Analyzing Medicaid’s T-MSIS Data to Inform Behavioral Health, Disability, and Aging Policy

The Office of the Assistant Secretary for Planning and Evaluation’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP) develops, coordinates, researches, and evaluates U.S. Department of Health and Human Services programs and policies that promote the health of people living with disabilities, people with substance abuse and mental health disorders, and older adults. T-MSIS data, which provide the most current information on health care service use, enrollment, and spending for Medicaid and the Children’s Health Insurance Program (CHIP), is a critical source of information to drive data-driven program planning and decision making for BHDAP. 

This project makes use of Mathematica’s three decades of experience working with Medicaid data (including helping states improve the quality of their T-MSIS data submissions) and our subject matter expertise in behavioral health, opioid use, long-term services and supports, COVID-19, and other areas.

To date, Mathematica has analyzed topics including telehealth, home and community-based services (HCBS), and crisis services for BHDAP. A few examples include the following:

• Using T-MSIS Analytic Files, we calculated descriptive statistics on the number of Medicaid- or CHIP-enrolled children with a health care encounter for suicidal behavior, and calculated the rate of these encounters per enrollee. We also calculated the percentage change in suicidal behaviors before and during the COVID-19 pandemic across various racial and ethnic groups, along with confidence intervals to aid interpretation. 
• We analyzed the impact of temporary program modifications during the COVID-19 pandemic on access to HCBS Medicaid services, using data gathered from states’ emergency amendments to their HCBS waiver programs. We developed a methodology to identify HCBS claims and calculated descriptive statistics on the number of Medicaid enrollees using HCBS. We then calculated the average and standard deviation of the use of HCBS by the type of program modification implemented by the state to aid BHDAP in understanding the impact of various short-term policies during the COVID-19 pandemic.

In addition to these analyses, Mathematica works closely with BHDAP to design studies and develop issue briefs and manuscripts. We also support BHDAP’s use of Medicaid data by providing technical assistance on T-MSIS data. Findings from this project have been published in the Maternal and Child Health Journal and Psychiatric Services.