CMS has been working with the states to improve Medicaid and CHIP data collection regarding beneficiaries, providers, fee-for-service claims, managed care claims and liable third parties. To improve the monitoring of these programs, CMS is changing the program’s data analytic infrastructure by transitioning state reporting from the legacy Medicaid Statistical Information System (MSIS) to the Transformed Medicaid Information System (T-MSIS).

CMS believes that T-MSIS will improve the methods by which CMS collects operational data by utilizing standardized definitions, adding data quality enhancements, and utilizing monthly, rather than quarterly, data submissions. Furthermore, T-MSIS includes a more comprehensive set of data files, which includes: (1) enhanced information regarding CHIP and Medicaid beneficiary eligibility and enrollment, and (2) fee-for-service claims and managed care service use and spending data. A future release will include managed care plan and provider information.

Due to the size and nature of the T-MSIS files, in addition to the frequency of updates, T-MSIS data are problematic to use directly for research and analytics purposes. To alleviate these problems, CMS has created a series of data sets which are optimal for analytics. These data sets are known as T-MSIS Analytic Files (TAF) and consist of research identifiable files (RIFs). There is a total of five TAF RIF file types that are being released for the calendar years 2014 through 2016. These file types include: Annual Demographics and Eligibility; Inpatient Hospital Claims; Long-Term Care Claims; Pharmacy Claims; and Other Services Claims.

As part of the 2019 fall release of the Medicaid and CHIP Scorecard, CMS additionally published de-identified, state-level per capita expenditures for the calendar year 2017. CMS will further publish de-identified average annual Medicaid expenditures per enrollee for the calendar year 2017 for certain eligibility groups including children, adults ages 65 and older, individuals with disabilities, and Medicaid expansion adults. These estimates will only be available for the states in which data quality assessments made the calculation possible.

Additional TAF RIFs with data ranging from 2017 to 2018, are expected to be released in 2020. This future release will include annual files containing information pertaining to providers and managed care plans.

CMS’s fact sheet about the Medicaid and CHIP T-MSIS files release is available here.