Use of Medicaid Payment Files for Medical Care Research

Concern for reliable medical care data is frequently expressed at the federal level of government. Such data are, however, already widely collected at the local level of government This paper demonstrates how a Department of Pediatrics can build a local data system for the child population, using household interviews and supplementing these with data abstracted from the local Medicaid payment files. The latter approach is of special importance for the evaluation of health centers designed to serve specific poverty areas. Major changes in the child health care system occurred in 1969. A new health center became fully operative in one of the two local poverty areas. Medicaid eligibility criteria were changed, the welfare rolls increased, and private practitioners began to withdraw from the Medicaid program after a 20 per cent fee cut was enacted. The Medicaid payment files of 1968 and 1970 were therefore compared to study the effects of these changes. The health center provided 10,000 more services to children in the target area, which led to a decrease of 2,000 hospital clinic visits, 500 private doctor visits, and 300 private dentist visits. In contrast, the second poverty area had 2,000 more privnte doctor visits, 1,000 more private dentist visits, 400 more hospital clinic visits and 600 more other clinic visits

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