Transcript Using Linked Data to Track Participation in the Medicaid Buy-In Program Henry T.

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
Goals of the Presentation
2

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
The Medicaid Buy-In Program
3

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
Number of States and Participants
in Medicaid Buy-In Program, 1999-2005
90,000
30
Number of states
30
24
23
25
20
16
69,218
70,000
60,000
61,985
50,000
45,481
40,000
13
15
10
80,000
27 76,645
30,000
7
22,940
20,000
16,173
5
10,000
6,980
0
0
1999
2000
2001
2002
States with a Buy-In finder file
2003
2004
2005
Enrollment as of December 31
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.
4
Data Source: Buy-In finder files from states
Number of participants
35
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)
5
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
6
Data Integration Process
CMS
data systems
MBI participants
finder files from
states
Medicaid
Statistical
Information
System
Medicare
eligibility
and claims
7
SSA
data systems
Ticket
Research
File
Integrated
Individual-Level
Analytical File
Masters
Earnings
File
Patterns of Enrollment in the
Medicaid Buy-In Program
31,193
2003
31,126
2002
31,601
63,770
46,673
Total 94,963
Total 77,799
Year
2004
2001
13,104
0
16,214
23,433
Total 55,034
Total 29,318
10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000
Number of Buy-In Participants
First Time
DataBuy-In
Source:
Buy-In
from 27 states
Source:
finder
filesfinder
from files
27 states
8
All Others
Percent of Buy-In Participants with
Reported Annual Earnings by State, 2004
100
90
80
70
60
50
40
30
20
10
0
IL
MI KS ME LA NE MN OR SC VT WA
IN WV CT NH NJ NY MA UT CA PA WI AK AR NM IA MO
Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File
9
Annual Earnings Among Buy-In Participants with
Reported Earnings, 27 States, 2000-2004
Total Earnings
in Dollars
Average Earnings
in Dollars
500,000,000
8,200
450,000,000
8,000
400,000,000
7,800
350,000,000
300,000,000
7,600
250,000,000
7,400
200,000,000
7,200
150,000,000
7,000
100,000,000
6,800
50,000,000
0
6,600
2000
2001
2002
2003
2004
2000
2001
2002
Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File
10
2003
2004
Demographics of High Earners, 2002
70
60
61
47
45
50
40
30
20
20
10
0
Percent age 21-44
Percent non-white
Participants with top 10% earnings
All 2002 participants
Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File
11
Other Characteristics of High
Earners, 2002
80
70
76
60
50
40
30
20
10
0
39
32
23
Percent with no SSDI or
SSI
25
17
Percent mental illness
Participants with top 10% earnings
Percent with lowest 25%
medical spendings ($312
PMPM)
All 2002 participants
Data Source: Buy-In finder files from 27 states, SSA’s TRF and MEF, MSIS and
12
Medicare eligibility and claims files
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
13
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
14
Recent Mathematica Reports
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.
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