TABLE A.1. Populations Excluded from Analysis

06/07/2015

TABLE A.1. Populations Excluded from Analysis

Data IssuePopulations Excluded from the StudyPopulations Included in the Study
MAX data contain only Medicaid-funded services.Beneficiaries with Medicare (duals) and those over age 64. Beneficiaries with private insurance. Beneficiaries qualifying only for restricted or partial benefits. Beneficiaries qualifying for full benefits with no other sources of health coverage. Beneficiaries with at least ten continuous months of enrollment. 
States vary in ability to report to CMS complete and reliable enrollment and claims data.Beneficiaries in states with known problems in reporting key variables in their 2007 data. 
HMO or BHO encounter data may be missing or unreliable.Children and adult beneficiaries qualifying for Medicaid due to family status; such populations are more likely to be enrolled in managed care. Beneficiaries in states using HMOs or BHOs that do not report encounter data to CMS. Beneficiaries in states using HMOs or BHOs whose reported encounter data have missing or unreliable data on key variables for the analysis. Working-age adults who qualify for Medicaid due to disability. Beneficiaries in states that use FFS or PCCM to deliver Medicaid services. Beneficiaries in states that use HMOs and/or BHOs to deliver services to disabled adults and report reliable and complete encounter data to CMS.