New report examines MSIS feasibility to fulfill requirements outlined in CHIPRA

A new report, published in Perspectives in Health Information Management, by The George Washington University School of Public Health and Health Services Department of Health Policy, examines the feasibility of using the Medicaid Statistical Information System (MSIS), an existing data source, to fulfill some of the requirements outlined in section 401 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). CHIPRA not only requires the Department of Health and Human Services to identify and publish healthcare quality measures for children enrolled in the Children's Health Insurance Program of Medicaid, but also requires core measures to identify disparities by race and ethnicity, among other factors.

The report identifies that with sufficient funding, enough lead time, and some feasible but not insignificant adjustments, MSIS may serve as an efficient and economical source of data for certain quality measures.

"Many state programs (CHIP and Medicaid) are facing budgetary constraints and programmatic challenges; therefore, utilizing this system could serve as a way to streamline some of the reporting requirements. Our analysis examined the system and we identified what would need to be done and the considerations needed to be taken into account to enable MSIS to serve as a tool that would help states stay in compliance with these new requirements," said Patricia MacTaggart, Lead Research Scientist and Lecturer in the Department of Health Policy.

The team of researchers identified five key themes that relate to the feasibility of sing MSIS as a data source for assessing quality measures. These themes include:
oStates have significant experience with data collection, performance measurement, and quality oversight for children in Medicaid and CHIP. All states are familiar with the opportunities and limitations associated with MSIS and already know how to interpret the data so that it is usable.

oCHIPRA provisions related to reporting of quality measure will be implemented at a time when states are facing major fiscal constraints. At a time when most states are facing budgetary shortfalls, and seeking to maintain their programs, putting resources into infrastructure to support new and additional performance measures may not be feasible.

oMSIS provides potential opportunities as it offers a rich source of data, but the difficulties in obtaining clean data should not be underestimated. While MSIS is the existing data source, it does have significant data issues related to eligibility and claims that have been worked through over time. The data is subject to different regulations which may be a barrier to enabling the system to work with ease.

oMSIS has limitations. States may be compared to each other, therefore the validity and completeness of encounter data and the gap created as a result of some states' not reporting their CHIP programs through MSIS are two specific operational issues that may affect the practicality of MISI to report Medicaid or CHIIP measures with comparability and consistency.

oStates, the federal government, providers, and enrollees benefit from standardization in data and quality measurement. States may use various types of quality measures for Medicaid and CHIP enrollees based on the sophistication of their information systems, expertise with quality measurement, and the availability of data for performance measurement and quality oversight. States and the federal government concur that everyone benefits when quality measurement and data used to develop the measurement are standardized.

Source: The George Washington University Medical Center