Mathematica Supports the Centers for Medicare & Medicaid Services’s State Medicaid and Children’s Health Insurance Program Transformation and Innovation Milestones

Experts at the National Association of Medicaid Directors Fall Conference support the Transformed Medicaid Statistical Information System (T-MSIS) data sets, the inaugural Substance Use Disorder (SUD) Data Book, and additional state tools and services
Nov 07, 2019

Washington, DC Skyline

For several decades, Mathematica has supported the Centers for Medicare & Medicaid Services (CMS) in its federal work to transform health care delivery and quality for low-income populations, people with disabilities, and older Americans. At this year’s National Association of Medicaid Directors fall conference in Washington, DC, Mathematica will showcase its new state Medicaid services and its recent support for CMS projects to modernize data analytics for Medicaid and the Children’s Health Insurance Program (CHIP), the nation’s largest source of health coverage for low-income populations. Visit us at booth 24 to learn more about our recent work supporting the development of the T-MSIS and related research analytic files, the first-ever T-MSIS SUD Data Book, and the Medicaid and CHIP Scorecard. Our staff will be on hand to discuss our new state offerings, our recent contributions to data analytics innovations, and the myriad ways our experts can help states navigate the road ahead.

“We are proud to support CMS on projects to advance data analytics innovations, potentially help slow cost growth, and increase the quality of care provided by Medicaid and CHIP,” said Jonathan Morse, senior vice president and managing director of Health Program Improvement. “We look forward to meeting with state Medicaid directors to discuss how our recent projects with CMS and our capabilities in enterprise risk management and program integrity, value-based care, state advisory services, and data strategy and production systems can help states deliver responsive, timely, and quality services to consumers in a cost-effective manner.”

Carol Irvin, senior fellow and project director of the complex T-MSIS data analytics effort instituted by CMS, added, “Working in close partnership with CMS staff and states, our experts designed and developed a suite of data products and analytic reports that can be used to help transform health care delivery. We are delighted to provide the subject matter expertise on data design and management to reach this milestone in delivering analytic tools to help states achieve federal compliance and to meet the research needs of the Medicaid and CHIP data user community in their work to inform policy decisions.”

Partnering with CMS on the Medicaid and CHIP Business Information Solution (MACBIS) initiative

As part of the MACBIS initiative, Mathematica supports CMS in building infrastructure for robust data analytics, integrating and aligning federal and state data sources to support data-driven policy decisions about Medicaid and CHIP policy and programs. Products from the multiyear partnership with CMS include data quality tools for state T-MSIS submissions, which encompass vital information about beneficiaries, their use of services, and the costs associated with those services, as well as other key Medicaid and CHIP program information. Mathematica also helped develop the research-optimized version of T-MSIS data, called the T-MSIS Analytic Files (TAF), which serve the broad research needs of the Medicaid and CHIP data user community. A series of data quality briefs for users of the TAF data are also available.

T-MSIS Substance Use Disorder Data Book

In addition, CMS released the Substance Use Disorder (SUD) Data Book and a series of supporting data quality briefs. Working with CMS, Mathematica experts developed these products for Congress. The data book uses TAF data to report the number of Medicaid beneficiaries treated for a SUD and the services they received during calendar year 2017. CMS released the inaugural SUD Data Book using the 2017 TAF data, which was the most recent complete year of TAF data available when the analysis was conducted. The SUD Data Book is congressionally mandated through the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The SUPPORT Act seeks to address the pressing need for SUD treatment and prevention services, with a focus on opioid use. The SUPPORT Act directs the U.S. Department of Health and Human Services to publish the SUD Data Book no later than October 24, 2019, and to issue an updated version of the SUD Data Book no later than January 1 of each calendar year through 2024.

Medicaid and CHIP Scorecard

Mathematica’s health experts also assisted CMS with the newly released Medicaid and CHIP Scorecard. Mathematica supported the agency’s initiative by providing subject matter, technical, and data visualization expertise to help CMS consider different ways of assessing federal and state accountability for Medicaid and CHIP, which together serve more than 75 million people.

Medicaid and CHIP Scorecard and Core Set Measures Technical Assistance and Analytic Support

Mathematica’s health experts also assisted CMS with the newly released Medicaid and CHIP Scorecard. Mathematica supported the agency’s initiative by providing subject matter, technical, and data visualization expertise to help CMS consider different ways of assessing federal and state accountability for Medicaid and CHIP, which together serve more than 75 million people. In addition, Mathematica leads the Technical Assistance and Analytic Support Program for the Center for Medicaid and CHIP Services’ (CMCS) Core Set Measures. The Mathematica team provides TA/AS to CMCS and states related to four core sets of health care quality measures: Child, Adult, Health Homes, and Maternal and Infant Health (MIH).


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