Nationwide Adult Medicaid CAHPS

Nationwide Adult Medicaid CAHPS Data Repository Codebook Version:.0 Date: December, 0

Table of Contents Table of Contents... About the National Adult Medicaid CAHPS... Purpose of this Document... Introduction to the NAM CAHPS Data Repository... Limited Dataset File File Layout... Claims Beneficiary Identifier File File Layout... Data Security and Privacy... About the National Adult Medicaid CAHPS The Nationwide Adult Medicaid CAHPS (NAM CAHPS), sponsored by the Centers for Medicare & Medicaid Services (CMS), is the first of its kind intended to capture baseline national and state-level estimates of adult Medicaid enrollees experiences with the health care system. The survey was conducted in the fall of 0 and was based on a nationwide sample of roughly,000 adult Medicaid enrollees from each state. The survey provides measures of access, barriers to care, satisfaction with providers, and customer service ratings, as well as indicators of the experiences of adult Medicaid enrollees who obtain care from managed care or fee-for-service providers. While many states currently conduct a CAHPS survey of adults covered by Medicaid, the NAM CAHPS survey offers a standardized instrument, with respondents sampled using a consistent methodology from 6 states and the District of Columbia (subsequently referred to as states ) and surveyed in a similar timeframe. The survey results are intended to assist CMS, states, and other stakeholders in improving Medicaid enrollees experiences in the health care system. Purpose of this Document CMS established the NAM CAHPS Data Repository to provide researchers, with appropriate permissions, the ability to analyze the NAM CAHPS microdata. This document provides an overview of the NAM CAHPS Data Repository and its contents for researchers interested in obtaining NAM CAHPS microdata for their research and also serves as a job aide for researchers that have gained access to familiarize themselves with the data. Alaska, New Hampshire, rth Dakota, Wisconsin chose not to participate in the Nationwide Adult Medicaid CAHPS and are therefore not a part of the sample.

Introduction to the NAM CAHPS Data Repository The NAM CAHPS Data Repository consists of two sets of tables. The Limited Data Sets (LDSs) are survey respondent level datasets containing each respondent s survey respondent ID (SID) and their responses to questions from the Nationwide CAHPS. The Claims Beneficiary Identifier Files (CBIFs) contain each respondent s survey respondent ID (SID) and its concordance to the respondent s security numbers (SSNs) and Medicaid Statistical Information System Identification Numbers (MSIS-IDs). These identifiers were obtained from the respondent s MSIS claims eligibility records, the database from which the NAM CAHPS Sample was drawn. The Claims Beneficiary Identifier File (CBIF) is only available to researchers who have applied for and been granted access to the NAM CAHPS Research Identifiable File (RIF). For researchers who have obtained this permission, they will find that the majority of survey respondents have both a social security number (SSN) and an MSIS Identification Number. The primary method for linking NAM CAHPS survey response data with claims can be achieved through matching the MSIS ID of the respondent in the Claims Beneficiary ID file. More information on linking the NAM CAHPS with Medicaid claims can be found in Guidance on Linking Survey Data with Medicaid Claims Data. Tables from the NAM CAHPS Data Repository are made available by state and at the U.S. level and are distributed based on what is requested in the Data Use Agreement (DUA) request. The Data Repository contains two tables (one LDS and one CBIF) for each state that participated in the NAM CAHPS. Furthermore, NAM CAHPS data is available in SAS and ASCII formats. Also made available through the Data Repository are SAS Infile programs for each table. Limited Dataset File File Layout SID MEMBER UNIQUE ID Char - STRATUM ENROLLEE STRATUM Char 0 - AGENCY STATE MEDICAID AGENCY NAME Char 0 - MC_NAME MANAGED CARE NAME Char 0 - LANGUAGE SURVEY LANGUAGE Num English Spanish Other Language STATE STATE OF MEMBER Char AL Alabama AR Arkansas AZ Arizona CA California CO Colorado CT Connecticut DC District of Columbia DE Delaware

FL Florida GA Georgia HI Hawaii IA Iowa ID Idaho IL Illinois IN Indiana KS Kansas KY Kentucky LA Louisiana MA Massachusetts MD Maryland ME Maine MI Michigan MN Minnesota MO Missouri MS Mississippi MT Montana NC rth Carolina NE Nebraska NJ New Jersey NM New Mexico NV Nevada NY New York OH Ohio OK Oklahoma OR Oregon PA Pennsylvania RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VA Virginia VT Vermont WA Washington WV West Virginia WY Wyoming Q. Our records show that in the last six months you were enrolled in (AGENCY). Is that right? Num

Q. In the last 6 months, did you have an illness, injury, or condition that needed care right away in a clinic, emergency room, or doctor's office? Num Q. In the last 6 months, when you needed care right away, how often did you get care as soon as you needed? Num Q. About how long has it been since you last visited a doctor for a check-up? Num Within the past year (anytime less than months ago) Within the past years ( year but less than years ago) Within the past years ( years but less than years ago) or more years ago Q6 6. In the last 6 months, did you make any appointments for a check-up or routine care at a doctor's office or clinic? Num Q. In the last 6 months, how often did you get an appointment for a check-up or routine care at a doctor's office or clinic as soon as you needed? Num Q. In the last 6 months, how many times did you go to an emergency room to get care for yourself? Num 0 ne

to 6 0 or more Q. What was the main reason for your last emergency room visit? Num 0 Didn't have a doctor Doctor's office or clinic was not open The problem was too serious for the doctor's office or clinic Get most of your care at the emergency room Doctor's office was open, but could not get an appointment Q0 0. In the last 6 months, not counting the times you went to an emergency room, how many times did you go to a doctor's office or clinic to get health care for yourself? Num 0 6 ne to 0 or more Q. In the last 6 months, did you and a doctor or other health provider talk about specific things you could do to prevent illness? Num Q. In the last 6 months, did you and a doctor or other health provider talk about starting or stopping a prescription medicine? Num Q. When you talked about starting or stopping a prescription medicine, how much did a doctor or Num t at all A little

other health provider talk about the reasons you might want to take a medicine? Some A lot Q. When you talked about starting or stopping a prescription medicine, how much did a doctor or other health provider talk about the reasons you might not want to take a medicine? Num t at all A little Some A lot Q. When you talked about starting or stopping a prescription medicine, did a doctor or other health provider ask you what you thought was best for you? Num Q6 6. Using any number from 0 to 0, where 0 is the worst health care possible and 0 is the best health care possible, what number would you use to rate all your health care in the last 6 months? Num 0 6 0 0 Worst health care possible 6 0 Best health care possible

Q. In the last 6 months, how often was it easy to get the care, tests, or treatment you needed? Num Q. In the last 6 months, how often was it easy to get special medical equipment, such as a cane, a wheelchair, diabetic testing supplies, or a nebulizer, you needed? Num Did not need special medical equipment in the last 6 months Q. In the last 6 months, how often was it easy to get the mental health or behavioral health services you needed? Num Did not need these services in the last 6 months Q0 0. In the last 6 months, how often was it easy to get the dental services you needed? Num Did not need these services in the last 6 months Q. In the last 6 months, were you ever not able to get medical care, tests, or treatment you or a doctor believed necessary? Num Q. What is the main reason you were not able to get medical care, tests, or treatment you or a doctor believed necessary? Num 0 Couldn't afford care My health plan wouldn't approve, cover, or pay for care Doctor refused to accept my insurance

Doctor doesn't speak my language Couldn't get transportation to doctor's office Couldn't take time off work or get child care 6 Didn't know where to go to get care The wait took too long Q. Is there a place that you usually go to when you are sick or need advice about your health? Num QA A. Why don't you have a usual source of medical care? Is it because... You haven't had any problems? Num 0 QB B. Why don't you have a usual source of medical care? Is it because... doctors take your insurance? Num 0 QC C. Why don't you have a usual source of medical care? Is it because... doctors speak your language? Num 0 QD D. Why don't you have a usual source of medical care? Is it because... The doctor's office is too far away or not convenient? Num 0 QE E. Why don't you have a usual source of medical care? Is it because... You don't plan to see a doctor even when you're sick? Num 0

Q. What kind of place do you go to most often for your medical care? Num 6 Clinic or health center Doctor's office or HMO Hospital emergency room Hospital outpatient department Some other place Don't go to one place most often Q6 6. A personal doctor is the one you would see if you need a check-up, want advice about a health problem, or get sick or hurt. Do you have a personal doctor? Num Q. In the last 6 months, how many times did you visit your personal doctor to get care for yourself? Num 0 6 ne to 0 or more Q. In the last 6 months, how often did your personal doctor explain things in a way that was easy to understand? Num Q. In the last 6 months, how often did your personal doctor listen carefully to you? Num

Q0 0. In the last 6 months, how often did your personal doctor show respect for what you had to say? Num Q. In the last 6 months, how often did your personal doctor spend enough time with you? Num Q. In the last 6 months, did you get care from a doctor or other health provider besides your personal doctor? Num Q. In the last 6 months, how often did your personal doctor seem informed and up-to-date about the care you got from these doctors or other health providers? Num Q. Using any number from 0 to 0, where 0 is the worst personal doctor possible and 0 is the best personal doctor possible, what number would you use to rate your personal doctor? Num 0 0 Worst personal doctor possible

6 6 0 0 Best personal doctor possible Q. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of health care. In the last 6 months, did you make any appointments to see a specialist? Num Q6 6. In the last 6 months, how often did you get an appointment to see a specialist as soon as you needed? Num Q. How many specialists have you seen in the last 6 months? Num 0 ne specialist specialists specialists specialists or more specialists Q. We want to know your rating of the specialist you saw most often in the last 6 months. Using any number from 0 to 0, where 0 is the worst specialist possible and 0 is the best specialist Num 0 0 Worst specialist possible

possible, what number would you use to rate that specialist? 6 0 6 0 Best specialist possible Q. In the last 6 months, how often did your health plan's customer service give you the information or help you needed? Num Did not try to get information or help Q0 0. In the last 6 months, how often did your health plan's customer service staff treat you with courtesy and respect? Num Q. Using any number from 0 to 0, where 0 is the worst health plan possible and 0 is the best health plan possible, what number would you use to rate your health plan? Num 0 6 0 0 Worst health plan possible 6 0 Best health plan possible

Q. In general, how would you rate your overall health? Num Excellent Very Good Good Fair Poor Q. In general, how would you rate your overall mental or emotional health? Num Excellent Very Good Good Fair Poor QA A. Has a doctor ever told you that you had any of the following conditions? High cholesterol? Num QB B. Has a doctor ever told you that you had any of the following conditions? High blood pressure? Num QC C. Has a doctor ever told you that you had any of the following conditions? A heart attack? Num QD D. Has a doctor ever told you that you had any of the following conditions? Angina or coronary heart disease? Num

QE E. Has a doctor ever told you that you had any of the following conditions? A stroke? Num QF F. Has a doctor ever told you that you had any of the following conditions? Any kind of diabetes or high blood sugar? Num QG G. Has a doctor ever told you that you had any of the following conditions? Cancer, other than skin cancer? Num QH H. Has a doctor ever told you that you had any of the following conditions? Emphysema, asthma or COPD (chronic obstructive pulmonary disease)? Num Q. Are you deaf or do you have serious difficulty hearing? Num Q6 6. Are you blind or do you have serious difficulty seeing, even when wearing glasses? Num Q. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? Num

Q. Do you have serious difficulty walking or climbing stairs? Num Q. Do you have difficulty dressing or bathing? Num Q0 0. In the last month, did you ever go without showering/taking a bath/washing up because no one was there to help? Num Q. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping? Num Q. In the last month, did you ever have to stay home because you had difficulty going out by yourself? Num Q. Have you had either a flu shot or flu spray in the nose within the past year? Num Don't know Q. Do you now smoke cigarettes or use tobacco every day, some days, or not at all? Num Every day Some days t at all Don't know

Q. In the last 6 months, how often were you advised to quit smoking or using tobacco by a doctor or other health provider in your plan? Num Q6 6. In the last 6 months, how often was medication recommended or discussed by a doctor or health provider to assist you with quitting smoking or using tobacco? Num Q. In the last 6 months, how often did your doctor or health provider discuss or provide methods and strategies other than medication to assist you with quitting smoking or using tobacco? Num Q. Do you take aspirin daily or every other day? Num Don't know Q. Do you have a health problem or take medication that makes taking aspirin unsafe for you? Num Don't know

Q60 60. Has a doctor or health provider ever discussed with you the risks and benefits of aspirin to prevent heart attack or stroke? Num Q6 6. In the last 6 months, did you get health care or more times for the same condition or problem? Num Q6 6. Is this a condition or problem that has lasted for at least months? Num Q6 6. Do you now need or take medicine prescribed by a doctor? Num Q6 6. Is this medicine to treat a condition that has lasted for at least months? Num Q6 6. What is your age? Num to to to to to 6 6 6 to or older Q66 66. Are you male or female? Num Male

Female Q6 6. What is the highest grade or level of school that you have completed? Num 6 th grade or less Some high school, but did not graduate High school graduate or GED Some college or -year degree -year college graduate More than -year college degree Q6A 6A. Are you of Hispanic, Latino/a or Spanish origin? Num 0 Q6B 6B. Are you of Mexican, Mexican American, Chicano/a origin? Num 0 Q6C 6C. Are you of Puerto Rican origin? Num 0 Q6D 6D. Are you of Cuban origin? Num 0 Q6E 6E. Are you of another Hispanic, Latino, or Spanish origin? Num 0 Q6A 6A. I am going to read a list of race categories. Are you White? Num 0 Q6B 6B. I am going to read a list of race categories. Black or African-American? Num 0 Q6C 6C. I am going to read a list of race categories. American Indian or Alaska Native? Num 0 Q6D 6D. I am going to read a list of race categories. Asian Indian? Num 0

Q6E 6E. I am going to read a list of race categories. Chinese? Num 0 Q6F 6F. I am going to read a list of race categories. Filipino? Num 0 Q6G 6G. I am going to read a list of race categories. Japanese? Num 0 Q6H 6H. I am going to read a list of race categories. Korean? Num 0 Q6I 6I. I am going to read a list of race categories. Vietnamese? Num 0 Q6J 6J. I am going to read a list of race categories. Other Asian? Num 0 Q6K 6K. I am going to read a list of race categories. Native Hawaiian? Num 0 Q6L 6L. I am going to read a list of race categories. Guamanian or Chamorro? Num 0 Q6M 6M. I am going to read a list of race categories. Samoan? Num 0

Q6N 6N. I am going to read a list of race categories. Other Pacific Islander? Num 0 Q6O 6O. I am going to read a list of race categories. Some other race? Num 0 Q0 0. Did someone help you complete this survey? Num QA a. How did that person help you? Read the questions to me Num 0 QB b. How did that person help you? Wrote down the answers I gave Num 0 QC c. How did that person help you? Answered the questions for me Num 0 QD d. How did that person help you? Translated the questions into my language Num 0 QE e. How did that person help you? Helped in some other way Num 0 FINALWEIGHT STANDARD FINAL WEIGHT Num - STATE_STRATUM COMBINED STATE AND STRATUM Num - MODE SURVEY MODE Num Phone Mail

Claims Beneficiary Identifier File File Layout STATE STATE OF MEMBER Char AL Alabama AR Arkansas AZ Arizona CA California CO Colorado CT Connecticut DC District of Columbia DE Delaware FL Florida GA Georgia HI Hawaii IA Iowa ID Idaho IL Illinois IN Indiana KS Kansas KY Kentucky LA Louisiana MA Massachusetts MD Maryland ME Maine MI Michigan MN Minnesota MO Missouri MS Mississippi MT Montana NC rth Carolina NE Nebraska NJ New Jersey NM New Mexico NV Nevada NY New York OH Ohio OK Oklahoma OR Oregon PA Pennsylvania RI Rhode Island SC South Carolina SD South Dakota TN Tennessee TX Texas UT Utah VA Virginia VT Vermont

WA Washington WV West Virginia WY Wyoming SID MEMBER UNIQUE ID Char - MSIS_ID MSIS ID NUMBER Char - SSN SOCIAL SECURITY NUMBER Char - Data Security and Privacy The separation of Personally Identifying Information (PII) in the CBIF is a continuation of the data management practices used throughout the sampling and administration of the NAM CAHPS survey. In addition to the unique personal identifiers in the CBIF, respondents SSNs and MSIS Identification Numbers, NORC considers enrollees names, addresses, and telephone numbers to be PII, and protects them accordingly. Compiling of data from MSIS and state MMIS systems was subject to a Data Usage Agreement between NORC and CMS, and an independent Data Governance Board provided recommendations and oversight. All data transfers, whether with CMS, states, or NORC s survey administration subcontractor, were conducted using NORC s FIPS 0- compliant secure FTP server. Any PII transmitted is encrypted using a 0-bit RSA algorithm, and, once received, reside behind an IDS/IPS firewall on a restricted-access analytic server, which resides in the NORC corporate datacenter. This facility meets NIST 00- security requirements and is constantly monitored.