1. Opportunities To Use Medicaid Data to Conduct Health Services Research
Ana Lòpez – De Fede, PhD
USC Institute for Families in Society
Division of Medicaid Policy Research
October 13, 2016

2. Impact of Medicaid Child Population on Hospitals — American Academy of Pediatrics, March 2015
Children & Medicaid
Medicaid covers 33 million children nationwide.
Approximately 20% of children have special health care needs, and 44% of them are covered by public insurance.
60% of children enrolled in Medicaid live in households where at least one household member works.
Historically, children represent half of all Medicaid enrollees, but they account for only 25% of Medicaid dollars spent.

3. Impact of Medicaid Child Population on Hospitals — American Academy of Pediatrics, March 2015
Impact of Medicaid on Hospitals
In South Carolina, children on Medicaid make up 48.4% of a pediatrician’s Patient Base 1.
Although they comprise less than 5% of the nation’s total hospitals, children’s hospitals provide about 47% of all inpatient care for children on Medicaid and almost all the hospital care required by children with complex conditions.

4. Impact of Medicaid Child Population on Hospitals — American Academy of Pediatrics, March 2015
Impact of Medicaid on Hospitals
On average, each children’s hospital devotes more than half its inpatient care (57% of inpatient days) to children assisted by Medicaid.
On average, Medicaid reimburses children’s hospitals only 77% of the cost of care provided, including Disproportionate Share Hospital payments.
If cuts or caps are adopted at the federal or state level, payment rates could decrease further.

5. Medicaid Data & Analytic Linked Components
MPR
Medicaid Data & Analytic Linked Components

6. Medicaid Data & Analytic Linked Components
Medicaid Providers
MPR
Medicaid Data & Analytic Linked Components

7. Medicaid Data & Analytic Linked Components
Professional Organizations:
SC LLR Professional Boards, CMS Provider of Services, National Provider Identifier Registry; Hospital Affiliation
MPR
Medicaid Data & Analytic Linked Components

8. Medicaid Data & Analytic Linked
ESRI Spatial and Attribute Data
MPR
Medicaid Data & Analytic Linked
Components

9. Medicaid Data & Analytic Linked
Medicare Dual
Eligible
DHEC Immunization Data
MPR
Medicaid Data & Analytic Linked
Components
Claims & Encounters
Lab
Results

10. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
CHIPRA

11. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
State Agency Provider Services

12. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
Hospital Designations Environmental Data

13. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
Community
Directories

14. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
SC Geographic Information Council

15. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
Boundary Data: Zip Code and Census Tract Designations

16. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
HSRA Designations and
Catchment

17. Medicaid Data & Analytic Linked
MPR
Medicaid Data & Analytic Linked
Components
Attribute Data: Census Data and Zip Code Updates

18. Medicaid Data & Analytic Linked
Eligibility/ Family Recipient File
MPR
Medicaid Data & Analytic Linked
Components

19. Medicaid Data & Analytic Linked
DHEC Recipient Mortaility Status
MPR
Medicaid Data & Analytic Linked
Components

20. Medicaid Data & Analytic Linked
Professional Organizations:
SC LLR Professional Boards, CMS Provider of Services, National Provider Identifier Registry; Hospital Affiliation
Medicaid Providers
DHEC Recipient Mortality Status
Medicare Dual
Eligible
ESRI Spatial and Attribute Data
DHEC Immunization Data
Eligibility/ Family Recipient File
MPR
Medicaid Data & Analytic Linked
Components
Claims & Encounters
Attribute Data: Census Data and Zip Code Updates
Lab
Results
HSRA Designations and
Catchment
CHIPRA
Boundary Data: Zip Code and Census Tract Designations
Hospital Designations Environmental Data
State Agency Provider Services
Community
Directories
SC Geographic Information Council

21. MPR Available Research Tools and Analytic Capacity

22. MPR Available Research Tools and Analytic Capacity
HEDIS NCQA Certified Software with Beta Testing Capacity and New Measures Benchmarking

23. MPR Available Research Tools and Analytic Capacity
Clinical Risk Stratification Tools
3M CRG; DXG
MPR Available Research Tools and Analytic Capacity

24. MPR Available Research Tools and Analytic Capacity
GeoDa
Spatial Statistical Software
MPR Available Research Tools and Analytic Capacity

25. MPR Available Research Tools and Analytic Capacity
ARHQ Software
CCS and PQI

26. MPR Available Research Tools and Analytic Capacity
Certified Survey Research
Geographic Aggregation Tool

27. MPR Available Research Tools and Analytic Capacity
Certified Survey Research

28. MPR Available Research Tools and Analytic Capacity
Tableau®

29. MPR Available Research Tools and Analytic Capacity
SAS; STATA; Spatial Microsimulation with R; SQL

30. MPR Available Research Tools and Analytic Capacity
Address Products

31. MPR Available Research Tools and Analytic Capacity
ESRI ArcGIS Desktop, Server, Extensions, ARCGIS Online

32. MPR Available Research Tools and Analytic Capacity
Compass Navigator Development and Testing HEDIS-LIKE Measures Benchmarking

33. MPR Available Research Tools and Analytic Capacity
GeoDa
Spatial Statistical Software
Clinical Risk Stratification Tools
3M CRG; DXG
MPR Available Research Tools and Analytic Capacity
Compass Navigator Development and Testing HEDIS-LIKE Measures Benchmarking
Certified Survey Research
HEDIS NCQA Certified Software with Beta Testing Capacity and New Measures Benchmarking
SAS; STATA; Spatial Microsimulation with R;
SQL
ESRI ArcGIS Desktop, Server, Extensions, ARCGIS Online
ARHQ Software
CCS and PQI
Address Products
Tableau®
Geographic Aggregation Tool

34. Applying Medicaid Data to Health Services Research Activities
The Institute of Medicine, defines Health Services Research (HSR) as an inquiry to produce knowledge about the . . .
Structure, e.g., physician workforce; structure of the delivery system
Process, e.g., use of different types of services, access
Effects (outcomes), e.g., changes in health, functional status, severity of condition, satisfaction with care, cost of care, quality of life
. . . of personal health services.

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