Data on Health and Well-being of American Indians, Alaska Natives, and Other Native Americans, Data Catalog

Medicaid Analytic Extract (MAX)

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Sponsor: U.S. Department of Health and Human Services (DHHS)/Centers for Medicare and Medicaid Services (CMS)
Description: The Medicaid Analytic Extract (MAX) files (formerly State Medicaid Research Files) are comprised of the Personal Summary, Inpatient, Long-Term Care, Drug, and Other Therapy data sets, and contain eligibility and utilization records. The Personal Summary File contains one record for every individual enrolled in Medicaid for at least one day during the year. These files include demographic data (e.g., date of birth, gender, race); basis of eligibility; maintenance assistance status; monthly enrollment status; utilization summary; complete inpatient stay records; claims for long term care services provided by Nursing Facilities, Skilled Nursing Facilities (SNFs), Intermediate Care Facilities (ICFs), and independent psychiatric facilities; drug claims; and claim records for all non-institutional Medicaid services, including physician services, lab/X-ray, clinic services and premium payments.
Relevant Policy Issues: Measurement of Health Status, Disease-specific Measurements, Health Disparities, Factors Contributing to Measured Health Disparities, Measures of Well-being for Children, and Measures of Well-being for Elders.
Data Type(s): Program reporting data
Unit of Analysis: Individual
Identification of AI/AN/NA: Racial/ethnic categories available:
  • White (was “White, not of Hispanic origin” through September 1998)
  • Black or African American (was “Black, not of Hispanic origin” through September 1998)
  • American Indian or Alaska Native (AI/AN)
  • Asian (was “Asian or Pacific Islander” through September 1998)
  • Hispanic or Latino – No Race information available (was “Hispanic” [without race annotation] through October 1998)
  • Native Hawaiian or other Pacific Islander (NH/PI) (new code beginning October 1998)
  • Hispanic or Latino and one or more Races (new code beginning October 1998)
  • More than one Race (new code beginning October 1998)
  • Unknown
AI/AN/NA Population in Data Set: Unweighted population in data source from 2003 files:
TOTAL: 55,157,775
AI/AN: 806,211
NH/PI: 508,106
Geographic Scope: The geographic scope of the MAX files is national. State, county, and zipcode also are available for analyses. Files for the District of Columbia are available beginning with the MAX 1999.
Date or Frequency: Data are submitted quarterly, with data files made available on an annual basis from 1992 to the present.
Data Collection Methodology: States submit data via the Medicaid Statistical Information System (MSIS), meeting standardized specifications. MSIS data are cleaned and reconciled and become the MAX files.
Participation: Mandatory
Response Rate: As the submission of these data are mandatory, it is assumed that the response is a near census of all states. This assumption is only valid for reporting of eligibles and Fee for Service utilization. Reporting of encounter data for services provided under a capitated managed care plan was mandated beginning with FY 1999. The data are still viewed as largely incomplete for utilization.
Authorization: The Balanced Budget Act of 1997 mandated that all states submit Medicaid-paid claims data to CMS. Prior to this, states submitted data on a voluntary basis.
Strengths: These data files contain a very large number of AI/AN/NA respondents. Data contain indicators concerning key policy issues including health, child well-being, and elder well-being. There are multiple years of data available. Because these data represent a census of Medicaid data, response rates and sample sizes are not an issue in using the data. States submit data on standardized forms and all data are available in electronic form making the data relatively easy to access and use.
Limitations: The data files are quite large and cumbersome to use. Potential users must also be extremely familiar with the data documentation to ensure that they are interpreting results obtained from this data set correctly. For example, the variation in procedures and practices across states (e.g., one state tracks or defines a certain service differently) means that there are numerous exceptions or variations on the data standardization requirements. The extensive documentation tracking these data anomalies that should be examined by potential users of these data.
Access Requirements and Use Restrictions: Researchers must submit a proposal and comply with multiple criteria of the data use agreement. Note that only approved academic research projects and certain government agencies are entitled to a data use agreement to obtain MAX data. Detailed information can be found at: http://www.resdac.umn.edu/Medicaid/requesting_data.asp.

Cost of the data set is dependent on the number of states, years, and file types requested.
Contact Information: Contact Information:
E-Mail: resdac@umn.edu
Phone: (888) 9-ResDAC or (888) 973-7322

Data documentation:
http://www.resdac.umn.edu/Medicaid/data_documentation.asp.
http://www.cms.hhs.gov/MedicaidDataSourcesGenInfo/07_MAXGeneralInformation.asp

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