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Data File Search
What does this file include? (variable highlights)
- Resource Utilization Group (RUG) code
- Clinical status measures
- Physical functioning assessment
- Psychological status measures
- Psycho-social functioning measure
What does this file include? (variable highlights)
- Resource Utilization Group (RUG) code
- Clinical status measures
- Physical functioning assessment
- Psychological status measures
- Psycho-social functioning measure
- End-of-life care decisions
What does this file include? (variable highlights)
- Resource Utilization Group (RUG) code
- Clinical status measures
- Physical functioning assessment
- Psychological status measures
- Psycho-social functioning measure
Healthcare providers/populations addressed by specific, individual surveys include:
- Hospital
- Home Health
- Home and Community Based Services
- Fee-for-Service
- Medicare Advantage & Part D Plan (PDP)
- In-Center Hemodialysis
- Nationwide Adult Medicaid
- Hospice
- Accountable Care Organizations
- Outpatient and Ambulatory Surgery
- Merit-based Incentive Payment System quality payment program …
What does this file include? (variable highlights)
- HRS data include:
- Demographic and background information, including household
- Physical and mental health
- Cognition
- Functional limitations
- Employment
- Disability
- Health insurance
- Assets and Income
- Wills, including advanced directives
- Linked files include:
- Medicare denominator/Beneficiary…
HOS variables contain the following information in a baseline survey and two-year follow-up survey:
- Demographic information including primary language
- Disability status
- Physical and mental health status
- HEDIS Effectiveness of Care measures
- Health-related quality of life (HRQOL)
Special considerations
- CMS will provide additional file specifications to…
HEDIS data are released as a set of two files per year:
What does this file include? (variable highlights)
- Colorectal cancer screening
- Comprehensive diabetes care (multiple measures)
- High risk medication usage
Each record represents the experience of a beneficiary in a specific plan for the calendar year (CY). Beneficiaries enrolled in more than one plan during the CY will have multiple records in this file.
Beneficiaries can be linked to other beneficiary data via the BENE_ID and to plan…
What does this file include? (variable highlights)
- Readmission indicator
- Chronic condition weight
Each record represents a hospitalization for a beneficiary in the calendar year (CY). Beneficiaries with multiple hospitalizations will have multiple records in this file.
Beneficiaries can be linked to other beneficiary data via the BENE_ID and to plan information via the HEDIS_CONTRACT_ID and HEDIS_PLAN_ID variables.
What does this file include? (variable highlights)
- The MD-PPAS contain data on specialty, TIN practice assignment, place of service information, provider demographics, geographic location, and summary Medicare utilization measures for over 1.2 million providers.
- The MD-PPAS has been updated to version 2.4 from version 2.3 to reflect the following changes:
- The MD-PPAS data include a modified broad specialty variable that provides a more detailed…
What does this file include? (variable highlights)
- ACO ID
- Assigned in Preliminary/Prospective Assignment Period
- Assigned in Quarter 1
- Assigned in Quarter 2
- Assigned in Quarter 3
- Assigned in Quarter 4
- Assigned in Final Reconciliation
- Part D Eligible Months
- HICN (populated in PY2013-PY2019/2019-A)
- Date of birth
- Date of death
- Gender
- Race
- Medicare Beneficiary Identifier (MBI)…
What does this file include? (variable highlights)
- ACO ID
- ACO Name
- Start Date
- Tax Identification Number (TIN) of ACO Participant
- TIN Legal Business Name
- National Provider Identifier (NPI) for practitioner
- Name of Provider Associated with the NPI
- CMS Certification Number (CCN; formerly OSCAR number)
- CCN Facility Type
- CCN Facility Type Description
- Provider Specialty Code
- ACO Location (county…
What does this file include (variable highlights)
- Beneficiary ID (allows linkage to other files)
- ESCO Name
- Monthly assignment status information
- Date of birth
- Date of death
Special Considerations
- This file can be linked to any other CMS file that includes the Bene ID…
What does this file include? (variable highlights)
- ESCO Name
- Period of Performance
- Tax Identification Number of the practice/facility associated with the Individual NPI
- Parent Participant NPI Number
- Organization Name
- Provider Type description
- CMS Certification Number (CCN)
Special considerations
- This file can be linked to any other CMS…
What does this file include? (variable highlights)
- Beneficiary ID (allows linkage to other files)
- ACO Name
- Monthly assignment status information
- Date of Birth
- Date of Death
Special considerations
- This file can be linked to any other CMS file that includes the Bene ID
- Beneficiaries can be linked to their assigned providers by linking the ACO_ID in the provider file to the ACO_NUM in the…
What does this file include? (variable highlights)
- ACO identifier
- Performance year
- Organization Name
- CMS organization identifiers including Tax Identification Number, CMS Certification Number (CCN)
- Provider type description
Special considerations
- This file can be linked to any other CMS file that contains the ORG_TIN, ORG_NPI or ORG_CCN
- Providers can be linked to their assigned…
The NHATS interview data include:
- Residence
- Health conditions
- Housing/household
- Functional status
- Insurance
- Labor force participation
The NHATS interview data are linked to CMS Medicare claims data for information on healthcare use.
Special considerations
- The NHATS website has information on obtaining this…
This file includes (variable highlights):
- Special services, treatments, and interventions
- For example: ventilator use, dialysis, chemotherapy, central line placement, total parenteral nutrition, high risk drugs
- Medical conditions and co-morbidities
- Cognitive function
- Mental status including depression and dementia
- Ability to communicate
Special considerations:
- This is a…
What does this file include? (variable highlights)
- Beneficiary identifiers
- Practice identifier for the practice to which the beneficiary was attributed
- Number and percent of primary care services provided to the beneficiary that were billed by the practice
- HCC percentile risk score
Special considerations
- Data documentation is specific to each performance year.
- …
What does this file include? (variable highlights)
- Practice Identifier
- Eligible professional NPI
- Eligible professional subject to the VM
- Provider specialty
- No practice-level Quality and Resource Use Report (QRUR) or VM information (must link to VM Practice-Level RIF)
Special considerations
- Data documentation is specific to each performance year.
- Two additional VM program RIFs…
What does this file include? (variable highlights)
- Practice Identifier
- Quality and Resource Use Report (QRUR) information
- VM information
- Benchmark information
Special considerations
- Data documentation is specific to each performance year.
- This RIF includes thousands of records with hundreds of variables.
- Can be linked to provider NPI in the VM NPI-Practice-Level RIF…
What is different about MMLEADS 3.0?
MMLEADS now consists of two files—a beneficiary summary file and single cost (i.e., payments) and use (i.e., claim counts) file that combines Medicare and Medicaid information. CCW Chronic Condition and other condition flags are no longer provided.
Source data
Medicare: FFS, PDE and MA
Medicaid: T-MSIS data
What does this file include? (variable highlights)
- Eligibility,…
What does this file include? (variable highlights)
- Provider file
- Pioneer ACO ID
- Tax identification number
- Provider specialty code
- Beneficiary file
- Bene ID
- Pioneer ACO ID
- Aggregated expenditures and claim counts
- Settlement file
- Pioneer ACO ID
- Beneficiary counts
- Performance year…