Medicaid/Medicare Data Sets

Vast amounts of data are now widely available, but the ability to take data sets from multiple sources and extract information that can be used is less common. At the Center for Health Policy and Research, we have analysts who specialize in linking complex, often unrelated data sets and draw out information relevant to health care researchers and policymakers.

Tracking patients between Medicare and Medicaid databases

With particular expertise in linking Medicare and Medicaid data sets, our team uses this data to understand and predict behavior and trends. We are now able to link the records of patients who receive benefits from Medicare and Medicaid. Accomplishing this requires a deep knowledge of both Medicare and Medicaid payment rules — and can produce data that is especially beneficial to programs designed for dual eligibles, those who qualify for both Medicare and Medicaid.

In one project, we linked Medicaid claims data from the six New England states and conduct a focused analysis on substance abuse and mental illness. Since the data was not originally developed for research purposes, our team had to identify and remove the overlapping data. After it was cleansed, we were able to link it across all six states, making it much more usable, and consequently more valuable. (Clark, R.E., Samnaliev, M., McGovern, M.P. The impact of substance use disorders on medical expenditures for Medicaid beneficiaries with behavioral health disorders. Psychiatric Services, 60(1): 35-42, 2009.)

In another study, we worked with multiple data sets — Medicaid claims, criminal offender record information, and records for Department of Public Health services related to substance abuse treatment — to determine how treatment for opioid addiction affects criminal justice costs. (Clark, R.E., Samnaliev, M., McGovern, M.P. Treatment for co-occurring mental illness and substance use disorders in five state Medicaid programs. Psychiatric Services, 58(7): 942-948, 2007)

Our team has also conducted other studies of linked Medicaid and Medicare claims in Massachusetts and beyond:

  • Lin, W.C., Zhang, Y., Leung, G.Y., Clark, R.E. Twelve-month Diagnosed Prevalence of Behavioral Health Disorders among Elderly Medicare and Medicaid Members. American Journal of Geriatric Psychiatry, 19(11): 970-979, 2011.
  • Lin W.C., Zhang J., Leung G.Y., Clark R.E., Chronic physical conditions in older adults with mental illness and/or substance use disorders, Journal of the American Geriatrics Society, 59 (11), 1913-1921, 2011.
  • Leung, G.Y., Zhang, Y. Lin, W.C. Clark, R.E. Behavioral Health Disorders and Adherence to Measures of Diabetes Care Quality. American Journal of Managed Care, 17(2): 144-150, 2011. 
  • Leung, G.Y., Zhang, Y. Lin, W.C. Clark, R.E. Behavioral health disorders and diabetes-related health outcomes: A claims data analysis of Medicare/Medicaid beneficiaries in Massachusetts. Psychiatric Services, 62(6), 659-665, 2011.
  • Clark R.E., Samnaliev M., Baxter J.D., Leung G.Y. The evidence doesn’t justify steps by state Medicaid programs to restrict opioid addiction treatment with buprenorphine, Health Affairs, 30(8), 1425-1433, 2011.