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.
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).
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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).
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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.
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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.
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The Plan Characteristics file contains Medicare Advantage plan and Prescription Drug Plan information separated into six subfiles.
The subfiles are:
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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 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)
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.
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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.
The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) 2.0 suite of files combines Medicare and Medicaid enrollment and claims data into four annual beneficiary-level files. The files include beneficiaries who are Medicare-only, Medicare-Medicaid dually enrolled and Medicaid-only blind and disabled.
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