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I ntroduction
to Wisconsin Medicaid Statistics
Medicaid / BadgerCare caseload
statistics provide information about the number of individual Medicaid recipients who
are eligible to receive services from Medicaid-certified providers.
In contrast to some of the other caseload reports published by
the state, the caseload data on this Medicaid web site represents individuals
as opposed to households or cases.
Caseload data are gathered from the Medicaid Management Information System (MMIS) which
is operated by the Medicaid fiscal agent. The eligibility information in MMIS is collected
from a variety of sources including:
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The Client Assistance for Reemployment and Economic Support (CARES)
system which is operated by the Department of
Workforce Development.
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The federal Social Security Administration.
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Other governmental agencies involved in Medicaid certification, such as
child welfare agencies.
The information about monthly participation totals is both county- and
state-wide beginning in January 1998 and continuing to the present.
The Medicaid caseload is large and constantly changing as cases are
opened, closed and adjusted. Total participation over time, such as over a year, is much
higher than the monthly count of open cases. The data contained within the report is
updated monthly and reflects changes as cases are opened, closed, or adjusted.
Caseload Categories
The monthly caseload information is divided into three categories
and individually subtotaled. The three categories are:
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Family coverage includes:
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Recipients formerly known as Aid to Families with Dependent Children
(AFDC) and AFDC-related households.
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Healthy Start participants.
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Pregnant women certified under the presumptive eligibility program
Some cases are certified manually through paper transactions directly to
the MMIS system while the majority are certified through the CARES system. |
- Persons With Disabilities and Elderly Coverage.
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Persons with disabilities and elderly coverage
includes:
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SSI (Supplemental Security Income) and SSI-related households.
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Individuals residing in institutions such as nursing facilities.
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Individuals approved through the CARES system for coverage under a home
and community based waiver.
Individuals who are eligible for SSI are automatically eligible for
Medicaid and do not need to apply separately. |
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Other coverage includes:
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Tuberculosis-related cases.
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Medicare beneficiaries who have applied and are eligible for Medicaid
assistance with their Medicare premiums.
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Foster care children.
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Subsidized adoption cases.
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Information about Wisconsin's Uninsured Families
Listed below are additional reports for the Wisconsin
Medicaid program:
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Number and
Proportion Without Health Insurance by Region in Wisconsin
On any one day, how many people in Wisconsin are uninsured? These tables
provide estimates of people without any health insurance at one point in time, sometimes
called a "snapshot" of the population. Overall, 9 percent of Wisconsin
residents were uninsured at any one point in time during 1995-1997. (The length of time
people remain uninsured varies considerably. During 1997, only 5 percent of respondents to
this Wisconsin survey had been uninsured for a full year.A national survey estimates 8
percent of Wisconsin residents were uninsured during all of 1997. See Technical
Information section within this report.)
People lacking health insurance in each of the five Department of Health and Family
Services regions are described in these tables, alongside comparable information for the
entire state.
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Family Health Survey
statistics
The Wisconsin Family Health Survey (FHS) was started in 1989 to collect information about
the health status, health problems, health insurance coverage, and use of health care
services among Wisconsin residents. This survey is conducted on a continuous basis,
collecting information every month. A random sample of households is telephoned by trained
interviewers, who speak with the household member most knowledgeable about the health of
all household members. This respondent provides information for all people living in the
household at the time of the interview.
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