Assessing the Usability of MAX 2008 Encounter Data for Comprehensive Managed Care

Abstract

Most states that have comprehensive managed care plans are reporting OT, IP, and RX encounter data. Of those data, the majority are complete and of comparable quality to FFS data for adults, children, the disabled, and aged populations.

Vital Signs: National and State-Specific Patterns of Attention Deficit/Hyperactivity Disorder Treatment Among Insured Children Aged 2–5 Years — United States, 2008–2014

“…Annual data from Medicaid Analytic eXtract files from the Centers for Medicare and Medicaid Services for 2008-2011 were used for children covered by Medicaid insurance for ≥3 continuous months during each calendar year in 29-34 states in each year, depending on data availability and usability (18)(19)(20). During 2008-2011, the years with the most complete Medicaid data, data were available for 5-7 million children aged 2-5 years for each year from 29-34 states.…”

Preventive asthma medication discontinuation among children enrolled in fee-for-service Medicaid

“…Unfortunately, encounter data from states administering separate-CHIP and managed care Medicaid plans is incomplete. Furthermore, those data do not undergo the same validation and quality checks as fee-for-service Medicaid and Medicaid-expansion CHIP data [25]. Thus, we restricted our sample to Medicaid and Medicaid-expansion CHIP participants within fee-for-service plans.…”

Utilization of Dental Services Among Medicaid-Enrolled Children

“…These states are excluded, because MAX data have not historically included comprehensive utilization data for managed care enrollees. Although reporting of dental services may be complete in some states (Byrd et al, 2012), evaluating the quality of the encounter data was beyond the scope of this study. These states may have feefor-service (FFS) claims for dental services for a subset of enrollees; however, the utilization of the FFS enrollees is generally not representative of the utilization of the full population in a state, because individuals enrolled in managed care programs generally are comparatively healthy.…”