Managed Care Information for Medicaid and CHIP Beneficiaries by Year

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each managed care plan type over the year (duplicated count); (2) the number of beneficiaries enrolled in each managed care plan type as of an individual’s last month of enrollment (duplicated count); and (3) average monthly enrollment in each managed care plan type.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. For some years, data quality assessments were performed on a newer version of the TAF than is available in DQ Atlas.