Data File Search
What does this file include? (variable highlights)
Beneficiary ID (allows linkage to other files)
ACO Name
Monthly assignment status information
Date of Birth
Date of Death
Special considerations
This file can be linked to any other CMS file that includes the Bene ID
Beneficiaries can be linked to their assigned providers by linking the ACO_ID in the provider file to the ACO_NUM in the beneficiary file
Questions regarding the Next Generation ACO Model can be directed to NextGenerationACOModel@cms.hhs.gov
Program:
Medicare
What does this file include? (variable highlights)
ACO identifier
Performance year
Organization Name
CMS organization identifiers including Tax Identification Number, CMS Certification Number (CCN)
Provider type description
Special considerations
This file can be linked to any other CMS file that contains the ORG_TIN, ORG_NPI or ORG_CCN
Providers can be linked to their assigned beneficiaries by linking the ACO_ID in the provider file to the ACO_NUM in the beneficiary file
Questions regarding the Next…
Program:
Medicare
The NHATS interview data include:
Residence
Health conditions
Housing/household
Functional status
Insurance
Labor force participation
The NHATS interview data are linked to CMS Medicare claims data for information on healthcare use.
Special considerations
The NHATS website has information on obtaining this restricted data.
Program:
Medicare
This file includes (variable highlights):
Special services, treatments, and interventions
For example: ventilator use, dialysis, chemotherapy, central line placement, total parenteral nutrition, high risk drugs
Medical conditions and co-morbidities
Cognitive function
Mental status including depression and dementia
Ability to communicate
Special considerations:
This is a standalone file and cannot be linked to any other RIF data.
Program:
Medicare
What does this file include? (variable highlights)
Beneficiary identifiers
Practice identifier for the practice to which the beneficiary was attributed
Number and percent of primary care services provided to the beneficiary that were billed by the practice
HCC percentile risk score
Special considerations
Data documentation is specific to each performance year.
This RIF can be linked to any other CMS file that includes the Bene ID.
Two additional VM program RIFs are available:
VM Practice-Level RIF…
Program:
Medicare
What does this file include? (variable highlights)
Practice Identifier
Eligible professional NPI
Eligible professional subject to the VM
Provider specialty
No practice-level Quality and Resource Use Report (QRUR) or VM information (must link to VM Practice-Level RIF)
Special considerations
Data documentation is specific to each performance year.
Two additional VM program RIFs are available:
VM Practice-Level RIF
VM Beneficiary-Level RIF
Program:
Medicare
What does this file include? (variable highlights)
Practice Identifier
Quality and Resource Use Report (QRUR) information
VM information
Benchmark information
Special considerations
Data documentation is specific to each performance year.
This RIF includes thousands of records with hundreds of variables.
Can be linked to provider NPI in the VM NPI-Practice-Level RIF
Two additional VM program RIFs are available:
VM NPI-Practice-Level RIF
VM Beneficiary-Level File RIF
Program:
Medicare
Source data
Medicare: FFS, PDE and MA
Medicaid: MAX data
What does this file include? (variable highlights)
Eligibility, enrollment variables
Aggregated cost and use
Medicare: FFS, PDE includes FFS and MA
Medicaid: FFS, managed care encounter where available
Prescription Drug service utilization reported for classes of drugs
Chronic Condition flags - 27 CCW Chronic Conditions plus an additional 25 other condition flags
All four files are released for approved MMLEADS data requests
Beneficiary file
Medicare…
Program:
Medicare, Medicaid
What does this file include? (variable highlights)
Provider file
Pioneer ACO ID
Tax identification number
Provider specialty code
Beneficiary file
Bene ID
Pioneer ACO ID
Aggregated expenditures and claim counts
Settlement file
Pioneer ACO ID
Beneficiary counts
Performance year expenditures and savings
Special considerations
Each file needs to be specified separately on a data request.
Only the Pioneer ACO Beneficiary file can be linked to other CMS data via the Bene ID.
Program:
Medicare
What is different about MMLEADS 3.0?
MMLEADS now consists of two files—a beneficiary summary file and single cost (i.e., payments) and use (i.e., claim counts) file that combines Medicare and Medicaid information. CCW Chronic Condition and other condition flags are no longer provided.
Source data
Medicare: FFS, PDE and MA
Medicaid: T-MSIS data
What does this file include? (variable highlights)
Eligibility, enrollment variables
Aggregated claim counts and payment amounts
Medicare: FFS, PDE includes FFS and MA…
Program:
Medicare, Medicaid