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values | col1 stringclasses 13
values | col2 stringclasses 121
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values | col6 stringlengths 1 26 ⌀ | col7 stringclasses 2
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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 |
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