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Fitting Square Pegs Into Round Holes: Linking Medicaid and Current Population Survey Data to Understand the 'Medicaid Undercount'   Center’s for Medicare and Medicaid Services Baltimore, MD February 15, 2007 Michael Davern, Ph.D. Assistant Professor, Research Director SHADAC, Health Policy & Management University of Minnesota Supported by a grant from The Robert Wood Johnson Foundation and the Office of the Assistant Secretary for Planning and Evaluation
“ SNACC” Project collaborators and co-authors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is the Medicaid undercount ? ,[object Object],[object Object],[object Object]
Raw ratios of enrollment counts
0.77- 1.22 0.70 - 0.76 0.62 - 0.69 0.55 - 0.61 0.47 - 0.54 0.36 - 0.46 Adults Ages 0-17 The Current Population Survey Estimate of the  Number Enrolled in Medicaid Divided by the Adjusted MSIS Number of Medicaid Enrollees  Ages 0-17 2000
Number Enrolled in Medicaid Divided by the Adjusted MSIS Number of Medicaid Enrollees 0.84- 1.35 0.77 - 0.83 0.69 - 0.76 0.62 - 0.68 0.54 - 0.61 0.29 - 0.53 Adults Ages 18-64 The Current Population Survey Estimate of the Ages 18-64 2000
0.80- 1.03 0.73 - 0.79 0.65- 0.72 0.58 - 0.64 0.50 - 0.57 0.32 - 0.49 Ages 0-64 The Current Population Survey Estimate of the Number Enrolled in Medicaid Divided by the Adjusted MSIS Number of Medicaid Enrollees Ages 0-64 2000
Why do we care? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What could explain the undercount? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Building a common ‘linked universe’ Group quarters, dead, not a valid ID, in two states Not a valid ID, born In linkable CPS and MSIS universe Medicaid Enrollees in CPS Sample Frame MSIS Medicaid Enrollees
Preparing MSIS Data for linking to CPS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fitting the MSIS records into the “linkable universe” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fitting the CPS into the  “linkable universe”  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Comparing linked universe totals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How well is the CPS classifying Medicaid enrollees? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What factors are associated with measurement accuracy/error?  ,[object Object],[object Object],[object Object],[object Object],[object Object]
How does the CPS compare to other studies of Medicaid reporting error?
Conclusions about the CPS estimates ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Explanations of the undercount revisited:  work remaining to be done  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Work to be done, continued ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SHADAC contact information www.shadac.org State Health Access Data Assistance Center University of Minnesota 2221 University Avenue, Suite 345  Minneapolis Minnesota 55414  (612) 624-4802 [email_address]

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Fitting Square Pegs Into Round Holes: Linking Medicaid and Current Population Survey Data to Understand the 'Medicaid Undercount'

  • 1. Fitting Square Pegs Into Round Holes: Linking Medicaid and Current Population Survey Data to Understand the 'Medicaid Undercount' Center’s for Medicare and Medicaid Services Baltimore, MD February 15, 2007 Michael Davern, Ph.D. Assistant Professor, Research Director SHADAC, Health Policy & Management University of Minnesota Supported by a grant from The Robert Wood Johnson Foundation and the Office of the Assistant Secretary for Planning and Evaluation
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  • 4. Raw ratios of enrollment counts
  • 5. 0.77- 1.22 0.70 - 0.76 0.62 - 0.69 0.55 - 0.61 0.47 - 0.54 0.36 - 0.46 Adults Ages 0-17 The Current Population Survey Estimate of the Number Enrolled in Medicaid Divided by the Adjusted MSIS Number of Medicaid Enrollees Ages 0-17 2000
  • 6. Number Enrolled in Medicaid Divided by the Adjusted MSIS Number of Medicaid Enrollees 0.84- 1.35 0.77 - 0.83 0.69 - 0.76 0.62 - 0.68 0.54 - 0.61 0.29 - 0.53 Adults Ages 18-64 The Current Population Survey Estimate of the Ages 18-64 2000
  • 7. 0.80- 1.03 0.73 - 0.79 0.65- 0.72 0.58 - 0.64 0.50 - 0.57 0.32 - 0.49 Ages 0-64 The Current Population Survey Estimate of the Number Enrolled in Medicaid Divided by the Adjusted MSIS Number of Medicaid Enrollees Ages 0-64 2000
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  • 10. Building a common ‘linked universe’ Group quarters, dead, not a valid ID, in two states Not a valid ID, born In linkable CPS and MSIS universe Medicaid Enrollees in CPS Sample Frame MSIS Medicaid Enrollees
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  • 17. How does the CPS compare to other studies of Medicaid reporting error?
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  • 22. SHADAC contact information www.shadac.org State Health Access Data Assistance Center University of Minnesota 2221 University Avenue, Suite 345 Minneapolis Minnesota 55414 (612) 624-4802 [email_address]