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Improving Quality of Care & Outcomes Data for Pregnant Medicaid Beneficiaries & Newborn Infants

Improving Quality of Care & Outcomes Data for Pregnant Medicaid Beneficiaries & Newborn Infants
Agency
  • Centers for Medicare & Medicaid Services (CMS)
Start Date
  • 03/01/23
Functionality
  • Use of Clinical Data for Research
  • Linking Clinical and Other Data for Research
  • Use of Publicly-Funded Data Systems for Research

 

STATUS: Active Project

BACKGROUND

Medicaid pays for about 40% of all births in the US, generating important administrative data on a priority population. Researchers’ access to clinical characteristics and outcomes data, when combined with service utilization data, as well as the ability to link maternal and infant records, is critical for generating the actionable evidence to improve maternal (and infant) health. With access to such a robust, integrated dataset, researchers can expand on existing PCOR (patient centered outcomes research) studies as well as address new PCOR questions, including, but not limited to, the effects of pre-pregnancy health conditions on pregnancy outcomes; impacts of post-partum service utilization on pregnancy intervals; understanding and addressing disparities in pre- and post-healthcare utilization and outcomes; and effects of interventions aimed at improving treatment of substance disorders or addressing premature birth rates.

In response to these data needs, and in alignment with HHS priorities, there has been increasing interest in linking (1) Vital Records (VR) birth certificates (BC) for Medicaid covered pregnancies and births with (2) claims data on mothers and infants from the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF). These TAF data include information on enrollment, demographics, service utilization, and payments in Medicaid and CHIP, but they do not include (or only poorly capture) certain demographic and clinical measures needed for research to improve maternal health outcomes (e.g., detailed information on birth outcomes, maternal and paternal characteristics that may be risk factors for poor child outcomes, timing and completeness of prenatal care, and linkage between mother and child). VR BC data often contain the detailed information that is not present in TAF data.

PROJECT PURPOSE

The overarching goal of this project is to expand and strengthen data capacity to support patient-centered outcomes research in maternal health by linking VR BC from up to twenty states and for the calendar years 2016 – 2020 with TAF data, thereby providing researchers with accessible, linked, longitudinal data on pregnant women and their infants through:

  • Supplemental TAF file shared on the CMCS data environment and Virtual Research Data Centers (VRDC)
  • Data brief describing the results of linked data, published on RESDAC and the Data Quality Atlas
  • Technical documentation describing the methods used to create the supplemental TAF file, published on RESDAC and the Data Quality Atlas.