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.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by benefit package (full-scope, comprehensive, limited, or unknown). There are three metrics presented: (1) the number of beneficiaries ever enrolled with each benefit package over the year (duplicated count); (2) the number of beneficiaries enrolled with each benefit package as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment with each benefit package.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Restricted Benefits Code. 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.

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

This data set includes monthly counts and rates (per 1,000 beneficiaries) of acute care services, including emergency department (ED) visits, inpatient stays, intensive care unit (ICU) stays, and ICU stays that include ventilator use, provided to Medicaid and CHIP beneficiaries, by state. Users can filter to acute care services for any reason, or acute care services for COVID-19. These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating acute care services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Claims Volume - IP, Claims Volume - OT, Diagnosis Code - IP, Diagnosis Code - OT, Procedure Codes - OT Professional. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data. Some cells have a value of “DS”. This indicates that data were suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries.

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by benefit package (full-scope, comprehensive, limited, or unknown).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Restricted Benefits Code. 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.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by dual eligibility status for Medicaid and Medicare (full dual eligibility, partial dual eligibility, or not dually eligible). There are three metrics presented: (1) the number of beneficiaries ever dually eligible for Medicaid and Medicare over the year (duplicated count); (2) the number of beneficiaries dually eligible for Medicaid and Medicare as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly eligibility for Medicaid and Medicare.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Dually Enrolled in Medicare. 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.

Context

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarize counts of enrollees who are dually-eligible for both Medicare and Medicaid program, including those in Medicare Savings Programs. “Duals” represent 20 percent of all Medicare beneficiaries, yet they account for 34 percent of all spending by the program, according to the Commonwealth Fund . As a representation of this high-needs, high-cost population, these data offer a view of regions ripe for more intensive care coordination that can address complex social and clinical needs. In addition to the high cost savings opportunity to deliver upstream clinical interventions, this population represents the county-by-county volume of patients who are eligible for both state level (Medicaid) and federal level (Medicare) reimbursements and potential funding streams to address unmet social needs across various programs, waivers, and other projects. The dataset includes eligibility type and enrollment by quarter, at both the state and county level. These data represent monthly snapshots submitted by states to the CMS, which are inherently lower than ever-enrolled counts (which include persons enrolled at any time during a calendar year.) For more information on dually eligible beneficiaries

Querying BigQuery tables

You can use the BigQuery Python client library to query tables in this dataset in Kernels. Note that methods available in Kernels are limited to querying data. Tables are at bigquery-public-data.sdoh_cms_dual_eligible_enrollment.

Sample Query

In what counties in Michigan has the number of dual-eligible individuals increased the most from 2015 to 2018? Find the counties in Michigan which have experienced the largest increase of dual enrollment households

duals_Jan_2015 AS ( SELECT Public_Total AS duals_2015, County_Name, FIPS FROM bigquery-public-data.sdoh_cms_dual_eligible_enrollment.dual_eligible_enrollment_by_county_and_program WHERE State_Abbr = "MI" AND Date = '2015-12-01' ),

duals_increase AS ( SELECT d18.FIPS, d18.County_Name, d15.duals_2015, d18.duals_2018, (d18.duals_2018 - d15.duals_2015) AS total_duals_diff FROM duals_Jan_2018 d18 JOIN duals_Jan_2015 d15 ON d18.FIPS = d15.FIPS )

SELECT * FROM duals_increase WHERE total_duals_diff IS NOT NULL ORDER BY total_duals_diff DESC

This dataset includes the number of people enrolled in DSS services by town and by gender from CY 2015-2024. To view the full dataset and filter the data, click the "View Data" button at the top right of the screen. More data on people served by DSS can be found here. About this data For privacy considerations, a count of zero is used for counts less than five. A recipient is counted in all towns where that recipient resided in that year. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly. Notes by year 2021 In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. 2018 On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree. On February 14, 2019 the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged. On January 16, 2019 these counts were revised to count a recipient in all locations that recipient resided in that year. On January 1, 2019 the counts were revised to count a recipient in only one town per year even when the recipient moved within the year. The most recent address is used.

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each major eligibility group over the year (duplicated count); (2) the number of beneficiaries enrolled in each major eligibility group as of an individual’s last month of enrollment (unduplicated count); and (3) average monthly enrollment in each major eligibility group.

These metrics are based on data in the T-MSIS Analytic Files (TAF). 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 topic Eligibility Group Code. 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.

In order to facilitate public review and access, enrollment data published on the Open Data Portal is provided as promptly as possible after the end of each month or year, as applicable to the data set. Due to eligibility policies and operational processes, enrollment can vary slightly after publication. Please be aware of the point-in-time nature of the published data when comparing to other data published or shared by the Department of Social Services, as this data may vary slightly.

As a general practice, for monthly data sets published on the Open Data Portal, DSS will continue to refresh the monthly enrollment data for three months, after which time it will remain static. For example, when March data is published the data in January and February will be refreshed. When April data is published, February and March data will be refreshed, but January will not change. This allows the Department to account for the most common enrollment variations in published data while also ensuring that data remains as stable as possible over time. In the event of a significant change in enrollment data, the Department may republish reports and will notate such republication dates and reasons accordingly. In March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. Effective January 1, 2021, this coverage group have been separated: (1) the COVID-19 Testing Coverage for the Uninsured is now G06-I and is now listed as a limited benefit plan that rolls up into “Program Name” of Medicaid and “Medical Benefit Plan” of HUSKY Limited Benefit; (2) the emergency medical coverage has been separated into G06-II as a limited benefit plan that rolls up into “Program Name” of Emergency Medical and “Medical Benefit Plan” of Other Medical. An historical accounting of enrollment of the specific coverage group starting in calendar year 2020 will also be published separately. This data represents number of active recipients who received benefits under a program in that calendar year and month. A recipient may have received benefits from multiple programs in the same month; if so that recipient will be included in multiple categories in this dataset (counted more than once.) 2021 is a partial year. For privacy considerations, a count of zero is used for counts less than five. NOTE: On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, corrections in the ImpaCT system for January and February 2019 caused the addition of around 2000 and 3000 recipients respectively, and the counts for many types of assistance (e.g. SNAP) were adjusted upward for those 2 months. Also, the methodology for determining the address of the recipients changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. 2. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This resulted in a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree. NOTE: On February 14 2019, the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged. NOTE: On 11/30/2018 the counts were revised because of a change in the way active recipients were counted in one source system.

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Eligibility Group Code. 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.

This data set includes monthly 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). These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month 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.

This data set includes monthly counts and rates (per 1,000 beneficiaries) of COVID-19 testing services provided to Medicaid and CHIP beneficiaries, by state.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating COVID-19 testing services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Procedure Codes - OT Professional, Claims Volume - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

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

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by program type (Medicaid or CHIP).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topics Medicaid-only Enrollment and M-CHIP and S-CHIP Enrollment. 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.

This data set includes monthly enrollment counts of Medicaid and CHIP beneficiaries by dual eligibility status for Medicaid and Medicare (full dual eligibility, partial dual eligibility, or not dually eligible).

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating these measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable or of high concern based on DQ Atlas thresholds for the topic Dually Enrolled in Medicare. 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.

This data set includes monthly counts and rates (per 1,000 beneficiaries) of pregnancy outcomes, including (1) live births and (2) miscarriages, stillbirths, and terminations, for female Medicaid and CHIP beneficiaries ages 15 to 44 (as of the first day of the month), by state.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating pregnancy measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Procedure Codes - OT Professional, Claims Volume - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

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

This dataset aggregates and displays the number of New York State Medicaid enrollees by eligibility year and month within each NYS Economic Region; health insurance plan information; and enrollee demographics. For more information, check out http://www.health.ny.gov/health_care/medicaid/, or go to the "About" tab.

This report provides information at the state and town level of people served by the Connecticut Department of Social Services for the Calendar Years 2012-2024 by demographics (gender, age-groups, race, and ethnicity) at the state and town level by Medical Benefit Plan (Husky A-D, Husky limited benefit, MSP and Other Medical); Assistance Type (Cash, Food, Medical, Other); and Program (CADAP, CHCPE, CHIP, ConnTRANS, Medicaid, Medical, MSP, Refugee Cash, Repatriation, SAGA, SAGA Funeral, SNAP, Social Work Services, State Funded Medical, State Supplement, TFA). NOTE: On March 2020, Connecticut opted to add a new Medicaid coverage group: the COVID-19 Testing Coverage for the Uninsured. Enrollment data on this limited-benefit Medicaid coverage group is being incorporated into Medicaid data effective January 1, 2021. Enrollment data for this coverage group prior to January 1, 2021, was listed under State Funded Medical. Effective January 1, 2021, this coverage group have been separated: (1) the COVID-19 Testing Coverage for the Uninsured is now G06-I and is now listed as a limited benefit plan that rolls up into “Program Name” of Medicaid and “Medical Benefit Plan” of HUSKY Limited Benefit; (2) the emergency medical coverage has been separated into G06-II as a limited benefit plan that rolls up into “Program Name” of Emergency Medical and “Medical Benefit Plan” of Other Medical. NOTE: On April 22, 2019 the methodology for determining HUSKY A Newborn recipients changed, which caused an increase of recipients for that benefit starting in October 2016. We now count recipients recorded in the ImpaCT system as well as in the HIX system for that assistance type, instead using HIX exclusively. Also, the methodology for determining the address of the recipients has changed: 1. The address of a recipient in the ImpaCT system is now correctly determined specific to that month instead of using the address of the most recent month. This resulted in some shuffling of the recipients among townships starting in October 2016. 2. If, in a given month, a recipient has benefit records in both the HIX system and in the ImpaCT system, the address of the recipient is now calculated as follows to resolve conflicts: Use the residential address in ImpaCT if it exists, else use the mailing address in ImpaCT if it exists, else use the address in HIX. This change in methodology causes a reduction in counts for most townships starting in March 2017 because a single address is now used instead of two when the systems do not agree. NOTE: On February 14 2019, the enrollment counts for 2012-2015 across all programs were updated to account for an error in the data integration process. As a result, the count of the number of people served increased by 13% for 2012, 10% for 2013, 8% for 2014 and 4% for 2015. Counts for 2016, 2017 and 2018 remain unchanged.

This data set includes monthly counts and rates (per 1,000 beneficiaries) of health screenings provided to Medicaid and CHIP beneficiaries under the age of 19 (as of the first day of the month) by state.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating screening services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Procedure Codes - OT Professional, Diagnosis Codes - OT, Claims Volume - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

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

This data set includes monthly counts and rates (per 1,000 beneficiaries) of services provided via telehealth, including live audio video, remote patient monitoring, store and forward, and other telehealth, to Medicaid and CHIP beneficiaries, by state.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating telehealth services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Claims Volume - OT, Procedure Codes - OT Professional. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

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

This data set includes monthly counts and rates (per 1,000 beneficiaries) of dental services provided to Medicaid and CHIP beneficiaries under the age of 19 (as of the first day of the month), by state.

These metrics are based on data in the T-MSIS Analytic Files (TAF). Some states have serious data quality issues for one or more months, making the data unusable for calculating dental services measures. To assess data quality, analysts adapted measures featured in the DQ Atlas. Data for a state and month are considered unusable if at least one of the following topics meets the DQ Atlas threshold for unusable: Total Medicaid and CHIP Enrollment, Procedure Codes - OT Professional, Claims Volume - OT. Please refer to the DQ Atlas at http://medicaid.gov/dq-atlas for more information about data quality assessment methods. Cells with a value of “DQ” indicate that data were suppressed due to unusable data.

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