This report outlines a feasibility study focused on obtaining identifiers for self-directed Home and Community-Based Services (HCBS) users within Medicaid claims data. Financial Management Services (FMS) entities assist individuals in managing the financial aspects of self-directed care, including payroll and billing. The study examines the data collected by FMS entities, variations in data quality, and the potential for linking these records to the Transformed Medicaid Statistical Information System (T-MSIS).
Based on 17 key informant interviews with the Centers for Medicare & Medicaid Services (CMS), FMS representatives, and state Medicaid officials, the study found that while FMS entities consistently gather essential payroll and billing data, the collection of demographic and program-specific information varies by state. The report recommends standardizing data across entities, addressing gaps in longitudinal data, and initiating a pilot database with select states. It emphasizes the importance of stakeholder collaboration in data sharing and governance, particularly to ensure accurate participant identifiers for T-MSIS linkage. Ultimately, this database could support research on program outcomes, participant satisfaction, and the influence of worker characteristics on HCBS utilization.
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