Medicaid is a health insurance program for low-income parents, pregnant women, children, seniors, and people with disabilities. The Medicaid program is a jointly funded by the federal and state government and has been serving North Carolinians since 1970. In fiscal year 2017, there were 2.0 million Medicaid beneficiaries in North Carolina. Just like our larger health care system, improving health outcomes while reducing healthcare costs is the main challenge facing our Medicaid program. The Jordan Institute for Families has recently established a formal partnership between the University of North Carolina and the NC Department of Health and Human Services. The purpose of this partnership is to support the use of data to understand the needs of the NC Medicaid population and to test innovative strategies. The Jordan Institute is working with investigators from the Cecil G. Sheps Center for Health Services Research and several other units across campus to bring the most rigorous analytic methods to support the administration of the NC Medicaid program.
Click here to read North Carolina’s Medicaid and NC Health Choice Annual Report for State Fiscal Year 2017.
The UNC-DHHS partnership is one of many state-university partnerships across the country participating in the AcademyHealth learning network. The State-University Partnership Learning Network (SUPLN) is an ongoing collaboration that works to facilitate peer-to-peer learning and dialogue among states. This network is already providing valuable resources to our team.
As of August 2018, there are 8 approved analyses and 4 pending including topics such as, Using Medicaid Non-Expansion in North Carolina to Study Health Outcomes, Access and Quality of Buprenorphine Treatment for Opioid Use Disorder in Medicaid, Effectiveness of a Prison System-Based Medicaid Enrollment Program, and Healthcare Outcomes for Primary Care Medication Assisted Treatment.
Current Process to Access Medicaid Claims Data
Sheps Carolina Cost and Quality Initiative (http://www.shepscenter.unc.edu/data/bcbsnc-claims-data-ccqi/data-access-guidelines/requests-analytic-data/)
The CCQI Oversight Committee reviews all requests to use NC Medicaid data. The full approval process can take several months, depending on whether revisions are required.
The CCQI Oversight Committee uses the following criteria to evaluate data requests:
- Is the research question one that is in keeping with the overall focus of the Initiative and important to be answered, for North Carolinians or the US health system as a whole, either from a policy or practice perspective?
- Can the research question be adequately answered using the requested database? Are there an adequate number of cases to be studied for the proposed analysis? Are the right data elements available and specified? For the key data elements needed, is the quality of the data adequate?
- Is the proposed methodology sound and viable with respect to the research questions, population and data requested?
- Does the research team possess the requisite skills/experience and proposed resources to conduct the research with high standards and in an adequately specified time frame?
In addition to approval by the CCQI oversight committee, requests will also be reviewed by relevant committees at the North Carolina Division of Medical Assistance. The entire review process will be coordinated by the CCQI project manager.
Documents Required for ALL Data Requests
- CCQI Data Request Form
- IRB approval (in PDF, on UNC IRBIS letterhead)
Additional Documents Required for NC Medicaid Data Requests