The Data & Systems Group (DSG) houses the data and systems work of CMCS. DSG is responsible for overseeing the collection of information from the states to ensure proper administration and integrity of the Medicaid and CHIP programs and supports states as they develop new and modernize existing eligibility and enrollment systems and the new Transformed Medicaid Statistical Information System (T-MSIS). FedHealthIT’s President, Susan Sharer, recently spoke with the group’s Director of the Division of Business and Data Analysis, Barbara Richards, and key Data Scientist, Jeff Galecki, to better understand the work they are driving.
Data & Systems Group’s Division of Business and Data Analysis
This Division was created five years ago to improve the way we use data to influence smarter spending and achieve better outcomes in Medicaid and CHIP. We work with others to improve and enhance the Federal IT systems we use to collect data from the states so that we do it in a more timely way and on more robust platforms, and then work to make meaning of that data. With $580B in spending annually in combined Federal and state budgets, we need to do better at getting data into people’s hands.
Transformed Medicaid Statistical Information System (T-MSIS)
Over the past few years, we have been building a data analytics foundation, setting in place those key building blocks. It started with T-MSIS which is the administrative data about beneficiaries and claims data that will allow us to answer questions about the who, what and how of our Medicaid spending.
The first set of files from that data set were released in November based on data from 2014-2016. Along with the T-MSIS files, we also released 35 data quality briefs that can help inform a data user about the quality of the data according to major themes, or by state. The data quality briefs can help researchers determine where they may want to look further based on the specific topic.
The specific topics the data covers include, for example, enrollment, service use, provider information, expenditures, managed care and special populations. Currently there is a cost associated with accessing the files but our goal is to quickly analyze and transform them to make these data more accessible.
The Deep Dive
We were also asked to develop per capita expenditure estimates by states. People look at Medicaid from the perspective of how much a state spends, on average by year and by different population types. We were able to release this for 12 states that met the four data quality assessments. We required and looked specifically at five major eligibility groups including children, elderly and the disabled. The remaining states have a way to go in data quality but we expect there will be progress and we hope to be able to include more states in the analysis next year.
Supporting States
We have a robust process in place where our teams work with each state to improve their T-MSIS data. These are complex data sets and include eight files states have to submit and hundreds of data points that have to be collected and sent to us in a consistent way to meet our business rules. Our teams are meeting regularly with the states, focused on a series of priorities and we have seen good progress. Now that we have released this first data set they can see it is data that can and will be used.
Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act
Congress passed the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. Understanding that you can’t study something if you can’t measure it, we released in October 2019 the T-MSIS Substance Use Disorder (SUD) Data Book. By looking at Substance Use Disorder in Medicaid, we can assess who has the disorder and the services they are accessing. That initial snapshot is the first step in measuring the impact of the respective substance use disorders and how to move forward.
We felt it was important to make the contents of the data book more easily accessible, so we created an interactive data tool that we were able to rapidly set up, deploy and create on demand visualizations. This allows users to explore the data by what they are interested in and then to download that background data for further study and action.
What has the Feedback Been?
Everything we have heard so far has been positive. We are receiving emails from states asking about our next data product release so we can already see it has served the purpose of engaging them in making improvements to their data submissions. Compared to the static PDF we used to be able to share we are getting a lot of great feedback and interaction that we wouldn’t have in the past.
What is Next?
Our mandate is to create this annual report and as data quality improves with other states, we will be able to add more components of analysis to the report, and some deeper dives that we couldn’t do this year. Using MicroStrategy for this an interactive tool was a first step in interactive data consumption by users that we will continue to build on and leverage.
In addition to what we did in November, we are on track to release 2017 and 2018 T-MSIS Analytic Files. We also want to move ahead on making the data quality information more interactive and more accessible and we’ll update the SUD Data Book and per capita expenditure data with the 2018 information.
Internally, we’ll be engaging with staff within our Centers to start to build out other interactive tools that they can use to answer the questions they need.
We have been collaborating with others in CMS for the last several years, including CPI and CMMI and we all share access to internal data so that anyone who wants and needs access to these data has it. We also want to learn from them about what they do to make data more accessible to staff.
About Jeff Galecki
Jeff Galecki, MS, LCADC, LCPC, graduated from Loyola University Maryland in 2011 with a masters in clinical psychology. He has worked in methadone clinics and at Johns Hopkins School of Medicine Department of Nuclear Medicine researching addiction and mental health. Presently, he serves as Vice-Chair and Chair of the disciplinary review committee on the Board of Counselors and Therapists. Additionally, he works full time for the Center for Medicare & Medicaid Services as a data analyst and subject matter expert focused on mental health and substance abuse in Medicaid. He conducts psychiatric evaluations in Sinai and Johns Hopkins Bayview’s emergency departments and conducts mental health groups at the National Institute for the Study, Prevent, and Treatment of Sexual Trauma.
