rowType
stringclasses
2 values
tafVersionId
int64
6
43
measureId
float64
1
124
stateId
float64
1
78
col0
stringclasses
57 values
col1
stringclasses
13 values
col2
stringclasses
121 values
col3
stringclasses
11 values
col4
stringclasses
7 values
col5
stringclasses
118 values
col6
stringlengths
1
26
col7
stringclasses
2 values
col8
stringclasses
4 values
data
43
47
49
Utah
Claim Files Completeness
Claims Volume - OT
2023
Medium concern
Multiple criteria: (1) Total other service (OT) header volume as a percentage of the national median, (2) total OT line volume as a percentage of the national median, and (3) average number of OT line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
48
49
Utah
Claim Files Completeness
Claims Volume - RX
2023
Medium concern
Multiple criteria: (1) Total pharmacy (RX) header volume as a percentage of the national median, (2) total RX line volume as a percentage of the national median, and (3) average number of RX line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
27
49
Utah
Claim Files Completeness
Service Users - IP
2023
Low concern
Percentage of non-dually eligible beneficiaries with at least one inpatient (IP) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median
103.0
TAF
Preliminary 1
data
43
28
49
Utah
Claim Files Completeness
Service Users - OT
2023
Low concern
Percentage of non-dually eligible beneficiaries with at least one other service (OT) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median
93.7
TAF
Preliminary 1
data
43
29
49
Utah
Claim Files Completeness
Service Users - RX
2023
Medium concern
Percentage of non-dually eligible beneficiaries with at least one pharmacy (RX) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median
59.7
TAF
Preliminary 1
data
43
121
49
Utah
Claim Files Completeness
Availability of CMC Plan Encounter Data
2023
Low concern
Multiple criteria: Percentage of CMC plans with no IP or OT encounter header records in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
56
49
Utah
Claim Files Completeness
CMC Plan Encounters - IP
2023
Low concern
Multiple criteria: (1) Inpatient (IP) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) IP CMC encounter line record volume as a percentage of the national median, (3) the average number of IP CMC encounter line records per header as a percentage of the national...
See Background and Methods
TAF
Preliminary 1
data
43
57
49
Utah
Claim Files Completeness
CMC Plan Encounters - LT
2023
Medium concern
Multiple criteria: (1) The average number of long-term care (LT) comprehensive managed care (CMC) encounter line records per LT claim header as a percentage of the national median and (2) the number of CMC plans with no LT encounter header records in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
58
49
Utah
Claim Files Completeness
CMC Plan Encounters - OT
2023
Medium concern
Multiple criteria: (1) Other service (OT) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) volume of OT CMC encounter line records as a percentage of the national median, (3) the average number of OT CMC line records per header as a percentage of the national m...
See Background and Methods
TAF
Preliminary 1
data
43
59
49
Utah
Claim Files Completeness
CMC Plan Encounters - RX
2023
Medium concern
Multiple criteria: (1) The average number of pharmacy (RX) comprehensive managed care (CMC) encounter line records per RX claim header as a percentage of the national median and (2) the number of CMC plans with no RX encounter header records in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
22
49
Utah
Claim Files Completeness
Benchmarking Inpatient Stays - IP
2023
Unclassified
Percent difference in adult inpatient hospital stays between the T-MSIS Analytic Files (TAF) and the Healthcare Cost and Utilization Project (HCUP) data
Missing benchmark data
TAF
Preliminary 1
data
43
77
49
Utah
Expenditure Benchmarking
Total Medicaid Expenditures
2023
Low concern
Percent difference in total Medicaid expenditures for medical assistance programs between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-2.5
TAF
Preliminary 1
data
43
87
49
Utah
Expenditure Benchmarking
Medicaid Beneficiary Expenditures
2023
Low concern
Percent difference in Medicaid beneficiary expenditures between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-3.0
TAF
Preliminary 1
data
43
67
49
Utah
Expenditure Benchmarking
Total FFS Expenditures
2023
Medium concern
Percent difference in Medicaid fee-for-service (FFS) expenditures between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-18.7
TAF
Preliminary 1
data
43
68
49
Utah
Expenditure Benchmarking
FFS Inpatient Expenditures
2023
High concern
Percent difference in Medicaid fee-for-service (FFS) expenditures for inpatient hospital services between the T-MSIS Analytic Files (TAF) and the CMS-64 data
23.7
TAF
Preliminary 1
data
43
69
49
Utah
Expenditure Benchmarking
FFS Long-Term Care Expenditures
2023
Medium concern
Percent difference in Medicaid fee-for-service (FFS) expenditures for institutional long-term care services between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-17.8
TAF
Preliminary 1
data
43
70
49
Utah
Expenditure Benchmarking
FFS Other Medical Expenditures
2023
High concern
Percent difference in Medicaid fee-for-service (FFS) expenditures for all other medical services between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-35.0
TAF
Preliminary 1
data
43
71
49
Utah
Expenditure Benchmarking
FFS Prescription Drug Expenditures
2023
Medium concern
Percent difference in Medicaid fee-for-service (FFS) expenditures for prescription drugs between the T-MSIS Analytic Files (TAF) and the CMS-64 data
9.0
TAF
Preliminary 1
data
43
72
49
Utah
Expenditure Benchmarking
Total Monthly Beneficiary Payments
2023
Medium concern
Percent difference in total monthly Medicaid beneficiary payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
11.1
TAF
Preliminary 1
data
43
73
49
Utah
Expenditure Benchmarking
CMC Payments
2023
Medium concern
Percent difference in comprehensive managed care (CMC) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
12.4
TAF
Preliminary 1
data
43
74
49
Utah
Expenditure Benchmarking
PHP Payments
2023
Unusable
Percent difference in prepaid health plan (PHP) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-72.4
TAF
Preliminary 1
data
43
75
49
Utah
Expenditure Benchmarking
PCCM Fees
2023
Unclassified
Percent difference in primary care case management plan (PCCM) fees between the T-MSIS Analytic Files (TAF) and the CMS-64 data
Not applicable
TAF
Preliminary 1
data
43
76
49
Utah
Expenditure Benchmarking
Premium Assistance Payments
2023
Unusable
Percent difference in premium assistance payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data
-100.0
TAF
Preliminary 1
data
43
66
49
Utah
Payments
Missing Payment Data - FFS Claims
2023
Medium concern
Percentage of fee-for-service (FFS) claims with a zero, missing, or negative payment amount in the T-MSIS Analytic Files (TAF)
12.8
TAF
Preliminary 1
data
43
86
49
Utah
Payments
Missing Payment Data - Encounters
2023
Low concern
Percentage of managed care (MC) encounters with a zero, missing, or negative payment amount in the T-MSIS Analytic Files (TAF)
8.7
TAF
Preliminary 1
data
43
101
49
Utah
Payments
Bundled Payments for Prenatal Care
2023
High concern
Percent of deliveries with bundled payment code including prenatal care in the T-MSIS Analytic Files (TAF)
45.3
TAF
Preliminary 1
data
43
81
49
Utah
Payments
Payment Data Consistency - IP
2023
Medium concern
Multiple criteria: (1) Percentage of fee-for-service (FFS) inpatient (IP) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of IP claims with an unknown payment level in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
80
49
Utah
Payments
Payment Data Consistency - LT
2023
Medium concern
Multiple criteria: (1) Percentage of fee-for-service (FFS) long-term care (LT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of LT claims with an unknown payment level in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
79
49
Utah
Payments
Payment Data Consistency - OT
2023
Low concern
Multiple criteria: (1) Percentage of fee-for-service (FFS) other service (OT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of OT claims with an unknown payment level in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
78
49
Utah
Payments
Payment Data Consistency - RX
2023
Low concern
Multiple criteria: (1) Percentage of fee-for-service (FFS) pharmacy (RX) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of RX claims with an unknown payment level in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
111
49
Utah
Financial Reporting
Category of Service Code - IP
2023
Low concern
Percentage of IP lines that have a category of service code consistent with program enrollment
98.6
TAF
Preliminary 1
data
43
112
49
Utah
Financial Reporting
Category of Service Code - LT
2023
Low concern
Percentage of LT lines that have a category of service code consistent with program enrollment
99.8
TAF
Preliminary 1
data
43
113
49
Utah
Financial Reporting
Category of Service Code - OT
2023
Low concern
Percentage of OT lines that have a category of service code consistent with program enrollment
93.8
TAF
Preliminary 1
data
43
114
49
Utah
Financial Reporting
Category of Service Code - RX
2023
Medium concern
Percentage of RX lines that have a category of service code consistent with program enrollment
84.0
TAF
Preliminary 1
data
43
115
49
Utah
Financial Reporting
Federal Reimbursement Category Code - IP
2023
Low concern
Percentage of IP lines that have a federal reimbursement category consistent with program enrollment
98.9
TAF
Preliminary 1
data
43
116
49
Utah
Financial Reporting
Federal Reimbursement Category Code - LT
2023
Low concern
Percentage of LT lines that have a federal reimbursement category consistent with program enrollment
100.0
TAF
Preliminary 1
data
43
117
49
Utah
Financial Reporting
Federal Reimbursement Category Code - OT
2023
Low concern
Percentage of OT lines that have a federal reimbursement category consistent with program enrollment
93.1
TAF
Preliminary 1
data
43
118
49
Utah
Financial Reporting
Federal Reimbursement Category Code - RX
2023
Medium concern
Percentage of RX lines that have a federal reimbursement category consistent with program enrollment
83.9
TAF
Preliminary 1
data
43
49
49
Utah
Service Use Information
Diagnosis Code - IP
2023
Low concern
Percentage of inpatient (IP) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)
93.3
TAF
Preliminary 1
data
43
50
49
Utah
Service Use Information
Diagnosis Code - LT
2023
Low concern
Percentage of long-term care (LT) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)
93.0
TAF
Preliminary 1
data
43
51
49
Utah
Service Use Information
Diagnosis Code - OT
2023
Low concern
Percentage of other service (OT) header records for outpatient hospital services, physician services, or clinic services with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)
96.1
TAF
Preliminary 1
data
43
65
49
Utah
Service Use Information
Procedure Codes - IP
2023
Low concern
Multiple criteria: (1) Percentage of inpatient (IP) header records with a missing primary procedure code, and (2) the percentage of IP header records with any invalid procedure codes in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
63
49
Utah
Service Use Information
Procedure Codes - OT Professional
2023
Low concern
Percentage of all other service (OT) professional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF)
1.0
TAF
Preliminary 1
data
43
64
49
Utah
Service Use Information
Procedure Codes - OT Institutional
2023
Low concern
Percentage of all other service (OT) institutional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF)
5.2
TAF
Preliminary 1
data
43
52
49
Utah
Service Use Information
Type of Service - IP
2023
Low concern
Percentage of inpatient (IP) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
54
49
Utah
Service Use Information
Type of Service - LT
2023
Low concern
Percentage of long-term care (LT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)
0.2
TAF
Preliminary 1
data
43
53
49
Utah
Service Use Information
Type of Service - OT
2023
Low concern
Percentage of other service (OT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
55
49
Utah
Service Use Information
Type of Service - RX
2023
Low concern
Percentage of pharmacy (RX) claim line records with a missing or invalid type of service code (TOS) in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
62
49
Utah
Service Use Information
Place of Service
2023
Low concern
Percentage of all other service (OT) header records with the expected combination of type of bill (TOB) code and place of service code (POS) in the T-MSIS Analytic Files (TAF)
99.9
TAF
Preliminary 1
data
43
41
49
Utah
Service Use Information
Admission Date - IP
2023
Low concern
Percentage of inpatient (IP) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
42
49
Utah
Service Use Information
Admission Date - LT
2023
Low concern
Percentage of long-term care (LT) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF)
6.2
TAF
Preliminary 1
data
43
43
49
Utah
Service Use Information
Discharge Date - IP
2023
Low concern
Percentage of inpatient (IP) records with an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
44
49
Utah
Service Use Information
Discharge Date - LT
2023
Low concern
Multiple criteria: Percentage of long-term care (LT) records with (1) a missing discharge date and (2) an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
23
49
Utah
Service Use Information
Type of Bill - IP
2023
Low concern
Percentage of inpatient (IP) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)
98.9
TAF
Preliminary 1
data
43
24
49
Utah
Service Use Information
Type of Bill - LT
2023
Low concern
Percentage of long-term care (LT) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)
100.0
TAF
Preliminary 1
data
43
25
49
Utah
Service Use Information
Type of Bill - OT
2023
Low concern
Multiple criteria: (1) Percentage of other service (OT) claim header records with an unexpected or invalid type of bill code and (2) percentage of OT claim header records with a missing type of bill code in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
40
49
Utah
Service Use Information
Generic Indicator - RX
2023
High concern
Multiple criteria: See Background and Methods
See Background and Methods
TAF
Preliminary 1
data
43
89
49
Utah
Service Use Information
National Drug Code - RX
2023
Low concern
Percentage of pharmacy (RX) line records with a missing or invalid National Drug Code (NDC) code in the T-MSIS Analytic Files (TAF)
5.2
TAF
Preliminary 1
data
43
90
49
Utah
Service Use Information
Days' Supply, Quantity, and Units - RX
2023
Low concern
Percentage of pharmacy (RX) line records with either (1) a days' supply value that is missing, invalid, or greater than 180, or (2) a missing or unusable National Drug Code (NDC) quantity in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
60
49
Utah
Non-Claim Records
Supplemental Payments
2023
High concern
Multiple criteria: See Background and Methods
See Background and Methods
TAF
Preliminary 1
data
43
61
49
Utah
Non-Claim Records
Non-Program (Other) Claims
2023
Low concern
Percentage of claim records with other, non-program claim type code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
85
49
Utah
Non-Claim Records
Service Tracking Claims
2023
Medium concern
Multiple criteria: Percentage of service tracking claims that meet any of the following criteria: (1) problematic MSIS ID value, (2) missing service tracking type code, or (3) missing service tracking payment in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
33
49
Utah
Provider Information
Billing Provider NPI - IP
2023
Low concern
Percentage of records in the IP file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
34
49
Utah
Provider Information
Billing Provider NPI - LT
2023
Low concern
Percentage of records in the LT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
35
49
Utah
Provider Information
Billing Provider NPI - OT
2023
Low concern
Percentage of records in the OT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
4.8
TAF
Preliminary 1
data
43
36
49
Utah
Provider Information
Billing Provider NPI - RX
2023
Low concern
Percentage of records in the RX file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
30
49
Utah
Provider Information
Servicing Provider NPI - OT
2023
Low concern
Percentage of other service (OT) line records with a missing servicing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
1.7
TAF
Preliminary 1
data
43
31
49
Utah
Provider Information
Prescribing Provider NPI - RX
2023
Low concern
Percentage of pharmacy (RX) header records with a missing prescribing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
6.3
TAF
Preliminary 1
data
43
32
49
Utah
Provider Information
Dispensing Provider NPI - RX
2023
Low concern
Percentage of pharmacy (RX) header records with a missing dispensing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
37
49
Utah
Provider Information
Billing Provider Type, Specialty, and Taxonomy - IP
2023
Low concern
Percentage of inpatient (IP) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES taxonomy code in the T-MSIS Analytic Files (TAF)
99.8
TAF
Preliminary 1
data
43
38
49
Utah
Provider Information
Billing Provider Type, Specialty, and Taxonomy - LT
2023
Low concern
Percentage of long-term care (LT) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)
99.9
TAF
Preliminary 1
data
43
104
49
Utah
Provider Information
Billing Provider Type, Specialty, and Taxonomy - OT Professional
2023
Low concern
Percentage of header records on other service (OT) professional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)
98.0
TAF
Preliminary 1
data
43
105
49
Utah
Provider Information
Billing Provider Type, Specialty, and Taxonomy - OT Institutional
2023
Low concern
Percentage of header records on other service (OT) institutional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)
100.0
TAF
Preliminary 1
data
43
103
49
Utah
Provider Information
Billing Provider Specialty and Taxonomy - RX
2023
Low concern
Percentage of RX header records with an expected billing provider specialty or taxonomy code
100.0
TAF
Preliminary 1
data
43
106
49
Utah
Provider Information
Servicing Provider Type, Specialty, and Taxonomy - OT Professional
2023
Low concern
Percentage of line records on other service (OT) professional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)
97.8
TAF
Preliminary 1
data
43
107
49
Utah
Provider Information
Servicing Provider Type, Specialty, and Taxonomy - OT Institutional
2023
Low concern
Percentage of line records on other service (OT) institutional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)
100.0
TAF
Preliminary 1
data
43
26
49
Utah
Provider Information
Hospital Type - IP
2023
Unusable
Percentage of inpatient (IP) claim header records with an expected type of hospital code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
91
49
Utah
Provider Information
Active Enrollment Status Indicator
2023
High concern
Percentage of unique Annual Provider (APR) file provider IDs where the active enrollment status indicator aligns with the claims in the T-MSIS Analytic Files (TAF)
57.9
TAF
Preliminary 1
data
43
94
49
Utah
Provider Information
Facility/Group/Individual Code
2023
Low concern
Multiple criteria: (1) Percentage of providers that are facility providers, (2) percentage of providers that are group providers, (3) percentage of providers that are individual providers, and (4) percentage of providers with a valid facility/group/individual code in the T-MSIS Analytic Files (TAF)
See Background and Methods
TAF
Preliminary 1
data
43
95
49
Utah
Provider Information
Group and Individual Providers - Classification Types
2023
High concern
Percentage of individual and group providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF)
63.3
TAF
Preliminary 1
data
43
97
49
Utah
Provider Information
Facilities - Classification Types
2023
High concern
Percentage of facility providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF)
69.5
TAF
Preliminary 1
data
43
96
49
Utah
Provider Information
Facility Characteristics
2023
Unusable
Percentage of facility providers with a valid value reported for ownership code and profit status code in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
102
49
Utah
Provider Information
Provider Location
2023
Low concern
Percentage of participating providers without a usable service or practice location: ZIP code or county code
0.4
TAF
Preliminary 1
data
43
109
49
Utah
Provider Information
National Provider Identifier
2023
High concern
Percentage of TAF Annual Provider Files (APR) records with a valid NPI
63.9
TAF
Preliminary 1
data
43
98
49
Utah
Managed Care Plans
Managed Care Plan Program and Population Characteristics
2023
High concern
Percentage of records missing key managed care plan program and population characteristics in the T-MSIS Analytic Files (TAF)
49.4
TAF
Preliminary 1
data
43
99
49
Utah
Managed Care Plans
Managed Care Plan Operational Characteristics
2023
Unusable
Percentage of records missing key managed care plan operational characteristics in the T-MSIS Analytic Files (TAF)
100.0
TAF
Preliminary 1
data
43
100
49
Utah
Managed Care Plans
Plan Name and Type
2023
Low concern
Percentage of records missing managed care plan name or type in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
108
50
Vermont
Linking Across Files
Linking Claims to Beneficiaries
2023
Low concern
Percentage of service use records that do not link to an eligibility record in the same month of service in the T-MSIS Analytic Files (TAF)
0.0
TAF
Preliminary 1
data
43
110
50
Vermont
Linking Across Files
Linking Expenditures to Beneficiaries
2023
Low concern
Percentage of absolute value of Medicaid and CHIP expenditures that do not link to an eligibility record in the month of service in the T-MSIS Analytic Files (TAF)
0.2
TAF
Preliminary 1
data
43
92
50
Vermont
Linking Across Files
Linking Claims to Providers
2023
Medium concern
Percentage of unique provider IDs on medical claims in the T-MSIS Analytic Files (TAF) that link to a provider ID on the TAF Annual Provider (APR) file
87.5
TAF
Preliminary 1
data
43
88
50
Vermont
Linking Across Files
Linking Beneficiaries to Managed Care Plans
2023
Low concern
Percentage of beneficiary-plan combinations in the T-MSIS Analytic Files (TAF) Demographic and Eligibility (DE) file that link to a plan ID in the TAF Annual Managed Care Plan (APL) file
100.0
TAF
Preliminary 1
data
43
7
50
Vermont
Enrollment Benchmarking
Total Medicaid and CHIP Enrollment
2023
Low concern
Average monthly percent difference in the count of Medicaid and CHIP beneficiaries with comprehensive benefits between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data
4.6
TAF
Preliminary 1
data
43
8
50
Vermont
Enrollment Benchmarking
Medicaid-Only Enrollment
2023
Low concern
Average monthly percent difference in the count of Medicaid beneficiaries with comprehensive benefits between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data
4.6
TAF
Preliminary 1
data
43
4
50
Vermont
Enrollment Benchmarking
M-CHIP and S-CHIP Enrollment
2023
Low concern
Average monthly percent difference in CHIP enrollment between the T-MSIS Analytic Files (TAF) and Performance Indicator (PI) data
4.8
TAF
Preliminary 1
data
43
9
50
Vermont
Enrollment Benchmarking
Dually Enrolled in Medicare
2023
Unclassified
Average percent difference in the count of dually eligible beneficiaries in March, June, September, and December between the T-MSIS Analytic Files (TAF) and Medicare Modernization Act (MMA) data
Missing benchmark data
TAF
Preliminary 1
data
43
1
50
Vermont
Enrollment Benchmarking
Enrollment in CMC Plans
2023
Unclassified
Percent difference in comprehensive managed care (CMC) organization enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Managed Care Enrollment and Program Characteristics (MMCEPC) report
Missing benchmark data
TAF
Preliminary 1
data
43
2
50
Vermont
Enrollment Benchmarking
Enrollment in PCCM Programs
2023
Unclassified
Percent difference in primary care case management (PCCM) enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Managed Care Enrollment and Program Characteristics (MMCEPC) report
Not applicable
TAF
Preliminary 1
data
43
3
50
Vermont
Enrollment Benchmarking
Enrollment in BHO Plans
2023
Unclassified
Percent difference in behavioral health organization (BHO) enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Managed Care Enrollment and Program Characteristics (MMCEPC) report
Not applicable
TAF
Preliminary 1
data
43
5
50
Vermont
Enrollment Benchmarking
Adult Expansion Enrollment
2023
Low concern
Average monthly percent difference in adult expansion group enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Budget and Expenditure System (MBES) data
-9.7
TAF
Preliminary 1
data
43
6
50
Vermont
Enrollment Benchmarking
Newly Eligible Adult Enrollment
2023
Low concern
Average monthly percent difference in 'newly eligible' adult expansion group enrollment between the T-MSIS Analytic Files (TAF) and the Medicaid Budget and Expenditure System (MBES) data
0.0
TAF
Preliminary 1