The data source for this study is the State Medicaid Research Files (SMRF), a series of analytic data files created from the Medicaid Statistical Information System (MSIS) data that are submitted by states to the Health Care Financing Administration (HCFA) on a quarterly basis. The SMRF files have several advantages over data from MSIS and individual state Medicaid management information systems (Dodds 1997):
- SMRF files are organized by calendar year date of service rather than quarterly date of payment.
- SMRF claims are adjusted to reflect final bills and include hospital stay records created from multiple interim bills.
- A person summary file contains monthly eligibility information in a single record, together with annual utilization and expenditure information.
- Analytic variables, such as condition flags, type of service indicators, and eligibility categories, are created for research purposes.
- Enhanced editing and verification procedures are performed to identify and document problems and to ascertain the validity of data for particular applications
The SMRF data are organized into five files, including the person summary file and four claims files: inpatient, long-term care, drug, and other (which comprises claims for professional services, outpatient clinics, and premium payments). We used the person summary file for descriptive analyses of the dynamics of Medicaid eligibility and distribution of Medicaid expenditures. We used the claims files primarily to compare patterns of diagnoses and utilization.
Mathematica Policy Research (MPR) obtained SMRF files from three states for two years. These data were obtained from HCFA solely for the purpose of this study through a data use agreement between HCFA, ASPE, and MPR. The states and study periods are as follows:
|California||1994 - 1995|
|Florida||1994 - 1995|
|Pennsylvania||1993 - 1994|
These study periods represent the most recent SMRF data available for each state that met our selection criteria. The next section explains the criteria used to select the three states for the study.