Opportunity for Public Comment: Proposed Additions to the List of Conditions Captured by Centers for Medicare and Medicaid Services' Chronic Conditions Warehouse Include HIV/AIDS

On April 17, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a request for public comment on a list of conditions and their related identification algorithms, which CMS proposes to add to its Chronic Conditions Warehouse (CCW). The public comment period will close on April 25, 2014.

The CCW is a database designed to improve the quality of care and reduce costs and utilization by supporting research on chronic conditions, as well as health policy analysis and evaluations of other CMS initiatives. The CCW provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across the continuum of care. In the past, researchers analyzing data files were required to perform extensive analysis related to beneficiary matching, deduplication, and merging of the files in preparation for their study analysis. With the CCW data, this preliminary linkage work is already accomplished and delivered as part of the data files sent to researchers.

Over the past few years, the CMS Medicare-Medicaid Coordination Office has been working to improve the utility of this database for researchers by expanding the 27 Medicare flags to Medicaid-only and Medicare-Medicaid dual enrollees as well as developing a number of additional condition flags. The third round condition list, which is now open for public comment, expands upon the previously released and now available mental health conditions (Round 1) and conditions related to developmental, intellectual and physical disability (Round 2). Like Rounds 1 and 2, while the conditions in this third Round were selected with dually eligible Medicare-Medicaid enrollees in mind, the final selected flags will be developed for all Medicare and Medicaid data.

The third round includes proposed condition indicators (or, “flags”) for HIV/AIDS and a number of related variables likely to be of particular interest to researchers and health policy analysts. The latter group includes the following:

1. HIV Screening
2. Antiretroviral Medication Use
3. HIV/AIDS Health Care Services Contact
4. HIV/AIDS program participation – participation in a demonstration, waiver program, health home or other initiative directly focusing on the HIV/AIDS population
5. SSA Disability-Qualifying Primary Diagnosis – Indication of HIV/AIDS diagnosis on SSA records {0 (none), 1 (Asymptomatic HIV Infection, 0440), 2 (Symptomatic HIV Infection, 0430); 3 (HIV Wasting Syndrome, 2630), 4 (HIV Encephalopathy, 3480)}
6. SSA Disability-Qualifying Secondary Diagnosis – Indication of HIV/AIDS diagnosis on SSA records {0 (none), 1 (Asymptomatic HIV Infection, 0440), 2 (Symptomatic HIV Infection, 0430); 3 (HIV Wasting Syndrome, 2630), 4 (HIV Encephalopathy, 3480)

CMS will accept public comments through April 25, 2014. The public notice is available at: https://www2.ccwdata.org/web/guest/condition-categoriesExit Disclaimer (bottom of the page, under the “Proposed Chronic Condition Indicators” header).