New Comprehensive ESRD Care (CEC) RIF Data Available
CMS is pleased to announce the availability of two new RIFs that contain data from the Comprehensive ESRD Care (CEC) Model. The first file, the CEC Beneficiary RIF, contains enrollment data for beneficiaries in the CEC Model. A second file, the CEC Provider RIF, contains identifying information about the providers participating in the CEC Model.
New Medicaid and CHIP Data Now Available
CMS is pleased to announce the release of two new annual files to the suite of research files based on state Transformed Medicaid Statistical Information System (T-MSIS) submissions, called T-MSIS Analytic Files (TAFs).
TAF Annual Managed Care Plan (APL)
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.
What does this file include (variable highlights)
- Managed Care Plan type
- Waivers such as 1115
- Eligible population indicators such as CHIP coverage
Special considerations
- This file does not contain individual service records but contains information about plans that can be linked to individual enrollment information and may help put utilization into context.
- CMS continues to work with states to address data quality issues. In addition to preliminary and fully mature files, CMS may provide updated releases of the files for a given year. Please see this page on CMS fee information for TAF data pricing.
- A bridge file will be provided to assist researchers that are conducting longitudinal analysis involving 2020 TAF research files along with earlier service years. For additional information, please see the CCW T-MSIS Analytic Files (TAF) User Guide posted on CCW’s User Documentation page.
TAF Annual Provider (APR)
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.
What does this file include (variable highlights)
- Provider taxonomy indicators such as eye or vision, behavioral health, speech language or hearing services
- Residential treatment facility indicator
- Substance Use Disorder Service provider indicator
Special considerations
- This file does not contain individual service records but contains information about providers that can be linked to individual service records.
- CMS continues to work with states to address data quality issues. In addition to preliminary and fully mature files, CMS may provide updated releases of the files for a given year. Please see this page on CMS fee information for TAF data pricing.
- A bridge file will be provided to assist researchers that are conducting longitudinal analysis involving 2020 TAF research files along with earlier service years. For additional information, please see the CCW T-MSIS Analytic Files (TAF) User Guide posted on CCW’s User Documentation page.
2019 Preliminary Medicare Encounter Data Now Available
CMS is pleased to announce the release of the Preliminary 2019 Medicare Advantage (MA, also known as Part C) Encounter Research Identifiable Files (RIFs). Beginning with 2019 data, CMS will release a “Preliminary” version of the Medicare Advantage Encounter RIFs for each service year to give researchers earlier access to Encounter data in the research file format.
Comprehensive ESRD Care (CEC) Provider RIF
CMS has created an analytical file that contains information about providers who are participating in the Comprehensive ESRD Care (CEC) Model. A related file, the CEC Beneficiary RIF, contains identifying information about the beneficiaries assigned to a provider who is participating in the CEC Model.
The CEC Provider Performance Year RIF files contain PY finder files for the providers participating in the ESRD Seamless Care Organization (ESCO).
What does this file include? (variable highlights)
- ESCO Name
- Period of Performance
- Tax Identification Number of the practice/facility associated with the Individual NPI
- Parent Participant NPI Number
- Organization Name
- Provider Type description
- CMS Certification Number (CCN)
Special considerations
- This file can be linked to any other CMS file that include the TIN, CCN, or NPI.
- PY1 is for a 15 month period beginning in October, all other PYs are for a calendar year beginning in January.
- All technical questions related to the CEC program should be directed to ESRD-CMMI@cms.hhs.gov.
Comprehensive ESRD Care (CEC) Beneficiary RIF
CMS has created an analytical file that contains enrollment data for beneficiaries in the Comprehensive ESRD Care (CEC) Model. A related file, the CEC Provider RIF, contains identifying information about the providers participating in the CEC Model.
The CEC Beneficiary Performance Year RIF files contain PY finder files for the beneficiary population attributed to an ESRD Seamless Care Organization (ESCO).
What does this file include (variable highlights)
- Beneficiary ID (allows linkage to other files)
- ESCO 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.
- PY1 is for a 15 month period beginning in October, all other PYs are for a calendar year beginning in January.
- All technical questions related to the CEC program should be directed to ESRD-CMMI@cms.hhs.gov.
Home Health Outcome and Assessment Information Set (OASIS)
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.
Long Term Care Minimum Data Set (MDS) 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.
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