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.

What does this file include? (variable highlights)

  • HIPPS code
  • socio-demographic variables
  • information on patient home environment and informal caregivers
  • health status, including diagnosis codes
  • functional status
  • psychosocial status
  • health service utilization
    • emergent care
    • hospital admission

Special considerations

  • The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) suspended required completion for non-Medicare and non-Medicaid patients.

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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.

What does this file include? (variable highlights)

  • Resource Utilization Group (RUG) code
  • Clinical status measures
  • Physical functioning assessment
  • Psychological status measures
  • Psycho-social functioning measure
  • End-of-life care decisions

The Plan Characteristics file contains Medicare Advantage plan and Prescription Drug Plan information separated into six subfiles.

The subfiles are:

  • Plan “Base” or Benefit package file
  • Premium
  • Cost Sharing Tier
  • Service Area
  • Special Needs Plans
  • Multi-year crosswalk file

What does this file include? (variable highlights)

  • Initial and gap coverage limits
  • Plan premium amount
  • Plan service area description
  • Crosswalk of current plan ID to previous years
  • Demonstration type
  • Special needs plan type
  • Linkage variables to the PDE and to each of the Plan Characteristic File sub-files:
    • Plan Contract ID, Plan Benefit Package ID (use in combination to link to specific plan)

Why do researchers request this file?

  • Studies that compare medication usage and clinical outcomes by plan benefits

Special considerations

  • Plan identifiers are encrypted in the data prior to the CY2015 file, so researchers must use this file to find out more information about the plan. Beginning with the CY2015 file, plan contract ID numbers are not encrypted
  • This file consists of six sub-files.
  • When the Plan characteristics file is requested and approved, all subfiles are delivered.

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.

What does this file include? (variable highlights)

  • Resource Utilization Group (RUG) code
  • Clinical status measures
  • Physical functioning assessment
  • Psychological status measures
  • Psycho-social functioning measure
  • End-of-life care decisions

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.

What does this file include? (variable highlights)

  • Resource Utilization Group (RUG) code
  • Clinical status measures
  • Physical functioning assessment
  • Psychological status measures
  • Psycho-social functioning measure

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.

What does this file include? (variable highlights)

  • Bene_ID (links to all other CMS Research Identifiable Files (RIF))
  • State, county, zipcode
  • Date of birth, gender, race
  • Eligibility category
  • Dual Medicare-Medicaid eligibility
  • Medicaid managed care enrollment
  • Summary utilization, Medicaid payments

The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) suite of files includes beneficiary-level Medicare and Medicaid enrollment and claims data for Medicare-only, Medicare-Medicaid dually enrolled and Medicaid-only blind and disabled beneficiaries. The 27 CCW Chronic Conditions plus an additional 25 other conditions flags are part of the included data.

What does this file include? (variable highlights)

  • Eligibility, enrollment variables
  • Aggregated cost and use
    • Medicare: FFSPDE includes FFS and MA
    • Medicaid: FFS, managed care encounter where available
  • Prescription Drug service utilization reported for classes of drugs
  • All four files are released for approved MMLEADS data requests
    • Beneficiary file
    • Medicare Services file
    • Medicaid Services file
    • Conditions file

Special considerations

Background:

CMS has developed a new Medicaid DQ Atlas, an interactive, web-based tool that helps policymakers, analysts, researchers, and other stakeholders explore the quality and usability of the Medicaid TMSIS Analytic File (TAF). The charts, maps, and tables in the new DQ Atlas show state-level DQ assessments and associated measure values for topics that are pertinent to Medicaid and CHIP.

Year of Data:
Source:
CMS
Format:
Background:

This document describes the development and content of the TAF annual Demographic & Eligibility (DE) file. The TAF DE includes information on the demographic, eligibility, and enrollment characteristics of beneficiaries who were enrolled in Medicaid or in CHIP for at least one day during any given calendar year.

Year of Data:
2016
Source:
CMS
Format:
Adobe PDF