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Using Linked Datato Track Participation in the Medicaid Buy-In Program
Using Linked Datato Track Participation in the Medicaid Buy-In Program
Henry T. IreysSu Liu
The Future of Disability Statistics:What We Know and Need to Know
Arlington, VirginiaOctober 2006
Henry T. IreysSu Liu
The Future of Disability Statistics:What We Know and Need to Know
Arlington, VirginiaOctober 2006
2
Goals of the PresentationGoals of the Presentation
Describe process of building an integrated database using administrative data from several agencies
Illustrate how the database can be used to address key policy questions related to the Medicaid Buy-In program
Describe process of building an integrated database using administrative data from several agencies
Illustrate how the database can be used to address key policy questions related to the Medicaid Buy-In program
3
The Medicaid Buy-In ProgramThe Medicaid Buy-In Program Encourages work by allowing individuals
with disabilities to “buy into” Medicaid without giving up higher earnings or assets
Optional state program under Medicaid
Currently offered by 31 states
More than 160,000 individuals have enrolled, as of December 2005
Encourages work by allowing individuals with disabilities to “buy into” Medicaid without giving up higher earnings or assets
Optional state program under Medicaid
Currently offered by 31 states
More than 160,000 individuals have enrolled, as of December 2005
4
Number of States and Participantsin Medicaid Buy-In Program, 1999-2005
Number of States and Participantsin Medicaid Buy-In Program, 1999-2005
7
1316
23 2427
30
6,980
16,173
22,940
45,481
69,218
76,645
61,985
0
5
10
15
20
25
30
35
1999 2000 2001 2002 2003 2004 2005
Nu
mb
er o
f st
ates
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
Nu
mb
er o
f p
arti
cip
ants
States with a Buy-In finder file Enrollment as of December 31
Note: Arizona and Mississippi also had a Buy-In program, but were not required to submit a finder file; Missouri’s Buy-In program was eliminated in August 2005.Data Source: Buy-In finder files from states
5
Examples of Policy Questionsand Related Data Sources
Examples of Policy Questionsand Related Data Sources
How many individuals participate in the Medicaid Buy-In program?
– Finder files from state Buy-In programs
How many have earnings and what are their average earnings?
– Finder files from state programs– SSA’s master earnings files (MEF)
How many individuals participate in the Medicaid Buy-In program?
– Finder files from state Buy-In programs
How many have earnings and what are their average earnings?
– Finder files from state programs– SSA’s master earnings files (MEF)
6
Policy Questions and Data Sources (continued)
Policy Questions and Data Sources (continued)
How do earnings vary by participant characteristics: demographics, disabling condition, prior program participation, and medical expenditures?
– Finder files from states– SSA’s MEF– SSA’s Ticket Research File (TRF)– Medicaid Statistical Information System
(MSIS)– Medicare eligibility and claims files
How do earnings vary by participant characteristics: demographics, disabling condition, prior program participation, and medical expenditures?
– Finder files from states– SSA’s MEF– SSA’s Ticket Research File (TRF)– Medicaid Statistical Information System
(MSIS)– Medicare eligibility and claims files
7
Medicaid Statistical
Information System
Medicare eligibility and claims
Ticket Research
File
Integrated Individual-Level Analytical File
Data Integration ProcessData Integration Process
Masters Earnings
File
MBI participants finder files from
states
CMSdata systems
SSAdata systems
8
Patterns of Enrollment in the Medicaid Buy-In Program
Patterns of Enrollment in the Medicaid Buy-In Program
13,104
31,601
31,126
31,193
16,214
23,433
46,673
63,770
0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000
2001
2002
2003
2004
Year
Number of Buy-In Participants
First Time All Others
Total 94,963
Total 29,318
Total 55,034
Total 77,799
Source: Buy-In finder files from 27 states Data Source: Buy-In finder files from 27 states
9
Percent of Buy-In Participants withReported Annual Earnings by State, 2004
Percent of Buy-In Participants withReported Annual Earnings by State, 2004
Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File
0
10
20
30
40
50
60
70
80
90
100
IL MI KS ME LA NE MN OR SC VT WA IN WV CT NH NJ NY MA UT CA PA WI AK AR NM IA MO
10
Annual Earnings Among Buy-In Participants with Reported Earnings, 27 States, 2000-2004
Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File
Total Earnings in Dollars
Average Earnings in Dollars
6,600
6,800
7,000
7,200
7,400
7,600
7,800
8,000
8,200
2000 2001 2002 2003 2004
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
300,000,000
350,000,000
400,000,000
450,000,000
500,000,000
2000 2001 2002 2003 2004
11
Demographics of High Earners, 2002Demographics of High Earners, 2002
61
47 45
20
0
10
20
30
40
50
60
70
Percent age 21-44 Percent non-white
Participants with top 10% earnings All 2002 participants
61
47 45
20
0
10
20
30
40
50
60
70
Percent age 21-44 Percent non-white
Participants with top 10% earnings All 2002 participants
Data Source: Buy-In finder files from 27 states and SSA’s Master Earnings File
12
Other Characteristics of High Earners, 2002
Other Characteristics of High Earners, 2002
76
2317
3239
25
0
10
20
30
40
50
60
70
80
Percent with no SSDI orSSI
Percent mental illness Percent with lowest 25%medical spendings ($312
PMPM)
Participants with top 10% earnings All 2002 participants
Data Source: Buy-In finder files from 27 states, SSA’s TRF and MEF, MSIS and Medicare eligibility and claims files
13
Benefits of Linking Datasets Benefits of Linking Datasets
Chief Benefits
– Able to address a wider range of questions compared with data from one agency alone
– Responsive to needs of multiple stakeholders
Chief Benefits
– Able to address a wider range of questions compared with data from one agency alone
– Responsive to needs of multiple stakeholders
14
Challenges of Linking DatasetsChallenges of Linking Datasets
Addressing differences in populations, time periods
Managing lack of data overlap
Establishing close collaboration between agency staff and researchers
Assuring data confidentiality
Gaining inter-agency collaboration
Addressing differences in populations, time periods
Managing lack of data overlap
Establishing close collaboration between agency staff and researchers
Assuring data confidentiality
Gaining inter-agency collaboration
15
Available at www.mathematica-mpr.com:
– How Much Are Medicaid Buy-In Participants Earning? William E. Black, Su Liu, Henry T. Ireys. June 2006 (first in a series of issue briefs)
– Participation in the Medicaid Buy-In Program: A Statistical Profile from Integrated Data. Su Liu, Henry T. Ireys. May 2006
– Understanding Enrollment Trends and Participant Characteristics of the Medicaid Buy-In Program, 2003-2004. William E. Black, Henry T. Ireys. January 2006.
Available at www.mathematica-mpr.com:
– How Much Are Medicaid Buy-In Participants Earning? William E. Black, Su Liu, Henry T. Ireys. June 2006 (first in a series of issue briefs)
– Participation in the Medicaid Buy-In Program: A Statistical Profile from Integrated Data. Su Liu, Henry T. Ireys. May 2006
– Understanding Enrollment Trends and Participant Characteristics of the Medicaid Buy-In Program, 2003-2004. William E. Black, Henry T. Ireys. January 2006.
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