ASSESSMENT OF OVERALL DATA QUALITY AND COMPLETENESS

*VERMONT* 1999 TABLES

Nine tables for each State show the use of mental health and other
services by Medicaid beneficiaries with mental health diagnoses in 1999.
Enrollment and claims data from the Medicaid Analytic eXtract (MAX)
files from the Centers for Medicare & Medicaid Services (CMS) are the
source for these analyses. Because Medicaid programs differ across the
States, and because administrative data vary in completeness and
quality, caveats about the State's data should be considered in
interpreting the information contained in these tables.

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  **Vermont Data Comments**
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  **Dual Eligibles:** Vermont reported all dual eligibles as having full
  Medicaid benefits although Medicaid benefits for many of its dual
  eligibles included only limited pharmacy benefits (under a Pharmacy
  Plus waiver).

  **Diagnosis Codes:** Diagnosis coding on claims was relatively
  complete. However, in Vermont, nearly all OT claims report apparent
  diagnoses, including many where the service provider would not be
  expected to know the diagnosis. This might be a factor in the state's
  relatively high apparent rate of MH beneficiaries.

  **Race:** Approximately 33 percent of enrollees were reported with
  unknown race.

  **Enrollment:** Vermont\'s enrollment was not consistently reported
  across months within each quarter. Since we excluded services provided
  during months where no enrollment was reported, these tables may
  understate utilization and expenditures.

  **Inpatient Days:** Vermont's inpatient crossover claims rarely
  included covered days. This causes inpatient hospital stays for groups
  of Medicaid beneficiaries that include a high proportion of dual
  eligibles (most aged and many disabled beneficiaries) to average "1"
  day in length, and explains the other low numbers that appear for some
  groups on Table 4.
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+----------------------+--------+-------+----------+-------+----------+
| **Percent of         |        |       |          |       |          |
| Beneficiaries        |        |       |          |       |          |
| Excluded in Vermont  |        |       |          |       |          |
| Eligibility Group**  |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+
|                      | *      | **A   | **Di     | **Ad  | **Ch     |
|                      | *All** | ged** | sabled** | ult** | ildren** |
+----------------------+--------+-------+----------+-------+----------+
| **Beneficiaries**    | 102022 | 17328 | 17660    | 28707 | 38327    |
|                      |        |       |          |       |          |
| **Included**         |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+
| **Beneficiaries**    | 39978  | 5     | 129      | 14554 | 25290    |
|                      |        |       |          |       |          |
| **Excluded Because** |        |       |          |       |          |
|                      |        |       |          |       |          |
| **of Managed Care**  |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+
| **Percent of**       | 28%    | 0%    | 1%       | 34%   | 40%      |
|                      |        |       |          |       |          |
| **Beneficiaries**    |        |       |          |       |          |
|                      |        |       |          |       |          |
| **Excluded Because   |        |       |          |       |          |
| of**                 |        |       |          |       |          |
|                      |        |       |          |       |          |
| **Managed Care**     |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+