Nysenbaum Jessica Beth, Bouchery Ellen, Malsberger Rosalie
Mathematica Policy Research-Health.
Medicare Medicaid Res Rev. 2014 Jun 9;4(2). doi: 10.5600/mmrr2014-004-02-b02. eCollection 2014.
To assess the availability, completeness, and quality of the Behavioral Health Organization (BHO) encounter data in MAX 2009.
The Medicaid Analytic Extract (MAX) 2009.
We compared metrics of reporting completeness and quality for BHOs to similar metrics for six states that primarily cover MH and SA services on a FFS basis. For the IP file, number of encounters per 1,000 person months of enrollment were compared. In the OT file, we examined three completeness measures: the number of claims per PME, number of claims reported per BHO outpatient service user, and the number of OT claims per service user.
Out of the 15 states reporting enrollment in BHO plans in MAX 2009, 10 reported complete capitation data. IP encounter data were available in four states (Arizona, Colorado, Florida, and Iowa), compared well to FFS ranges, and appear usable for research. OT data are available for five states, but our analysis suggests data are only sufficiently complete for analysis in Arizona and Iowa.
The initial assessment of the availability, completeness and quality of BHO encounter data in MAX 2009 suggests that only limited data are available and usable.
评估2009年MAX中行为健康组织(BHO)诊疗数据的可得性、完整性和质量。
2009年医疗补助分析提取物(MAX)。
我们将BHO的报告完整性和质量指标与六个主要按按服务项目付费(FFS)方式提供精神健康(MH)和药物滥用(SA)服务的州的类似指标进行了比较。对于住院病人文件,比较了每1000人月登记的诊疗次数。在门诊病人文件中,我们检查了三项完整性指标:每个精神疾病评估(PME)的索赔次数、每个BHO门诊服务使用者报告的索赔次数以及每个服务使用者的门诊病人索赔次数。
在2009年MAX中报告了BHO计划登记情况的15个州中,有10个州报告了完整的人均定额付费数据。四个州(亚利桑那州、科罗拉多州、佛罗里达州和爱荷华州)有住院病人诊疗数据,与FFS范围相比情况良好,似乎可用于研究。五个州有门诊病人数据,但我们的分析表明,只有亚利桑那州和爱荷华州的数据足够完整可用于分析。
对2009年MAX中BHO诊疗数据的可得性、完整性和质量的初步评估表明,只有有限的数据可用且适用。