1. Using Linked Data to Track Participation in the Medicaid Buy-In Program Henry T. Ireys Su Liu The Future of Disability Statistics: What We Know and Need to Know Arlington, Virginia October 2006 Henry T. Ireys Su Liu The Future of Disability Statistics: What We Know and Need to Know Arlington, Virginia October 2006

2. 2 Goals of the Presentation Describe process of building an integrated database using administrative data from several agencies Illustrate how the database can be used to address key policy questions related to the Medicaid Buy-In program Describe process of building an integrated database using administrative data from several agencies Illustrate how the database can be used to address key policy questions related to the Medicaid Buy-In program

3. 3 The Medicaid Buy-In Program Encourages work by allowing individuals with disabilities to “buy into” Medicaid without giving up higher earnings or assets Optional state program under Medicaid Currently offered by 31 states More than 160,000 individuals have enrolled, as of December 2005 Encourages work by allowing individuals with disabilities to “buy into” Medicaid without giving up higher earnings or assets Optional state program under Medicaid Currently offered by 31 states More than 160,000 individuals have enrolled, as of December 2005

4. 4 Number of States and Participants in Medicaid Buy-In Program, 1999-2005 Note: Arizona and Mississippi also had a Buy-In program, but were not required to submit a finder file; Missouri’s Buy-In program was eliminated in August 2005. Data Source: Buy-In finder files from states

5. 5 Examples of Policy Questions and Related Data Sources How many individuals participate in the Medicaid Buy-In program? –Finder files from state Buy-In programs How many have earnings and what are their average earnings? –Finder files from state programs –SSA’s master earnings files (MEF) How many individuals participate in the Medicaid Buy-In program? –Finder files from state Buy-In programs How many have earnings and what are their average earnings? –Finder files from state programs –SSA’s master earnings files (MEF)

6. 6 Policy Questions and Data Sources (continued) How do earnings vary by participant characteristics: demographics, disabling condition, prior program participation, and medical expenditures? –Finder files from states –SSA’s MEF –SSA’s Ticket Research File (TRF) –Medicaid Statistical Information System (MSIS) –Medicare eligibility and claims files How do earnings vary by participant characteristics: demographics, disabling condition, prior program participation, and medical expenditures? –Finder files from states –SSA’s MEF –SSA’s Ticket Research File (TRF) –Medicaid Statistical Information System (MSIS) –Medicare eligibility and claims files

7. 7 Medicaid Statistical Information System Medicare eligibility and claims Ticket Research File Integrated Individual-Level Analytical File Data Integration Process Masters Earnings File MBI participants finder files from states CMS data systems SSA data systems

8. 8 Patterns of Enrollment in the Medicaid Buy-In Program Total 94,963 Total 29,318 Total 55,034 Total 77,799 Source: Buy-In finder files from 27 states Data Source: Buy-In finder files from 27 states

9. 9 Percent of Buy-In Participants with Reported Annual Earnings by State, 2004 Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File

10. 10 Annual Earnings Among Buy-In Participants with Reported Earnings, 27 States, 2000-2004 Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File Total Earnings in Dollars Average Earnings in Dollars

11. 11 Demographics of High Earners, 2002 Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File

12. 12 Other Characteristics of High Earners, 2002 Data Source: Buy-In finder files from 27 states, SSA’s TRF and MEF, MSIS and Medicare eligibility and claims files

13. 13 Benefits of Linking Datasets Chief Benefits –Able to address a wider range of questions compared with data from one agency alone –Responsive to needs of multiple stakeholders Chief Benefits –Able to address a wider range of questions compared with data from one agency alone –Responsive to needs of multiple stakeholders

14. 14 Challenges of Linking Datasets Addressing differences in populations, time periods Managing lack of data overlap Establishing close collaboration between agency staff and researchers Assuring data confidentiality Gaining inter-agency collaboration Addressing differences in populations, time periods Managing lack of data overlap Establishing close collaboration between agency staff and researchers Assuring data confidentiality Gaining inter-agency collaboration

15. 15 Available at www.mathematica-mpr.com: –How Much Are Medicaid Buy-In Participants Earning? William E. Black, Su Liu, Henry T. Ireys. June 2006 (first in a series of issue briefs) –Participation in the Medicaid Buy-In Program: A Statistical Profile from Integrated Data. Su Liu, Henry T. Ireys. May 2006 –Understanding Enrollment Trends and Participant Characteristics of the Medicaid Buy-In Program, 2003-2004. William E. Black, Henry T. Ireys. January 2006. Available at www.mathematica-mpr.com: –How Much Are Medicaid Buy-In Participants Earning? William E. Black, Su Liu, Henry T. Ireys. June 2006 (first in a series of issue briefs) –Participation in the Medicaid Buy-In Program: A Statistical Profile from Integrated Data. Su Liu, Henry T. Ireys. May 2006 –Understanding Enrollment Trends and Participant Characteristics of the Medicaid Buy-In Program, 2003-2004. William E. Black, Henry T. Ireys. January 2006. Recent Mathematica Reports