Arkansas APCD Universe Counts for Data Request Support

Transcription

1 Arkansas APCD Universe Counts for Data Request Support Version August, 2018

2 Arkansas APCD Universe Counts This information provides highlevel counts by submitting entity type, as well as month and year to help data requestors understand how many individuals and claims are contained within the Arkansas APCD Data requestors can use these counts to inform the design of their data request Data request process information can be found here: For questions about a data request or pricing: Reach out to adrs@achiapcd.atlassian.net 2

3 Supporting Information The Arkansas APCD does not contain an absolute identifier that represents enrollees longitudinally or across submitting entities (SEs) Distinct enrollees are counted for each SE (carrier/payer) by month and year and totaled to get the counts provided It is possible that individuals who have migrated between SEs within a year will be counted more than once Arkansas APCD is updated twice annually Counts will change based on data received from each updated data warehouse 3

4 Arkansas APCD Enrollee Age & Gender Counts by Year Commercial Carriers Ages (Male) Ages (Female) Year <1 1 to to to to <1 1 to to to to , , , , ,964 19,301 3, , , , ,505 43, , , , , ,558 23,624 3, , , , ,908 51, , , , , ,146 27,814 3, , , , ,565 57, , , , , ,616 32,032 3, , , , ,419 66, , , , , ,970 30,090 4, , , , ,431 62,463 Arkansas Medicaid Ages (Male) Ages (Female) Year <1 1 to to to to <1 1 to to to to , , ,751 56,756 43,935 37,185 13, , , ,046 70,143 98, , , ,641 94,971 46,269 39,463 13, , , ,120 72, , , , , ,911 48,640 41,829 13, , , ,330 75, , , , , ,402 51,160 44,147 13, , , ,520 77, , , , , ,253 51,724 44,395 14, , , ,023 78, ,735 Arkansas Medicare Ages (Male) Ages (Female) Year <1 1 to to to to <1 1 to to to to ,060 72, ,639 60, ,264 66, , , ,980 73, ,791 67, ,182 68, , , ,631 74, ,960 75, ,855 69, , , ,157 74, ,994 83, ,269 69, , ,069 4

5 Arkansas APCD Enrollee Age & Gender Counts by Year Arkansas Workers Compensation Commission Ages (Male) Ages (Female) <1 1 to to to to <1 1 to to to to ,252 1, , ,105 1, , ,038 2, ,256 1, ,183 1, ,080 1,

6 Commercial Enrollees by Month & Year 2,500,000 2,000,000 1,500,000 1,000, , ,404,338 1,405,513 1,411,980 1,415,178 1,418,208 1,422,901 1,427,410 1,432,495 1,440,155 1,449,824 1,454,003 1,459, ,608,190 1,625,054 1,646,193 1,679,004 1,728,804 1,739,884 1,755,712 1,768,538 1,781,209 1,792,916 1,834,675 1,844, ,902,803 1,905,534 1,927,049 1,929,088 1,931,658 1,940,791 1,942,999 1,946,609 1,947,311 1,949,112 1,954,672 1,956, ,065,341 2,075,709 2,088,520 2,090,646 2,092,011 2,098,481 2,104,802 2,107,018 2,114,274 2,116,562 2,119,515 2,097, ,180,393 2,177,421 2,169,038 2,158,984 2,153,382 2,136,701 2,127,990 2,124,732 2,071,260 2,068,817 2,064,234 2,043,304 This data table contains the count of distinct commercial carrier enrollees by month and year, including fully insured plans, third party administrators (TPA), and Qualified Health Plans (QHP), plus the statefunded, selfinsured Arkansas State Employee Benefits Division plan. Enrollees were counted once for each month and year falling within their enrollment start and end dates. For example, if an enrollee s enrollment start date is January 1, 2014, and enrollment end date is March 15, 2014, that individual would be counted once in the January 2014 column, once in the February 2014 column, and once in the March 2014 column. Table columns categorize counts by the enrollment start date. Table rows contain monthly member counts by year. 6

7 Qualified Health Plan Enrollees by Month & Year 450, , , , , , , ,000 50, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,718 This data table represents the count of distinct Qualified Health Plan (QHP) enrollees by month and year, including Arkansas Works enrollees regardless of the length of coverage period(s) for that year. Enrollees were counted once for each month and year falling within their enrollment start and end dates. For example, if an enrollee s enrollment start date is January 1, 2014, and enrollment end date is March 15, 2014, that individual would be counted once in the January 2014 column, once in the February 2014 column, and once in the March 2014 column. Table columns categorize counts by the enrollment start date. Table rows contain monthly member counts by year. Count fluctuations can be the result of the migration of enrollees between Arkansas Medicaid and QHPs. 7

8 Arkansas Works Enrollees by Month & Year 400, , , , , , ,000 50, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,283 This data table represents the count of distinct, active Arkansas Works enrollees by month and year regardless of the length of coverage period(s) for that year. Enrollees were counted once for each month and year falling within their enrollment start and end dates. For example, if an enrollee s enrollment start date is January 1, 2014, and enrollment end date is March 15, 2014, that individual would be counted once in the January 2014 column, once in the February 2014 column, and once in the March 2014 column. Table columns categorize counts by the enrollment start date. Table rows contain monthly member counts by year. 8

9 Commercial Medical Claims by Month & Year 1,400,000 1,200,000 1,000, , , , , , , , , , , , , , , , , , , , , , , , ,994 1,010,938 1,136, ,389 1,031, ,039, ,547 1,063,215 1,123,358 1,031,220 1,124,145 1,136,273 1,068,711 1,092,885 1,174,882 1,031,442 1,044, ,081,961 1,117,405 1,252,216 1,167,682 1,166,197 1,186,038 1,105,770 1,277,728 1,211,209 1,264,276 1,181,455 1,063, ,244,252 1,202,667 1,251,426 1,198,372 1,290,574 1,260,516 1,186,780 1,329,769 1,205,805 1,329,824 1,163, ,879 This data table contains the count of distinct medical claims by service month and year based on claim number (inpatient, outpatient, and professional claims) for commercial carriers, including fully insured plans, third party administrators (TPA), and Qualified Health Plans (QHP), plus the statefunded, selfinsured Arkansas State Employee Benefits Division plan. Unique claims were counted once for each month and year derived from the date services began. For example, if the month and year from the date services began are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the service began. Rows contain monthly counts by year. 9

10 Commercial Pharmacy Claims by Month & Year 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000, , ,711,884 1,576,082 1,774,192 1,717,221 1,842,723 1,667,267 1,778,581 1,758,424 1,664,648 1,839,272 1,822,579 1,878, ,921,181 1,837,285 1,917,007 1,969,137 2,024,632 1,971,713 2,091,390 2,035,810 2,174,562 2,290,984 2,170,867 2,378, ,181,152 1,991,981 2,172,687 2,175,162 2,078,291 2,080,409 2,222,021 2,095,635 2,145,042 2,228,906 2,163,114 2,354, ,264,895 2,158,195 2,578,182 2,430,064 2,444,228 2,629,064 2,430,953 2,555,017 2,861,872 2,739,598 2,741,166 2,823, ,584,926 2,454,510 2,876,348 2,587,461 2,879,633 2,643,050 2,547,146 2,745,462 2,597,273 2,690,049 2,689,828 3,010,254 This data table contains the count of distinct pharmacy claims by payment month and year based on claim number for commercial carriers, including fully insured plans, pharmacy benefits managers (PBMs), and Qualified Health Plans (QHP), plus the statefunded, selfinsured Arkansas State Employee Benefits Division plan. Unique claims were counted once for each month and year derived from the payment date. For example, if the month and year from the paid date are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the prescription was paid. Rows contain monthly counts by year. 10

11 Commercial Dental Claims by Month & Year 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10, ,722 41,937 42,952 44,816 42,114 44,562 50,976 45,513 38,155 45,329 40,373 39, ,493 41,518 42,572 45,844 40,986 45,822 52,020 44,041 40,967 44,943 40,552 50, ,765 38,930 47,917 49,507 41,587 52,172 54,408 55,968 60,526 62,524 59,925 70, ,408 63,601 70,984 61,863 63,731 74,088 66,579 75,695 59,559 63,129 64,950 68, ,818 64,446 70,944 62,086 69,486 74,096 68,757 77,379 59,326 68,455 64,686 57,466 This data table contains the count of distinct medical claims by service month and year based on claim number (inpatient, outpatient, and professional claims) for commercial carriers, including fully insured plans, third party administrators (TPA), and Qualified Health Plans (QHP). Unique claims were counted once for each month and year derived from the date services began. For example, if the month and year from the date services began are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the service began. Rows contain monthly counts by year. 11

12 Arkansas Medicaid Enrollees by Month & Year 800, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,687 This data table represents the count of distinct Arkansas Medicaid enrollees by month and year, regardless of the length of coverage period(s) for that year. Enrollees were counted once for each month and year falling within their enrollment start and end dates. For example, if an enrollee s enrollment start date is January 1, 2014, and enrollment end date is March 15, 2014, that individual would be counted once in the January 2014 column, once in the February 2014 column, and once in the March 2014 column. Table columns categorize counts by the enrollment start date. Table rows contain monthly member counts by year. 12

13 Arkansas Medicaid Medical Claims by Month & Year 2,000,000 1,800,000 1,600,000 1,400,000 1,200,000 1,000, , , , , ,674,402 1,507,898 1,520,149 1,619,555 1,561,335 1,407,488 1,592,010 1,538,167 1,561,551 1,757,966 1,478,502 1,337, ,703,900 1,508,674 1,543,701 1,690,639 1,611,425 1,558,278 1,729,829 1,618,794 1,746,323 1,851,407 1,504,025 1,581, ,694,637 1,421,816 1,610,838 1,737,552 1,582,285 1,608,434 1,711,625 1,629,762 1,712,341 1,835,398 1,607,955 1,580, ,649,114 1,657,525 1,764,562 1,671,687 1,632,313 1,613,323 1,576,763 1,750,936 1,730,363 1,766,961 1,656,920 1,516, ,737,693 1,668,881 1,740,237 1,620,685 1,690,832 1,582,862 1,567,273 1,722,215 1,604,045 1,753,003 1,548,881 1,384,379 This data table contains the count of distinct Arkansas Medicaid medical claims by service month and year based on claim number. Unique claims were counted once for each month and year derived from the date services began. For example, if the month and year from the date services began are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the service began. Rows contain monthly counts by year. 13

14 Arkansas Medicaid Pharmacy Claims by Month & Year 600, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,930 This data table contains the count of distinct Arkansas Medicaid pharmacy claims by payment month and year based on claim. Unique claims were counted once for each month and year derived from the payment date. For example, if the month and year from the paid date are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the prescription was paid. Rows contain monthly counts by year. 14

15 Arkansas Medicaid Dental Claims by Month & Year 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10, ,098 53,869 57,867 60,586 54,457 52,227 63,299 64,164 56,438 66,601 52,248 43, ,944 54,172 60,424 67,573 60,507 60,960 71,834 67,418 67,079 72,469 57,770 59, ,155 51,553 63,765 69,506 55,986 64,974 71,836 69,551 63,477 65,566 57,209 59, ,595 59,967 65,880 57,155 52,719 57,573 58,527 75,303 64,240 66,129 62,029 55, ,369 61,512 64,595 57,958 61,092 61,268 60,385 75,382 59,172 69,135 60,921 48,645 This data table contains the count of distinct Arkansas Medicaid dental claims by service month and year based on claim number. Unique claims were counted once for each month and year derived from the date services began. For example, if the month and year from the date services began are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the service began. Rows contain monthly counts by year. 15

16 Arkansas Medicare Members by Month & Year 900, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,315 This data table represents the count of distinct Arkansas Medicare enrollees (beneficiaries) by month and year, regardless of the length of coverage period(s) for that year. Enrollees were counted once for each month and year falling within their enrollment start and end dates. For example, if an enrollee s enrollment start date is January 1, 2014, and enrollment end date is March 15, 2014, that individual would be counted once in the January 2014 column, once in the February 2014 column, and once in the March 2014 column. Table columns categorize counts by the enrollment start date. Table rows contain monthly member counts by year. Medicare data is available only through Record counts from data requests may vary depending on request criteria. 16

17 Arkansas Medicare Medical Claims by Month & Year 1,400,000 1,200,000 1,000, , , , , ,213,402 1,070,216 1,109,483 1,182,415 1,156,812 1,077,776 1,159,618 1,157,969 1,132,841 1,290,026 1,055,944 1,046, ,208,082 1,045,684 1,110,205 1,207,750 1,147,670 1,131,036 1,182,803 1,132,254 1,182,113 1,300,888 1,054,152 1,160, ,204,920 1,005,898 1,191,849 1,239,237 1,137,507 1,207,005 1,204,251 1,176,352 1,219,685 1,319,258 1,144,937 1,190, ,165,252 1,200,981 1,266,977 1,203,302 1,212,719 1,229,783 1,129,585 1,287,884 1,227,557 1,283,672 1,198,365 1,144,458 This data table contains the count of distinct Arkansas Medicare medical claims by service month and year based on claim number. Unique claims were counted once for each month and year derived from the date services began. For example, if the month and year from the date services began are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the service began. Rows contain monthly counts by year. Medicare data is available only through Record counts from data requests may vary depending on request criteria. 17

18 Arkansas Medicare Pharmacy Claims by Month & Year 1,800,000 1,600,000 1,400,000 1,200,000 1,000, , , , , ,467,189 1,320,283 1,392,544 1,438,446 1,455,206 1,343,631 1,478,865 1,455,062 1,395,624 1,498,659 1,382,643 1,490, ,529,778 1,376,307 1,466,920 1,479,300 1,492,426 1,453,015 1,520,670 1,465,581 1,496,155 1,543,767 1,382,013 1,610, ,551,610 1,405,117 1,564,271 1,539,132 1,491,099 1,555,425 1,569,816 1,521,390 1,539,702 1,568,903 1,502,498 1,637, ,520,617 1,546,462 1,635,715 1,530,530 1,567,898 1,581,003 1,505,271 1,636,558 1,557,776 1,559,134 1,559,465 1,604,897 This data table contains the count of distinct Arkansas Medicare pharmacy claims by payment month and year based on claim. Unique claims were counted once for each month and year derived from the payment date. For example, if the month and year from the paid date are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the prescription was paid. Rows contain monthly counts by year. Medicare data is available only through Record counts from data requests may vary depending on request criteria. 18

19 Arkansas Workers Compensation Commission Claims by Month & Year This data table contains the count of distinct Arkansas Workers Compensation Commission claims by filing date and year based on claim. Unique claims were counted once for each month and year derived from the filing date. For example, if the month and year from the filing date are January 2014, the claim would be counted in the January 2014 column. Columns categorize counts by the month of the date the prescription was paid. Rows contain monthly counts by year. Arkansas Workers Compensation data includes claims data only. 19

20 Data Request Process and Forms Arkansas APCD data request information is located: Complete the data request packet using the process instructions at the above link Reach out to for questions about a data request or pricing 20