Objective: To evaluate the completeness and quality of Medicaid comprehensive managed care (CMC) data in national MAX/TAF research files.
Study Setting And Design: This observational study compared CMC with fee-for-service (FFS) enrollee data in 2001-2019 Medicaid MAX/TAF inpatient, outpatient, and pharmacy files. Completeness was assessed as the proportion of enrollees with any claim and mean claims per enrollee with any claim. Quality was assessed as the proportion of inpatient and outpatient claims with primary diagnosis and procedure codes and the proportion of prescription drug claims with fill dates, National Drug Codes (NDC), days supplied, and quantity dispensed. Acceptable ranges for each study measure were defined as the national FFS mean ± 2 standard deviations.
Data Sources And Analytic Sample: We analyzed secondary data on 45 states from 2001 to 2013 (MAX) and 50 states and DC from 2014 to 2019 (TAF). The sample included adults aged 18-64 with continuous calendar-year enrollment who were eligible for full Medicaid benefits and ineligible for Medicare. We determined CMC enrollment rates and assessed data completeness and quality among state-years with ≥10% CMC penetration, comparing CMC with FFS enrollees.
Principal Findings: Across 891 state-years, 194,364,647 enrollees met inclusion criteria. Of 540 state-years (60.6%) with ≥10% CMC enrollment, CMC data were largely comparable to national FFS distributions for all inpatient (n = 430; 79.6%), outpatient (n = 467, 86.5%), and prescription (n = 459, 85.0%) completeness criteria and for all inpatient (n = 449, 83.1%), outpatient (n = 511, 94.6%), and prescription (n = 528, 97.8%) quality criteria. Overall completeness (92.3%) and quality (84.6%) improved substantially by 2019.
Conclusions: Completeness and quality of CMC data were largely comparable to FFS data, with increasing state-years meeting criteria over time. Further research on national Medicaid populations should assess and address differences in data completeness and quality by plan type across states, over time, and in relation to specific study samples and measures of interest.
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http://dx.doi.org/10.1111/1475-6773.14429 | DOI Listing |
Tech Coloproctol
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Colorectal Surgery Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona UAB, Barcelona, Spain.
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View Article and Find Full Text PDFEnviron Health
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Academic Center for General Practice, KU Leuven, Kapucijnenvoer 7 bus 7001 block h, Leuven, 3000, Belgium.
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View Article and Find Full Text PDFBMC Health Serv Res
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Logistics Education (LEED) at Kühne Foundation, Hamburg, Germany.
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View Article and Find Full Text PDFBMC Musculoskelet Disord
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Department of Orthopaedics and Traumatology, Faculty of Medicine, Dokuz Eylül University, İzmir, 35340, Turkey.
Background: Menisci, one of the most important anatomical structures of the knee joint, plays a role in load transfer, stability, shock absorption, prevention of articular cartilage degeneration, and proprioception. Type I collagen, the main component of the meniscus, and type II collagen fibers play an important role in the stability of the knee joint. This study aimed to evaluate the effects of Naturagen® 4 Joint product containing type I, II, and III collagen on pain, quality of life, and physical functions in patients with meniscopathy.
View Article and Find Full Text PDFBMC Geriatr
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Deputy Director of the Health and Social Care Workforce Research Unit (HSCWRU), The Policy Institute, King's College London, 22 Kings Way, London, WC2B 6LE, England.
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