ASSESSMENT OF OVERALL DATA QUALITY AND COMPLETENESS

*VIRGINIA* 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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  **Virginia Data Comments**
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  **Excluded Services:** Virginia's MAX data are missing a significant
  share of home- and community-based waiver services; this omission does
  not significantly affect identification of beneficiaries with mental
  health conditions, but does mean that total expenditures are
  understated.

  **Diagnosis Codes:** Diagnosis coding on claims was relatively
  complete, with no known quality problems.

  **Inpatient Days:** Virginia'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 Virginia |        |       |          |       |          |
| Eligibility Group**  |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+
|                      | *      | **A   | **Di     | **Ad  | **Ch     |
|                      | *All** | ged** | sabled** | ult** | ildren** |
+----------------------+--------+-------+----------+-------+----------+
| **Beneficiaries**    | 611194 | 94758 | 120344   | 84378 | 311714   |
|                      |        |       |          |       |          |
| **Included**         |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+
| **Beneficiaries**    | 85222  | 595   | 12365    | 13222 | 59040    |
|                      |        |       |          |       |          |
| **Excluded Because** |        |       |          |       |          |
|                      |        |       |          |       |          |
| **of Managed Care**  |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+
| **Percent of**       | 12%    | 1%    | 9%       | 14%   | 16%      |
|                      |        |       |          |       |          |
| **Beneficiaries**    |        |       |          |       |          |
|                      |        |       |          |       |          |
| **Excluded Because   |        |       |          |       |          |
| of**                 |        |       |          |       |          |
|                      |        |       |          |       |          |
| **Managed Care**     |        |       |          |       |          |
+----------------------+--------+-------+----------+-------+----------+