Minnesota All Payer Claims Database Public Use File Workgroup Meeting 2: Initial Public Use Files

Transcription

1 Minnesota All Payer Claims Database Public Use File Workgroup Meeting 2: Initial Public Use Files February 8, 2016 Kris Van Amber Senior Management Consultant Management Analysis & Development Minnesota Management & Budget Linda Green Vice President, Programs Freedman HealthCare

2 Agenda Welcome and Overview Types of Public Use Files PUF Support and Logistics Public Comment Next Steps and Adjourn 40 minutes 50 minutes 15 minutes 10 minutes 5 minutes 2

3 MEETING GOALS AND PROJECT OVERVIEW 3

4 Goals of Today s Meeting Update the Workgroup on the trajectory of the Public Use File (PUF) development process Gather feedback from the Workgroup on the development and release of the initial PUFs in March 2016 Discuss key considerations for PUF data release/access Share plans for presenting the PUFs to the user community and gathering feedback 4

5 Overview of the MN APCD PUFs Legislature s requirements for MN APCD Public Use Files: Summary data must be made available to the public Data about patients, providers and payers requires continuing protection Provide initial PUFs by March 1, 2016; downloadable web-based files by June 30, 2019 Files should be available at no (or minimal cost) to the user Principles for PUF development Iterative process that engages users at all stages Incorporates feedback from stakeholders and users Includes clear and explanatory documentation for data users PUFs must be free or low-cost, available to anyone Minimal data request process Uses the MN APCD as the sole data source 5

6 PUF Development Process November 2015: PUF Workgroup Meeting Incorporate guidance and insight received January-February 2016: Develop framework for initial PUFs March 2016: Release initial PUFs and documentaiton Pre-release user webinar Post-release user survey and Q&A for feedback April 2016 and onwards: Future strategies to expand PUF development and meet June 2019 directive Incorporate guidance and insight received Refresh data files Create new stratifications Align with ongoing research activities 6

7 Why are these files important? The PUFs demonstrate the value of the MN APCD to the members of the public The PUFs contain the same information that the Minnesota Department of Health uses to design, monitor, and evaluate new interventions and programs to improve the health of Minnesotans. The PUFs offer a high-level look at trends The PUFs create open data by providing public access to state-produced information Discussion What other points should we raise to the public about the value of these files? 7

8 Interviews with Minnesota Health Data Users Potential data uses Service utilization across care settings Understanding care provided to individuals over a long period of time Examining readmissions Advantages of summary tables Helps identify new research questions Is a validation/comparison tool for researchers own data Helps compare Minnesota s population to the rest of the country Advantages of detailed summary files Allows researchers to conduct extensive data validation and nuanced analysis Researchers can use the same analytic approach with PUF data and their other datasets Provides patient-level information Desired characteristics of PUFs As detailed as possible Multiple years of 8 data to show trend Type of service provided (x-ray, lab, examination, surgery) Type of service setting (inpatient, outpatient, ambulatory surgical center ) Primary care vs. specialty provider Tracking patients across different types of coverage (commercial, Medicare, public program) 8

9 Diverse Data Interests Different types of users with different needs Researchers want a more detailed file that is only useful to users with extensive skill and training Other users want a file that provides useful answers without further analysis The aim: find a balance that starts out meeting some needs and move on from there 9

10 SOURCE DATA 10

11 Data Parameters and Characteristics of the Source Data All Insured: Commercial, Medicaid, Medicare Includes 2013 data but will be built out over time to add additional years All settings of care Paid claims Supports population analysis, trends, geographic variation Understanding the data Patient privacy protections Provider and payer information Data sources 11

12 FRAMEWORK FOR THE PUBLIC USE FILES 12

13 Characteristics of the PUFs Meaningful information that protects individuals privacy Summary data only (not claims level) Does not identify individual patients, payers, or providers Uses age banding and zip code aggregation to group records together Cell size suppression prevents re-identification (each cell in the file must include data for 11 unique individuals) Annual updates Freely accessible to the public Clear data documentation Topics include: protection of sensitive data, what is included in each file, and the most powerful uses for the data User engagement to gather feedback Pre- and post-release user engagement and education (webinar, survey, Q&As with monthly updates) Feedback and recommendations from stakeholders will be documented to inform future PUF development 13

14 Plan for a Phased Approach to File Production Current thinking: Start with smaller summary files that provide helpful insights to a range of users; then expand to more detailed summary files for more experienced researchers March 2016: Dates of service for 2013 Summer 2016: Expand to include dates of service for (with potential for partial 2015) Ongoing Will refresh the initial March 2016 files by late summer, if possible Beginning in 2017, will add new data when available Will identify other themes to include in future PUFs Medicare medical data for calendar year 2014 will be included in summer 2016 PUF release; anticipating Medicare Part D 2014 data as well Discussion Does the Workgroup agree that these plans are consistent with the guardrails? What does the Workgroup think the next refresh should focus on: more years or more stratifications? Are there other things we should keep in mind? 14

15 TYPES OF FILES 15

16 March 2016 PUFs Probable Structure/Format Spreadsheet or csv (depending on total size) One year of data Patient residence by county and 5-digit ZIP code Age bands at 5 year intervals where appropriate Each row will show a count of patients Each file contains an all other category to help users understand what proportion of the total data is included in the PUF Discussion Have we interpreted the guardrails too narrowly? 16

17 Initial File Type: Diagnosis Summary File Shows the frequency and distribution of principal diagnoses that Minnesotans received during an inpatient hospital stay or other settings What can users learn from this file? Disease incidence condition categories from actual claims for hospital patients Disease prevalence prevalence of conditions by geography and demographics in hospital stays Hospitalizations due to chronic conditions prevalence of chronic diseases Access to care 17

18 Initial File Type: Utilization Summary File Shows the types of settings in which Minnesotans receive care Care settings include inpatient hospital stays, outpatient visits, ambulatory surgical center visits, physician office visits, and Emergency Department visits What can users learn from this file? Utilization variation in service utilization by geography, demographics, and place of service Access to care In potential future files, health system cost trends total cost of care by service setting 18

19 Initial File Type: Service Line Summary File Information on the frequency and distribution of health care services provided to Minnesotans One file for medical claims Would show: Service Code (CPT/HCPCS/ICD) Counts of number of patients File permits customized queries Most likely user is a researcher with reasonably extensive experience with data query tools and deep knowledge of drug and procedure codes, code groupings, and terminology What can users learn from this file? Prevention rates of screening and prevention services delivered to Minnesotans Access to care 19

20 Questions Do these sets of files represent a good starting point for the development of PUFs, while staying within guard rails? Are there other middle ground PUF topics that should be in the pipeline? Are there any other population or service characteristics that would enrich these PUFs? 20

21 PUF SUPPORT AND LOGISTICS 21

22 PUF Data Documentation Data documentation for the 2016 PUFs will include: Explanation of data included in the APCD Challenges to summarizing APCD data Disclaimers on what is and is not included in the PUFs Overview of how the PUFs were created Data source File size and data aggregation Protection against re-identification Name and brief description of the data elements included in each summary file Summary of the PUF data access process Discussion What is the expected audience for the data documentation? How can we best frame the documentation for this audience? Are the topics listed above consistent with users expectations? What else might users need to know about the data? 22

23 How can users access the PUFs? The PUFs are considered public data according to MN state law. Simple data request process to access the PUFs Users will request access via Users will be provided simple training materials that explain how the data should be best used Depending on file size, users will receive the PUFs via CD or other removable media in compressed format Having users name and contact information will allow MDH to help provide technical assistance and gather feedback from users User feedback will inform the direction of future PUFs The first set of PUFs will be available on March 1, 2016 with a refresh in late summer, if possible 23

24 PUF User Engagement User engagement strategy for the PUFs is based on similar efforts in other states Pre-release: Data User Webinar (late February) Introduce the contents, format, and potential uses of the initial PUFs Clarify limitations of the PUFs Review the data documentation Explain the data access process Post-release: Web-based survey for users Online survey via Survey Monkey Designed to gather user feedback on their experiences with requesting, obtaining, and using the files Allows users to submit questions and/or recommendations Post-release: Monthly Q&A document Will answer questions received from users via the survey tool or sent directly to MDH Published and updated monthly from March-June 2016 Discussion Would users be comfortable with receiving outreach for their feedback? At what point should users be solicited for feedback? 24

25 Summary: Anticipated Next Steps February 2016: Finalize framework for initial PUFs with 2013 data March 2016: Release initial PUFs Pre-release user webinar Post-release user survey and Q&A for feedback April 2016 and onwards: Develop future strategies to expand PUF development and meet June 2019 directive Incorporate guidance and insight received Summer 2016: Release more detailed PUF with additional years of data Fall 2016: Update March 2016 files Discussion Comments or questions? 25

26 PUBLIC COMMENT 26

27 NEXT STEPS AND ADJOURN Please send any additional comments or feedback to by Monday, February 15, 2016 Workgroup members are invited to join the PUF Data User webinar in late February (more details to be provided). 27