Health Services Data: The Centers for Medicare and Medicaid Services (CMS) Claims Records

Abstract

The US Centers for Medicare and Medicaid Services (CMS) is the largest purchaser of healthcare in the nation – serving almost 123 million people, more than one in three Americans. CMS is responsible for administering and overseeing three of the nation’s largest ongoing healthcare programs: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The Medicare program provides government-sponsored health insurance for people 65 or older and under age 65 with certain diseases and disabilities. The Medicaid program, which is a joint state-federal program, provides healthcare for the poor. CHIP is a grant program that provides health insurance to targeted low-income children in families with incomes above Medicaid eligibility levels. CMS sponsors many data and information initiatives for health services researchers, policymakers, educators, students, and the general public. In 2014, CMS established the Office of Enterprise Data and Analytics (OEDA) to better oversee and coordinate its large portfolio of data and information. The office also funds the privately run Research Data Assistance Center (ResDAC), which provides training and technical assistance to individuals requesting the agency’s data files. CMS information products include an online research journal Medicare and Medicaid Research Review (MMRR); other publications including Medicare and Medicaid Statistical Supplement, Statistics Reference Booklet, and CMS Fast Facts; a data navigator; and several interactive dashboards. Its data products include numerous Medicare and Medicaid public use data files, the Chronic Conditions Data Warehouse (CCW), the Medicare Current Beneficiary Survey (MCBS) files, and the Medicare Qualified Entity (QE) Program. Many examples of CMS’ information and data products are highlighted and discussed.