Hospital file and a Patient file, which are both provided for a research request (i.e., cannot be requested separately). The Hospital file contains hospital-specific information, including facility location information, the waiver participation tier, and the submission date for the data represented in the file record. The submission date represents the data submitted by the facility for the previous month or week.The Hospital file also contains three key metrics related…
Program:
Medicare
What does this file include? (variable highlights)Model ID (in which the Entity participates)Model Name (in which the Entity particpates)Entity IDEntity NameEntity TypeEntity Start DateEntity End DateThe Entity ID is unique to CMMI systems and cannot be used to link to claims data or other CCW data. The Entity ID is the key field for tying CMDS Provider and Beneficiary participation data to a specific Entity and is unique across all models.An Entity may have an End Date of 12/31/9999, which indicates that the…
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
What does this file include? (variable highlights)State, county annual SSA codesState, county monthly FIPS codesZip code, State and CountyDate of birth, date of deathRaceReason for entitlementMonthly enrollment for each part of the Medicare program, A/B/C/DDual eligible statusPart C plan and enrollment informationPart D plan and enrollment informationPart D low income cost sharingSpecial considerationsFour additional segments are available for order with this file:Chronic ConditionsOther Chronic…
Program:
Medicare
What does this file include? (variable highlights)Two flags for each chronic condition:First occurrence dateEnd of year indicatorSpecial considerationsThe algorithms used to assign the flags are available from the CCW website.Algorithms requiring a multiple-year look back period are completed without requiring the researcher to order multiple years of data.Algorithms search data from Medicare Fee-For-Service (FFS) claims.This file is a segment that can be requested in addition to the Master Beneficiary…
Program:
Medicare
What does this file include? (variable highlights)
Three flags for each chronic condition:
First occurrence date
Mid year indicator
End of year indicator
Special considerations
The algorithms used to assign the flags are available from the CCW website.
Algorithms requiring a multiple-year look back period are completed without requiring the researcher to order multiple years of data.
Algorithms search data from Medicare Fee-For-Service (FFS) claims.
The 27 CCW algorithms are being replaced with 30…
Program:
Medicare
What does this file include? (variable highlights)Two flags for each chronic condition:First ever occurrence dateEnd of year indicatorThis file is a segment that can be requested in addition to the Master Beneficiary Summary File (MBSF) base file.Special considerationsThis file uses information from Fee-For-Service (FFS) Medicare claims.
Program:
Medicare
What does this file include? (variable highlights)Summary of utilization and total annual payments for services such as:physician visits, dialysis, DME, IP recorded emergency room visits, Ambulatory Surgical Centers, anesthesia, imaging, Part B drugs from Fee-for-service (FFS) MedicareNumber of hospital stays, Medicare covered days and total annual inpatient payments for services covered by FFS MedicareSummary of Part D payments, events and prescription fillsThis file is a segment that can be requested in…
Program:
Medicare
What does this file include? (variable highlights)
NDI date of death
ICD-10 code for cause of death
Underlying conditions for cause of death
CDC category code for cause of death
This file is a segment that can be requested in addition to the Master Beneficiary Summary File (MBSF) base file.
Program:
Medicare
What does this file include? (variable highlights)Admission, discharge datesDiagnosis (ICD diagnosis)Procedure (ICD procedure code)FFS reimbursement amountHospital provider number
Program:
Medicare
This file includes (variable highlights)Diagnosis (ICD diagnosis),Procedure (ICD procedure code)Admission, discharge dates or end date of covered benefitsCharge amounts, total and assigned to specific departmentsFFS reimbursement amountHospital provider identification number Some dummy records for Medicare managed care coverage of IP stays
Program:
Medicare
What does this file include? (variable highlights)Diagnosis (ICD diagnosis)Procedure (ICD procedure code)Healthcare Common Procedure Coding System (HCPCS) codes, including CPT codesDates of serviceMedicare FFS reimbursement amountOutpatient facility provider number
Program:
Medicare
What does this file include? (variable highlights)Diagnosis (ICD diagnosis)Procedure (CPT code)Dates of serviceChargesAllowed amountsReimbursement amountProvider NPI number
Program:
Medicare