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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) June 11, 2013

Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) June 11, 2013. AGENDA. Submission Guides Published APCD Version 3.0 Submission Timeline Testing Update Highlights of the Month – APCD Growth. Submission Guides Published . Medical, Pharmacy, Dental

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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) June 11, 2013

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  1. Massachusetts All-Payer Claims Database:Technical Assistance Group (TAG) June 11, 2013

  2. AGENDA • Submission Guides Published • APCD Version 3.0 Submission Timeline • Testing Update • Highlights of the Month – APCD Growth

  3. Submission Guides Published Medical, Pharmacy, Dental Product, Provider, Eligibility 6/10/2013 Benefit Plan Control Total Under final review

  4. DENTAL CLAIM UPDATE

  5. REMINDER:VERSION 3.0 SUBMISSION TIMELINE • PRODUCTION DATA NOW DUE NOVEMBER 2013 FOR OCTOBER 2013 DATA • THIS WILL ALLOW: • ADDITIONAL TIME FOR UPDATES • ADDITIONAL TIME FOR TESTING • DECREASE NEED FOR VARIANCES • DECREASE BURDEN ON PAYERS REQUESTED TO MEET OTHER DEADLINES AS WELL

  6. TESTING UPDATE • TESTING PROCESS • FORMAT TESTING ONLY • FULL EDIT TESTING

  7. APCD GROWTH • Where did we start? • Where are we now? • Where are we going?

  8. The APCD Builds on Core Competencies and Systems Case Mix Files – Discharge, ED, Observation(Acute Care Hospitals) Health Care Quality and Cost Council (Payers) All Payer Claims Database(Payers) 1982 2006 2010 2012 17

  9. APCD: DATA EVOLUTION

  10. Building the Data Warehouse User-Specific Views and WorkspacesConnector , TME, GIC, HPC, etc. Data Warehouse Data Enhancement/Standardization GroupersGeocoding Master Data ManagementMaster Patient Master Provider • As of June 2013 • Operational • In process • Funded through grants, but not started APCD Repository (Central) APCD FilesIntakeQuality Assurance 35

  11. Approved Applications to Date 32

  12. Current State Initiatives using APCD Data 31

  13. FUTURE STATE INITIAVES

  14. Administrative Simplification Selected Data Elements in the APCD • CHIA for Total Medical Expense, Cost TrendsNon Claims Payments, Payment Arrangement Type • Connector/Risk Adjustment for ACAIndicator Purchased thru HIX, Actuarial Value, Tobacco Use • Health Policy CommissionTotal Medical Expense • Group Insurance Commission • GIC ID • Division of InsuranceNAIC Code • Connector and DOIMonthly Premium, Employer ZIP, Family Size • Connector, DOI and GIC • Market Category Code • Connector, CHIA and DOI • Employer Contribution All Payer Claims Data Base Private and Public Payers 18

  15. WRAP-UP QUESTIONS?

  16. TAG SCHEDULE • JULY 9, 2013 at 2:00 PM • AUGUST 13, 2013 at 2:00 PM

  17. QUESTIONS • Questions emailed to APCD Liaisons • Questions emailed to DHCFP (CHIA-APCD@state.ma.us).  • Questions on the Data Release and Application emailed to DHCFP (apcd.data@state.ma.us)

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