Advancing Medicare and Medicaid Integration: An Update on Improving State Access to Medicare Data

NAMD released the second in its Working Paper Series, “Advancing Medicare and Medicaid Integration.” This paper builds on NAMD’s first paper on this topic.

This is the second in NAMD’s Working Paper Series titled, “Advancing Medicare and Medicaid Integration.” NAMD’s October 2011 working paper presented the overarching policy and operational challenges Medicaid Directors experience when seeking to access and utilize Medicare data.[1] Specifically, states face overly burdensome and costly operational hurdles in accessing Medicare data; they must navigate inconsistent federal policies for obtaining the data; and they lack a mechanism that translates and diffuses any successful state experiences with obtaining and utilizing Medicare data.

The Center for Medicare and Medicaid Services (CMS), including the Medicare-Medicaid Coordination Office, has made great strides in the last several months to assist states that wish to obtain Medicare data to help improve care coordination for enrollees of both Medicare and Medicaid. CMS also has begun to make critical improvements in the process for states to obtain historical and more recent Medicare Parts A and B data and some historical Part D data. However, more work needs to be done to make Medicare data readily accessible and useable for states.

This paper builds on NAMD’s previous recommendations. The proposals are targeted towards meeting the shared goals of Medicaid Directors’ and the federal government to: advance integration of Medicaid and Medicare in ways that facilitate a more efficient delivery system that provides better care for Medicaid and low income Medicare clients in a more cost rational manner.

NAMD’s three overarching requests to improve states’ ongoing access to the evolving sources of Medicare data include:

States wish to continue working with CMS to streamline the current process and policies for accessing Medicare data.

  • States that have or are pursuing access to the currently available Medicare data need additional technical assistance and training in order to maximize the utility and application of the data.
  • States also have identified the need for access to additional Medicare data sets that could help facilitate care coordination, improve the quality of care, and result in more efficient use of health care resources.

Read the full report here. 

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