New Enrollee-level EDGE Data Now Available for Research

CMS is pleased to announce the availability of the Enrollee-Level External Data Gathering Environment (EDGE) Limited Data Set (LDS) for the 2019 benefit year to requesters who seek the data for research purposes. The EDGE LDS contains certain masked enrollment and claims data for on- and off-Exchange enrollees in risk adjustment covered plans in the individual and small group (including merged) markets, in states where HHS operated the risk adjustment program for the 2019 benefit year. HHS operated the risk adjustment program for all states and the District of Columbia for the 2019 benefit year. The dataset is composed of 4 data files: enrollment, medical claims, pharmaceutical claims, and supplemental claims. The data elements document, posting today, describes the data elements that are included in the 2019 benefit year enrollee-level EDGE LDS. The data creation guide explains the methods, decisions, and key steps taken in creating the 2019 benefit year EDGE LDS. The EDGE LDS file includes masked randomly generated enrollee numbers to link the enrollment and claims data for each enrollee. The EDGE LDS file does not include enrollees’ direct identifiers, as issuers do not upload those identifiers to their EDGE servers.

The EDGE LDS can be requested for research through the CMS LDS process, found on the CMS LDS website, under a data use agreement with CMS.