How States Can Better Understand their Dually Eligible Beneficiaries: A Guide to Using CMS Data Resources

This technical assistance tool presents an overview of the various data sources available on the CMS Medicare-Medicaid Coordination Office (MMCO) website that may be useful to states in designing, developing, and refining programs that serve dually eligible beneficiaries. CMS regularly publishes data collected from states, health plans, and other sources on its website. The data include dually eligible beneficiary eligibility categories, demographics, service utilization, and spending that states can use to better understand the specific needs and characteristics of this population as they develop, operate, monitor, and refine programs that serve dually eligible beneficiaries in their state.

The purpose of this guide is to help states effectively interpret and use this information. This guide can help states locate, sort, and manipulate relevant data to develop user-friendly and accessible tables, graphs, and figures. The data that is publically available on the MMCO pages of the CMS website can help state decision makers and external stakeholders to better understand their dually eligible beneficiaries and the Medicare and Medicaid services they are receiving. State Medicaid staff can use CMS data sources to access current information, identify trends over time, demonstrate the need for future integrated care, target areas to enhance integration, and learn from the experiences of other states.