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Data Tools for Researchers

Guidance for MMCO data tools to study health care utilization, expenditures, health status, and other characteristics of people who are enrolled in both Medicare and Medicaid.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 09, 2020

SPOTLIGHT & RELEASES

 

 

MMCO Data Tools

The CMS Medicare-Medicaid Coordination Office (MMCO) developed special tools to help you study health care utilization, expenditures, health status, and other characteristics of people who are enrolled in both Medicare and Medicaid.

  • MMLEADS PUF - Medicare-Medicaid Linked Enrollee Analytic Data Source, version 2.0 Public Use File (MMLEADS PUF V2.0 (XLSX)) (2006-2012):
    • Free Public Use File (PUF) Excel document
    • Makes the data within the CCW-hosted MMLEADS-v2.0 accessible to everyone, irrespective of technical readiness to analyze the files
    • Has summary information for full and partial benefit Medicare-Medicaid enrollees as well as Medicare-only and Medicaid-only with disability
    • Has information on eligibility, enrollment, cost, use, and broad array of health, mental health, and disability-related conditions
    • Is available for all states and the nation as a whole, for years 2006 through 2012
  • MMLEADS - Medicare-Medicaid Linked Enrollee Analytic Data Source, version 2.0 (MMLEADS-v2.0):
  • Chronic Condition Data Warehouse (CCW) Condition Flags (CCW Condition Flags)
    • CMS' database of multiple chronic condition indicators or variables (i.e., "flags") on all beneficiaries in the Medicare, Medicaid and Medicare-Medicaid dually enrolled populations
    • All flags are available for calendar years 2000 through 2012
    • Medicare-only flags are also available for more recent data
    • Condition indicators built from Medicare and Medicaid claims data across the following two sets:
      • Set 1: CCW Chronic Conditions (original set)
      • Set 2: Other Chronic or Potentially Disabling Conditions (developed by MMCO), including:
        • New! (as of September, 2018) Opioid Use Disorder (OUD), Utilization of Medication-Assisted Therapy (MAT) for OUD, and Opioid-related Hospitalizations/Emergency Department (ED) visits
        • 8 Mental health conditions
        • 14 disability-related conditions (intellectual, developmental, and physical)
        • Alcohol use disorder, Drug use disorder, and Tobacco use disorder
        • Pain-related conditions (Fibromyalgia, Chronic Pain and Chronic Fatigue, Migraine and Other Chronic Headache)
        • HIV/AIDS*
        • 8 Viral Hepatitis conditions
        • Other conditions (e.g., Leukemia and Lymphoma, Liver-related conditions (excluding Hepatitis), Obesity, Pressure Ulcers and Chronic Ulcer, Peripheral Vascular Disease)

*In addition to the HIV/AIDS flag, there are six additional HIV/AIDS-related flags: HIV Screening; Antiretroviral Medication Use; HIV/AIDS Health Care Services Contact; HIV/AIDS program participation; SSA Disability-Qualifying Primary and Secondary Diagnoses.*


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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.