Medicaid Administrative Data Training

What is Medicaid?

Medicaid is a public benefit program that provides health insurance and medical services to eligible individuals. Across the country, Medicaid is the nation’s single largest health insurer, covering more than 93 million adults and children as of January 2023—nearly 28 percent of the U.S. population.

Medicaid is financed by state and federal governments and is administered by states. The Centers for Medicare & Medicaid Services (CMS) oversees the Medicaid program. Medicaid providers must submit information to its state Medicaid administrator for reimbursement or payment of bills, resulting in a wealth of Medicaid health services utilization and administrative data.

States use Medicaid administrative data to comply with CMS reporting requirements to sustain federal support for state Medicaid programs. Aside from these purposes, Medicaid administrative data have also proven to be a powerful tool used by state, local, and federal agencies to improve the delivery of Medicaid program services as well as researchers dedicated to informing Medicaid program and policy decision makers.

While transparency and access to Medicaid administrative data have increased in the last decade, at both the federal and local levels, the knowledge and training of how to utilize that data has remained relatively unchanged. An extensive environmental scan proves quality Medicaid administrative data analysis training opportunities are nonexistent. Further, Medicaid administrative data were fashioned to obtain reimbursement and were not designed for the purposes of researchers.

Health Affairs Institute is addressing the expressed market need for a high-quality and comprehensive Medicaid administrative data analysis training to build analytic capacity, increase the responsible use of Medicaid administrative data for public impact research purposes, and support ongoing Medicaid delivery system reform.

About the courses

Health Affairs Institute has developed two levels of asynchronous Medicaid Administrative Data Analysis courses featuring the following components:

• Comprehensive online asynchronous training
• Modules, divided into introductory and advanced sections
• Assessments with overall competency assessment
• Learning reflections
• Technical and subject matter expert assistance

Introductory

This 10-week asynchronous course provides a comprehensive insight into the data structure and formation of variables in Medicaid administration administrative data. It demonstrates with real-world applications how to analyze administrative data efficiently using SAS programming as well as advanced analytics measures.  Space is limited.

Advanced

This 12-week asynchronous course is intended for researchers and healthcare employees who want to gain a better understanding of the complex data structure and formation of variables in Medicaid administrative data. It demonstrates with real-world application on how to analyze data efficiently as well as advanced analytics measures. This in turn enables the learner to leverage the enriched health information in Medicaid administrative data for a wide range of research and health practice topics, including evaluation of health policy; assessment of treatment effectiveness; estimation of health services costs; risk factors associated with diseases and medical conditions; social inequity in accessing healthcare services, and more. Space is limited.

Course Outcomes

By the end of the course, introductory learners will be able to:  

• Identify data structure and formation of variables in Medicaid administrative data. 
• Examine the relational nature of enrollment tables, professional tables, facility tables, and pharmacy tables in the data. 
• Explain the nature of research that could be performed using Medicaid administrative data, including its limitations. 

By the end of the course, advanced learners will be able to:

• Develop an insight into advanced analytics using Medicaid data, such as HEDIS measures. 
• Apply common SAS/SQL queries in combination with MACRO to analyze claim data efficiently. 
• Independently perform a thesis-level analysis on Medicaid data. 

Introduction course learners who pass the final assessment will receive a certificate of completion and digital badge. Advanced course learners who wish to bypass the introduction course will need to pass a pre-assessment before starting the course. Upon completion of the advanced course, learners will receive a certificate of completion and digital badge.

Registration Fees

Introductory course: $3,500 per participant (WVU rate $1,750*)

Advanced​ course: $4,750 per participant (WVU rate $2,375*)

Introductory and Advanced course group rates: Reduced rates are available when 10 people are registered from the same organization. Please email ProEducation@hsc.wvu.edu for more information.

*West Virginia University students, faculty, and staff all qualify. Email ProEducation@hsc.wvu.edu to receive the discount code.

Refund Policy

Introductory course: We honor course fee refunds of up to 90 percent that are requested no later than one week after the course start date. The remaining percentage not refunded is for processing the refund. Refunds should be requested by emailing ProEducation@hsc.wvu.edu.

Advanced course: We honor course fee refunds of up to 90 percent that are requested no later than one day prior to the course start date. The remaining percentage not refunded is for processing the refund. Refunds should be requested by emailing ProEducation@hsc.wvu.edu.