Data File Search
What does this file include? (variable highlights)Pre-hospitalization living situationCo-morbid conditionsCommunication statusFunctional status
Program:
Medicare
Healthcare providers/populations addressed by specific, individual surveys include:
Hospital
Home Health
Home and Community Based Services
Fee-for-Service
Medicare Advantage & Part D Plan (PDP)
In-Center Hemodialysis
Nationwide Adult Medicaid
Hospice
Accountable Care Organizations
Outpatient and Ambulatory Surgery
Merit-based Incentive Payment System quality payment program
Measures of beneficiary experience focus on the patient experience or perception rather than patient satisfaction. Focus areas...
Program:
Medicare
What does this file include? (variable highlights)Eligibility, enrollment variablesAggregated cost and useMedicare: FFS, PDE includes FFS and MAMedicaid: FFS, managed care encounter where availablePrescription Drug service utilization reported for classes of drugsAll four files are released for approved MMLEADS data requestsBeneficiary fileMedicare Services fileMedicaid Services fileConditions fileSpecial considerationsExternal resource of detailed information on MMLEADS files and structure: CCW MMLEADS User...
Program:
Medicare, Medicaid
The NHATS interview data include:ResidenceHealth conditionsHousing/householdFunctional statusInsuranceLabor force participationThe NHATS interview data are linked to CMS Medicare claims data for information on healthcare use.Special considerationsPre-approval is required from the NHATS program prior to submitting a CMS data request for the Medicare linked files.The NHATS website has information on obtaining this restricted data.
Program:
Medicare
What does this file include? (variable highlights)HRS data include:Demographic and background information, including householdPhysical and mental healthCognitionFunctional limitationsEmploymentDisabilityHealth insuranceAssets and IncomeWills, including advanced directivesLinked files include:Medicare denominator/Beneficiary Summary File (BSF) Medicare fee-for-service (FFS) claimsInpatient, MedPAR, Outpatient, Durable Medical Equipment (DME), Carrier, Skilled Nursing Facility, Home Health, Hospice Part D drug...
Program:
Medicare
HOS variables contain the following information in a baseline survey and two-year follow-up survey:Demographic information including primary languageDisability statusPhysical and mental health statusHEDIS Effectiveness of Care measuresHealth-related quality of life (HRQOL)Special considerationsCMS will provide additional file specifications to researchers with approved data requests.Information on the survey and data can be found on the Medicare Health Outcomes Survey website.
Program:
Medicare
What does this file include? (variable highlights)NDI date of deathICD-10 description and code for cause of deathUnderlying conditions for cause of deathCDC category code for cause of deathSpecial considerationsOnly beneficiaries with a date of death in the annual MAX PS file are included in the file. The date can be the MSIS date of death or the Medicare date of death reported in MAX for the dually eligible.Some states are not included in the later years. See specific availiability below.This is a segment...
Program:
Medicaid
What does this file include? (variable highlights)Three flags for each chronic condition (based on end of calendar year):Medicaid only (found in Medicaid claims)Medicare only (found in Medicare claims)Combined data (found in Medicare and Medicaid claims)Special considerationsThe algorithms used to assign the flags are available from the CCW website.Algorithms that include multi-year look-back periods are applied without the purchase of additional years of data.This is a segment of the MESF file. Another...
Program:
Medicaid
What does this file include? (variable highlights)Two flags for each chronic condition:First ever occurrence dateEnd of year indicatorThis file is a segment that can be requested in addition to the Master Beneficiary Summary File (MBSF) base file.Special considerationsThis file uses information from Fee-For-Service (FFS) Medicare claims.
Program:
Medicare
What does this file include? (variable highlights)NDI date of deathICD-10 code for cause of deathUnderlying conditions for cause of deathCDC category code for cause of deathThis file is a segment that can be requested in addition to the Master Beneficiary Summary File (MBSF) base file.
Program:
Medicare
What does this file include? (variable highlights)Summary of utilization and total annual payments for services such as:physician visits, dialysis, DME, IP recorded emergency room visits, Ambulatory Surgical Centers, anesthesia, imaging, Part B drugs from Fee-for-service (FFS) MedicareNumber of hospital stays, Medicare covered days and total annual inpatient payments for services covered by FFS MedicareSummary of Part D payments, events and prescription fillsThis file is a segment that can be requested in...
Program:
Medicare
What does this file include? (variable highlights)
Three flags for each chronic condition:
First occurrence date
Mid year indicator
End of year indicator
Special considerations
The algorithms used to assign the flags are available from the CCW website.
Algorithms requiring a multiple-year look back period are completed without requiring the researcher to order multiple years of data.
Algorithms search data from Medicare Fee-For-Service (FFS) claims.
This file is a segment that can be requested in addition...
Program:
Medicare
What does this file include? (variable highlights)State, county annual SSA codesState, county monthly FIPS codesZip code, State and CountyDate of birth, date of deathRaceReason for entitlementMonthly enrollment for each part of the Medicare program, A/B/C/DDual eligible statusPart C plan and enrollment informationPart D plan and enrollment informationPart D low income cost sharingSpecial considerationsFour additional segments are available for order with this file:Chronic ConditionsOther Chronic...
Program:
Medicare
What does this file include? (variable highlights)Bene_ID (links to all other CMS Research Identifiable Files (RIF))State, county, zipcodeDate of birth, gender, raceEligibility categoryDual Medicare-Medicaid eligibilityMedicaid managed care enrollmentSummary utilization, Medicaid payments
Program:
Medicaid
What does this file include? (variable highlights)5 diagnosis codesAdmission dateCharges and payments (FFS only)Provider identifierPatient discharge status or destinationCounts of covered daysSpecial considerationsEncounter record reporting may not be complete. Data reporting may vary by state, year and eligibility group.Stays may be made up of multiple records.Long term care services provided to community-dwelling beneficiaries are found the MAX OT file.
Program:
Medicaid
What does this file include? (variable highlights)10 diagnosis code fields7 procedure code fieldsDischarge statusCharges and payments (FFS only)Provider identifier Special considerationsEncounter record reporting may not be complete. Data reporting may vary by state, year and eligibility group.
Program:
Medicaid
What does this file include? (variable highlights)As appropriate for the type of service on the record:2 diagnosis codes1 procedure codeBroadly defined Type of Service codesCharges and payments (FFS only)Provider identifierSpecial considerationsEncounter record reporting may not be complete. Data reporting may vary by state, year and eligibility group
Program:
Medicaid
The Medicaid RX Prescription Drug file includes fee-for-service (FFS) claim and managed care encounter records that contain a National Drug Code (NDC) for a filled prescription.What does this file include? (variable highlights)National Drug Code (NDC)Days supply covered by the prescriptionCharges and Medicaid payments (FFS only)National Provider Identifier (NPI) for the billing providerSpecial considerationsEncounter record reporting may not be complete. Data reporting may vary by state, year, eligibility...
Program:
Medicaid
What does this file include? (variable highlights)Practice IdentifierEligible professional NPIEligible professional subject to the VMProvider specialtyNo practice-level Quality and Resource Use Report (QRUR) or VM information (must link to VM Practice-Level RIF)Special considerationsData documentation is specific to each performance year.Two additional VM program RIFs are available:VM Practice-Level RIFVM Beneficiary-Level RIF
Program:
Medicare
What does this file include? (variable highlights)Whether beneficiary met target criteriaLong term care residenceNumber of drug-therapy recommendations madeNumber of drug-therapy problems resolvedLinking variableCCW Beneficiary IDsWhy do researchers request this file?Assess the effect of medication management on prescribing patterns and clinical outcomeIdentify cost of illness impact of the Part D MTM programSpecial considerationsAll beneficiaries in the file were enrolled in MTM at some point during the...
Program:
Medicare
What does this file include? (variable highlights)Part D Plan enrollment and disenrollment datesEnrollment type, eg: auto, facilitated, passive, point of saleMonths of LIS subsidyBeneficiary self-selector indicatorContract IDPlan IDLinking variables:CCW Beneficiary ID: linkage to the PDE and all other CMS Medicare or Medicaid data filesContract ID and Plan ID: linkage to the Part D Plan Characteristics fileWhy do researchers request this file?Conduct research that identifies LIS beneficiaries and studies...
Program:
Medicare
What does this file include? (variable highlights)Service dateProduct Service ID (NDC code)Quantity dispensedDays supplyCostPaymentLinkage variables:Plan Contract ID, Plan Benefit Package ID for linkage to Plan Characteristics fileProduct ID (NDC code) used by the CCW to link to the Drug Characteristics dataBeneficiary Id for linkage to MTM and Plan Election characteristics files, CMS utilization, enrollment and assessment data for Medicare and MedicaidFormulary drug identifier for linkage to the Part D...
Program:
Medicare
What does this file include? (variable highlights)CCW Formulary Drug IdentifierTier IDStep Therapy IndicatorQuantity LimitPrior authorizationLinking variables to the PDE file record:Formulary Identification Number (in each sub-file)Why do researchers request this file?To examine differences in utilization based on formulary inclusion or restrictionsTo examine plan differences in formulariesSpecial considerationsLinking variables provide information for each Part D Drug Event (PDE) record.The Tier ID...
Program:
Medicare
What does this file include? (variable highlights)
Pharmacy type
Pharmacy dispenser type code
Pharmacy Primary Taxonomy code
DME service
Walk-in service
Linking variable to the PDE file:
CCW Pharmacy ID
Why do researchers request this file?
Evaluate medication possession rates by pharmacy type
Assess the effect of pharmacy type on clinical outcomes
Special considerations
Beginning with the CY2014 file, it is possible to request an unencrypted pharmacy identifier.
Researchers who request and are approved by...
Program:
Medicare
What does this file include? (variable highlights)Initial and gap coverage limitsPlan premium amountPlan service area descriptionCrosswalk of current plan ID to previous yearsDemonstration typeSpecial needs plan typeLinkage variables to the PDE and to each of the Plan Characteristic File sub-files:Plan Contract ID, Plan Benefit Package ID (use in combination to link to specific plan)Why do researchers request this file?Studies that compare medication usage and clinical outcomes by plan benefitsSpecial...
Program:
Medicare