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Data Infrastructure Supporting Research on Refugee Medicaid Service Utilization and Outcomes

Data Infrastructure Supporting Research on Refugee Medicaid Service Utilization and Outcomes
  • Administration for Children and Families (ACF)
  • Office of the Assistant Secretary for Planning and Evaluation (ASPE)- Human Services Policy (HSP)
Start Date
  • 03/01/23
  • Linking Clinical Data and Other Data for Research
  • Use of Publicly-Funded Data Systems for Research


STATUS: Active Project


The United States refugee resettlement program is the largest in the world, welcoming over three million people since the 1970s. Refugees may arrive with health issues and health care needs and can receive various benefits and services through the refugee resettlement program in the Administration for Children and Families’ (ACF) Office of Refugee Resettlement (ORR). Practitioners, programs managers, and policymakers need access to strong, high-quality evidence to understand and improve the services provided to refugees, and the impact on their health and well-being. However, limitations in the availability of relevant data on refugee populations, including data on health outcomes, access to and utilization of health services, and social determinants of health (SDOH), make it difficult for researchers to conduct the patient-centered outcomes research (PCOR) studies needed to generate this evidence to inform decisions and improve health outcomes.

To address these gaps, this project will develop, implement, and evaluate methods for linking data from two HHS administrative data systems:

  • The Office of Refugee Arrivals Data System (RADS) contains information on refugee demographics and services provided.
  • The Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF), managed by the Centers for Medicare and Medicaid Services (CMS), contain data on Medicaid enrollment and claims, and over 60% of recently arrived refugees were estimated to have Medicaid coverage.

By linking these datasets (and evaluating the quality of the result linkages), the project will strengthen data infrastructure for conducting PCOR studies with refugee populations. The resulting linked datasets will enable researchers to address critical PCOR questions about the outcomes and effects of policies and programs designed to increase access to and improve quality of services and care, including, but not limited to, refugees’ long-term health trajectories; maternal health and infant outcomes; and interventions to increase access to preventive care.


The overarching goal of this project is to advance data capacity for patient-centered outcomes research by developing, evaluating, and supporting researchers’ use of linked datasets on refugees served by the Medicaid program.

  • Develop and evaluate linked TAF and RADS dataset
  • Produce research dataset and documentation, including publicly available user guide
  • Create data products for public use on refugee health