This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees who received a well-child visit paid for by Medicaid or CHIP, overall and by five subpopulation topics: age group, race and ethnicity, urban or rural residence, program type, and primary language. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. Results include enrollees with comprehensive Medicaid or CHIP benefits for all 12 months of the year and who were younger than age 19 at the end of the calendar year. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the primary language subpopulation topic exclude select states with data quality issues with the primary language variable in TAF. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid and CHIP enrollees who received a well-child visit in 2020." Enrollees are identified as receiving a well-child visit in the year according to the Line 6 criteria in the Form CMS-416 reporting instructions. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to a program type subpopulation based on the CHIP code and eligibility group code that applies to the majority of their enrolled-months during the year (Medicaid-Only Enrollment; M-CHIP and S-CHIP Enrollment). Enrollees are assigned to a primary language subpopulation based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

The following table provides eligibility levels in each state for key coverage groups that use Modified Adjusted Gross Income (MAGI), as of April 1, 2018. The data represent the principal, but not all, MAGI coverage groups in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). All income standards are expressed as a percentage of the federal poverty level (FPL). The MAGI-based rules generally include adjusting an individual’s income by an amount equivalent to a 5% FPL disregard. Other eligibility criteria also apply, such as citizenship, immigration status, and state residency. For more information, see: https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees by urban or rural residence. Results are shown overall; by state; and by four subpopulation topics: scope of Medicaid and CHIP benefits, race and ethnicity, disability-related eligibility category, and managed care participation. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. Results shown overall (where subpopulation topic is "Total enrollees") and for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the race and ethnicity, disability category, and managed care participation subpopulation topics only include Medicaid and CHIP enrollees with comprehensive benefits. Results shown for the disability category subpopulation topic only include working-age adults (ages 19 to 64). Results for states with TAF data quality issues in the year have a value of "Unusable data." Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Rural Medicaid and CHIP enrollees in 2020." Enrollees are assigned to an urban or rural category based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF. Enrollees are assigned to the comprehensive benefits or limited benefits subpopulation according to the criteria in the "Identifying Beneficiaries with Full-Scope, Comprehensive, and Limited Benefits in the TAF" DQ Atlas brief. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to a disability category subpopulation using their latest reported eligibility group code and age in the year (Medicaid enrollees who qualify for benefits based on disability in 2020). Enrollees are assigned to a managed care participation subpopulation based on the managed care plan type code that applies to the majority of their enrolled-months during the year (Enrollment in CMC Plans). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees by primary language spoken (English, Spanish, and all other languages). Results are shown overall; by state; and by five subpopulation topics: race and ethnicity, age group, scope of Medicaid and CHIP benefits, urban or rural residence, and eligibility category. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands who were enrolled for at least one day in the calendar year, except where otherwise noted. Enrollees in Guam, American Samoa, the Northern Mariana Islands, and select states with data quality issues with the primary language variable in TAF are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown overall (where subpopulation topic is "Total enrollees") exclude enrollees younger than age 5 and enrollees in the U.S. Virgin Islands. Results for states with TAF data quality issues in the year have a value of "Unusable data." Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Primary language spoken by the Medicaid and CHIP population in 2020." Enrollees are assigned to a primary language category based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to the comprehensive benefits or limited benefits subpopulation according to the criteria in the "Identifying Beneficiaries with Full-Scope, Comprehensive, and Limited Benefits in the TAF" DQ Atlas brief. Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to an eligibility category subpopulation using their latest reported eligibility group code, CHIP code, and age in the calendar year. Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees who received mental health (MH) or substance use disorder (SUD) services, overall and by six subpopulation topics: age group, sex or gender identity, race and ethnicity, urban or rural residence, eligibility category, and primary language. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, ages 12 to 64 at the end of the calendar year, who were not dually eligible for Medicare and were continuously enrolled with comprehensive benefits for 12 months, with no more than one gap in enrollment exceeding 45 days. Enrollees who received services for both an MH condition and SUD in the year are counted toward both condition categories. Enrollees in Guam, American Samoa, the Northern Mariana Islands, and select states with TAF data quality issues are not included. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the primary language subpopulation topic exclude select states with data quality issues with the primary language variable in TAF. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid and CHIP enrollees who received mental health or SUD services in 2020." Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a sex or gender identity subpopulation using their latest reported sex in the calendar year. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to an eligibility category subpopulation using their latest reported eligibility group code, CHIP code, and age in the calendar year. Enrollees are assigned to a primary language subpopulation based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees by race and ethnicity overall and by three subpopulation topics: scope of Medicaid and CHIP benefits, age group, and eligibility category. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, and Puerto Rico who were enrolled for at least one day in the calendar year. Enrollees in Guam, American Samoa, the Northern Mariana Islands, and the U.S. Virgin Islands are not included. Results shown for the age group and eligibility category subpopulation topics only include enrollees with comprehensive Medicaid and CHIP benefits in the year. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on information shown in the brief: "Race and ethnicity of the national Medicaid and CHIP population in 2020." Enrollees are assigned to six race and ethnicity categories using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG). Enrollees are assigned to a child (ages 0-18) or adult (ages 19 and older) subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to the comprehensive benefits or limited benefits subpopulation according to the criteria in the "Identifying Beneficiaries with Full-Scope, Comprehensive, and Limited Benefits in the TAF" DQ Atlas brief. Enrollees are assigned to an eligibility category subpopulation using their latest reported eligibility group code, CHIP code, and age in the calendar year. Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

This data set includes annual counts and percentages of Medicaid and Children’s Health Insurance Program (CHIP) enrollees who received a well-child visit paid for by Medicaid or CHIP, overall and by five subpopulation topics: age group, race and ethnicity, urban or rural residence, program type, and primary language. These results were generated using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Release 1 data and the Race/Ethnicity Imputation Companion File. This data set includes Medicaid and CHIP enrollees in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, except where otherwise noted. Enrollees in Guam, American Samoa, and the Northern Mariana Islands are not included. Results include enrollees with comprehensive Medicaid or CHIP benefits for all 12 months of the year and who were younger than age 19 at the end of the calendar year. Results shown for the race and ethnicity subpopulation topic exclude enrollees in the U.S. Virgin Islands. Results shown for the primary language subpopulation topic exclude select states with data quality issues with the primary language variable in TAF. Some rows in the data set have a value of "DS," which indicates that data were suppressed according to the Centers for Medicare & Medicaid Services’ Cell Suppression Policy for values between 1 and 10. This data set is based on the brief: "Medicaid and CHIP enrollees who received a well-child visit in 2020." Enrollees are identified as receiving a well-child visit in the year according to the Line 6 criteria in the Form CMS-416 reporting instructions. Enrollees are assigned to an age group subpopulation using age as of December 31st of the calendar year. Enrollees are assigned to a race and ethnicity subpopulation using the state-reported race and ethnicity information in TAF when it is available and of good quality; if it is missing or unreliable, race and ethnicity is indirectly estimated using an enhanced version of Bayesian Improved Surname Geocoding (BISG) (Race and ethnicity of the national Medicaid and CHIP population in 2020). Enrollees are assigned to an urban or rural subpopulation based on the 2010 Rural-Urban Commuting Area (RUCA) code associated with their home or mailing address ZIP code in TAF (Rural Medicaid and CHIP enrollees in 2020). Enrollees are assigned to a program type subpopulation based on the CHIP code and eligibility group code that applies to the majority of their enrolled-months during the year (Medicaid-Only Enrollment; M-CHIP and S-CHIP Enrollment). Enrollees are assigned to a primary language subpopulation based on their reported ISO language code in TAF (English/missing, Spanish, and all other language codes) (Primary Language). Please refer to the full brief for additional context about the methodology and detailed findings. Future updates to this data set will include more recent data years as the TAF data become available.

This data shows healthcare utilization for asthma by Allegheny County residents 18 years of age and younger. It counts asthma-related visits to the Emergency Department (ED), hospitalizations, urgent care visits, and asthma controller medication dispensing events.

The asthma data was compiled as part of the Allegheny County Health Department’s Asthma Task Force, which was established in 2018. The Task Force was formed to identify strategies to decrease asthma inpatient and emergency utilization among children (ages 0-18), with special focus on children receiving services funded by Medicaid. Data is being used to improve the understanding of asthma in Allegheny County, and inform the recommended actions of the task force. Data will also be used to evaluate progress toward the goal of reducing asthma-related hospitalization and ED visits.

Regarding this data, asthma is defined using the International Classification of Diseases, Tenth Revision (IDC-10) classification system code J45.xxx. The ICD-10 system is used to classify diagnoses, symptoms, and procedures in the U.S. healthcare system.

Children seeking care for an asthma-related claim in 2017 are represented in the data. Data is compiled by the Health Department from medical claims submitted to three health plans (UPMC, Gateway Health, and Highmark). Claims may also come from people enrolled in Medicaid plans managed by these insurers. The Health Department estimates that 74% of the County’s population aged 0-18 is represented in the data.

Users should be cautious of using administrative claims data as a measure of disease prevalence and interpreting trends over time. Missing from the data are the uninsured, members in participating plans enrolled for less than 90 continuous days in 2017, children with an asthma-related condition that did not file a claim in 2017, and children participating in plans managed by insurers that did not share data with the Health Department.

Data users should also be aware that diagnoses may also be subject to misclassification, and that children with an asthmatic condition may not be diagnosed. It is also possible that some children may be counted more than once in the data if they are enrolled in a plan by more than one participating insurer and file a claim on each policy in the same calendar year.

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