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Managed Care Information for Medicaid and CHIP Beneficiaries by Year

Metadata Updated: February 3, 2025

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by managed care participation (comprehensive managed care, primary care case management, MLTSS, including PACE, behavioral health organizations, nonmedical prepaid health plans, medical-only prepaid health plans, and other). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each managed care plan type over the year (duplicated count); (2) the number of beneficiaries enrolled in each managed care plan type as of an individual’s last month of enrollment (duplicated count); and (3) average monthly enrollment in each managed care plan type.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some cells have a value of “DS”. Some states have serious data quality issues, making the data unusable for calculating these measures. To assess data quality, analysts used measures featured in the DQ Atlas. Data for a state and year are considered unusable or of high concern based on DQ Atlas thresholds for the topics Enrollment in CMC, Enrollment in PCCM Programs, and Enrollment in BHO Plans. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods.

Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

Access & Use Information

Public: This dataset is intended for public access and use. License: us-pd

Downloads & Resources

Dates

Metadata Created Date March 29, 2023
Metadata Updated Date February 3, 2025
Data Update Frequency R/P10Y

Metadata Source

Harvested from Healthdata.gov

Additional Metadata

Resource Type Dataset
Metadata Created Date March 29, 2023
Metadata Updated Date February 3, 2025
Publisher Centers for Medicare & Medicaid Services
Maintainer
Identifier c0bef49e-46ea-4b9d-9153-76b4078d58b7
Data First Published 2023-03-28
Data Last Modified 2023-03-20
Category Enrollment
Public Access Level public
Data Update Frequency R/P10Y
Bureau Code 009:00
Metadata Context https://project-open-data.cio.gov/v1.1/schema/catalog.jsonld
Metadata Catalog ID https://healthdata.gov/data.json
Schema Version https://project-open-data.cio.gov/v1.1/schema
Catalog Describedby https://project-open-data.cio.gov/v1.1/schema/catalog.json
Harvest Object Id 8dd50c38-debf-44ca-8fa9-8fe1ce415921
Harvest Source Id 651e43b2-321c-4e4c-b86a-835cfc342cb0
Harvest Source Title Healthdata.gov
Homepage URL https://healthdata.gov/d/x7rp-ggcs
License http://www.usa.gov/publicdomain/label/1.0/
Program Code 009:000
Source Datajson Identifier True
Source Hash 0f7a17f93eb05aa0efe5d3a2fc061a2b9c1a2ac23a40e84febf23dd9e753d13c
Source Schema Version 1.1

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