IBM Health Plan Data Model V8.6 helps healthcare organizations rapidly deploy comprehensive enterprise healthcare analytics systems

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1 IBM United States Software Announcement , dated March 11, 2014 V8.6 helps healthcare organizations rapidly deploy comprehensive enterprise healthcare analytics systems Table of contents 1 Overview 4 Publications 2 Key prerequisites 5 Technical information 2 Planned availability date 6 Ordering information 2 Description 9 Terms and conditions 3 Product positioning 11 Prices 3 Program 12 Order now At a glance IBM Health Plan Data Model V8.6 helps health insurance plan organizations: Measure the cost and effectiveness of healthcare outcomes, based on industrywide regulations and best practices (US-specific and worldwide) Assess the effectiveness of healthcare providers and negotiate reimbursement rates accordingly Communicate with other health plans and providers, based on good healthcare practices For ordering, contact your IBM representative, or IBM Americas Call Centers at 800- IBM-CALL (Reference: YE001). Overview is the strategic blueprint necessary to deliver comprehensive health analytics and business insights required to transform, innovate, and improve the cost, quality, and experience of healthcare. This offering is part of the IBM InfoSphere software portfolio. It includes a sophisticated set of business-centric blueprints that promote business and IT collaboration on requirements design and on IT standardization and implementation. It also delivers innovative content in healthcare payer domains and provides updated regulatory and business information. V8.6: Delivers published updates to the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness and Data Information Set (HEDIS) standard Delivers updated clinical, technical, and healthcare performance measures content Helps enable data governance and standardization, operational insight, risk and compliance reporting, and performance management In addition to delivering selected regulatory and business content, this release helps lower the total cost of ownership through integrated offerings that include tooling such as IBM InfoSphere Data Architect, hardware and software solutions such as IBM PureData TM System for Analytics, and solutions that simplify implementation and maintenance. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 1

2 V8.6 features Enhanced HEDIS support HEDIS Volume 2 updates to the latest version of standard 2014 Enhanced Continuity of Care Document (CCD)/Clinical Document Architecture (CDA) support Support for disease-specific outcome and measures Support for risk scores Extended support for groupers Support for Relative Value Units Support for census data (consumerism) Support for reinsurance, risk corridors, and risk adjustment programs (3Rs) Support for Accountable Care Organization (ACO) measures Enhanced pharmacy benefits management support Support for social media Platform support Model extensions to support alignment with big data Dimensional models (validated to ensure deployment to DB2 with BLU Acceleration) Model types and tooling support Multi-Model Mapper V3.5.1, IBM InfoSphere Data Architect, and integrated IBM InfoSphere Business Glossary/CA ERwin Data Modeler IBM InfoSphere Data Architect V9.1 and InfoSphere Business Glossary V9.1 support Key prerequisites The optimal operating environment for includes: Operating system Microsoft TM Windows TM 7 Professional for x86 (32-bit) Microsoft Windows 7 Professional for x86 (64-bit) Microsoft Windows 8 Professional for x86 (32-bit) Microsoft Windows 8 Professional for x86 (64-bit) Memory: 3 GB For details, refer to the Hardware requirements and Software requirements sections. Planned availability date March 13, 2014 Description To help healthcare organizations achieve faster results, IBM has packaged the knowledge from years of experience with information projects in industries into IBM Industry Models. These models deliver industry expertise and regulatory best practices in a form usable by both business and IT, enabling IT to implement projects more quickly. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 2

3 Key components of the data models: Business terms: An enterprise-wide vocabulary of business concepts that provides an organization a view of itself and its industry. Business data model: A conceptual data model that specifies the third normal form data structures required to represent concepts defined in business terms. Atomic warehouse model: A design-level data model that represents an enterprise-wide repository of atomic data used for informational processing. Dimensional warehouse model: An enterprise-wide repository for analytical data. It contains star schema-style dimensional data structures organized around fact entities that support analytical requirements. Business solution templates: A set of industry-relevant analytical reporting requirements organized around business focus areas. The dimensional model approach, based on business solution templates, enables integration with IBM PureData System and OLAP environments such as IBM Cognos. Product positioning V8.6 helps accelerate deployment of enterprise data warehouses with a prebuilt data model. It enables health plan insurers to better understand their members, groups, providers, and networks, thereby improving the handling of claims and client health management. is used in critical business initiatives with attributes that help enable: Operational insight: Clients are using the IBM Industry Data Models to provide a comprehensive, analytical reporting framework. Risk and compliance reporting: The IBM Industry Data Models support the reporting for a series of regulatory requirements. Data governance and standardization: Clients can use data models to help define a corporate set of standard definitions and best practices related to their data. IT can then use data integration, business integration, and master data management infrastructure to enforce standards and use data profiling techniques for compliance monitoring and exception alerting. Enterprise architecture: The Industry Models provide structure and content to support the business and application layers of an enterprise architecture. Availability of national languages Product description Language GA date English March 13, 2014 V8.6.0 IBM IS BG Pk for Health Plan English March 13, 2014 V8.6.0 Program Program VRM Program name 5724-V IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 3

4 Education support IBM training provides education to support many IBM offerings. Descriptions of courses for IT professionals and managers are on the IBM training website Call IBM training at 800-IBM-TEACH ( ) for catalogs, schedules, and enrollments. Available training offerings include client onsite training, public training at IBM facilities, and remote learning via FlexLearning. Through client onsite training, IBM delivers standard or customized training to meet the requirements of its clients. IBM can also provide mobile academies for a rental fee to minimize clients' setup activities. IBM public training simplifies the process by providing the complete environment for standard course deliveries and giving students the ability to learn without the distractions of everyday responsibilities. Public training is offered on a regular schedule worldwide. For more information on public instructor-led training, visit The newly enhanced FlexLearning program enables clients to attend training on their own schedule at their own location. This program offers state-of-the-art technology to deliver highly valuable training at minimum cost. All current courses are approximately three hours in length and offer a valuable learn-by-doing, selfpaced format. For more information on any of the training offerings, contact iiseduc@us.ibm.com Offering Information Product information is available via the Offering Information website Also, visit the Passport Advantage website Publications No publications are shipped with this product. The IBM Publications Center The Publications Center is a worldwide central repository for IBM product publications and marketing material with a catalog of 70,000 items. Extensive search facilities are provided. Payment options for orders are via credit card (in the US) or customer for 20 countries. A large of publications are available online in various file formats, and they can all be downloaded by all countries. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 4

5 Technical information Specified operating environment Hardware requirements V8.6 does not have specific hardware requirements. Hardware requirements will vary for each customer deployment, depending on the modeling environments used. Software requirements V8.6 does not have specific software requirements. Supported platform requirements will vary for each customer, depending on the modeling environments used. V8.6 is supported in the following software modeling environments: Multi-Model Mapper V3.5.1 (shipped as part of the product) Microsoft Office Access 2007 or 2010 (a prerequisite for Multi-Model Mapper) CA ERwin Data Modeler IBM InfoSphere Data Architect V9.1 Glossary terms can be managed in IBM InfoSphere Business Glossary V9.1. IBM InfoSphere Business Glossary is a component of IBM InfoSphere Information Server Business Information Exchange. The program's specifications and specified operating environment information may be found in documentation accompanying the program, if available, such as a readme file, or other information published by IBM, such as an announcement letter. Documentation and other program content may be supplied only in the English language. Planning information Packaging V8.6 is available on a DVD. Security, auditability, and control uses the security and auditability features of the host hardware or software. The customer is responsible for evaluation, selection, and implementation of security features, administrative procedures, and appropriate controls in application systems and communication facilities. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 5

6 Ordering information This product is only available via Passport Advantage. It is not available as shrinkwrap. Product information Licensed function title Product Product group category IBM Industry IBM Industry Enterprise Edition Models Models Project IBM Industry IBM Industry Edition Models Models IBM InfoSphere Business Glossary IBM Industry IBM Industry Pack for Health Plan Enterprise Models Models Edition PID Charge unit Program name description 5724-V45 PA per Resource Enterprise Edition Value Unit 5724-V45 Per Resource Enterprise Edition Value Unit for System z Project 5724-V45 PA per Resource Edition Value Unit Project 5724-V45 Per Resource Edition Value Unit for System z IBM InfoSphere Business Glossary 5724-V45 PA per Resource Pack for Health Plan Enterprise Value Unit Edition IBM InfoSphere Business Glossary 5724-V45 Per Resource Pack for Health Plan Enterprise Value Unit for Edition System z Charge metrics definitions Resource Value Unit (RVU) RVU is the unit of measure by which this program is licensed. RVU entitlements are based on the quantity of a specific designated measurement for the given program. A Proof of Entitlement (PoE) must be obtained for the appropriate of RVUs required for your environment as defined by the specific program terms. The RVU entitlements are specific to the program and may include, but are not limited to the following: client devices, data source records, messages, and servers, and may not be exchanged, interchanged, or aggregated with RVU entitlements of another program. To understand these benefits of RVU licensing, and to determine how many RVUs to obtain for the program, contact your IBM representative. The Resource for the purpose of RVU calculation is five hundred million US dollar Premium Income. Premium Income is defined as the total insurance premium income earned in millions of US dollars as reported in licensee's last annual report. RVU conversion table From 1 to 2 Resources, 1.00 RVU per Resource From 3 to 5 Resources, 2 RVUs plus 0.90 RVUs per Resource above 2 From 6 to 10 Resources, 4.7 RVUs plus 0.80 RVUs per Resource above 5 From 11 to 20 Resources, 8.7 RVUs plus 0.70 RVUs per Resource above 10 From 21 to 35 Resources, 15.7 RVUs plus 0.60 RVUs per Resource above 20 IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 6

7 From 36 to 50 Resources, 24.7 RVUs plus 0.45 RVUs per Resource above 35 For more than 50 Resources, RVUs plus 0.30 RVUs per Resource above 50 Passport Advantage program licenses description Enterprise Edition IBM Health Plan Data Modl EE PA per Resource Value Unit E0J8ZLL Annual SW S&S Rnwl IBM Health Plan Data Modl EE PA per Resource Value Unit D13ZQLL Lic + SW S&S 12 Mo IBM Health Plan Data Modl EE PA per Resource Value Unit D13ZRLL SW S&S Reinstate 12 description Project Edition IBM Health Plan Data Mod PE PA per Resource Value Unit E0J90LL Annual SW S&S Rnwl IBM Health Plan Data Mod PE PA per Resource Value Unit D13ZSLL Lic + SW S&S 12 Mo IBM Health Plan Data Mod PE PA per Resource Value Unit D13ZTLL SW S&S Reinstate 12 description IBM InfoSphere Business Glossary Pack for Health Plan Enterprise Edition IIBG Pack for Health Plan EE PA per Resource VU SW S&S D13ZVLL Reinstate 12 IIBG Pack for Health Plan EE PA per Resource Value Unit E0J91LL Annual SW S&S Rnwl IIBG Pack for Health Plan EE PA per Resource Value Unit D13ZULL Lic + SW S&S 12 Mo Passport Advantage trade-up licenses Trade-up part Precursor product Trade-up product Enterprise Edition IS Business Glossary Pack IBM Health Plan Data Modl D14D9LL for Health Plan Ent Ed EE PA per RVU Fr BG PK HPEE Trade Up Lic + SW S& Passport Advantage supply Program name/description V8.6.0 V8.6 Windows English Media Pack B704AEN IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 7

8 IBM IS BG Pk for Health Plan V8.6.0 InfoSphere Business Glossary Pack for Health Plan V8.6 B704BEN Windows English MP Passport Advantage customer: Media pack entitlement details Customers with active maintenance or subscription for the products listed are entitled to receive the corresponding media pack. IBM InfoSphere Business Glossary Pack for Health Plan V8.6.0 Entitled maintenance offerings description Media packs description IBM InfoSphere Business InfoSphere Business B704BEN Glossary Pack for Health Glossary Pack for Health Plan Enterprise Edition Plan V8.6 Windows English per Resource Value Unit MP IBM InfoSphere Business InfoSphere Business B704BEN Glossary Pack for Health Glossary Pack for Health Plan Enterprise Edition Plan V8.6 Windows English per Resource Value Unit on MP System z V8.6.0 Entitled maintenance offerings description Media packs description Enterprise Edition per V8.6 Windows English Media Resource Value Unit Pack Enterprise Edition per V8.6 Windows English Media Resource Value Unit on Pack System z Project Edition per V8.6 Windows English Media Resource Value Unit Pack Project Edition per V8.6 Windows English Media Resource Value Unit on Pack System z B704AEN B704AEN B704AEN B704AEN Cross-platform products Cross-platform products for use on System z Order the part s that follow when the product is used for either the development of code that will be deployed on System z servers or when the product will be communicating or transferring data between a distributed server and a System z server. Otherwise, order from the other set of part s in this announcement. This set of part s provides the identical supply and authorization as the other set in this announcement. description Enterprise Edition IBM Health Plan Data Modl EE Per RVU for System z Annual SW S&S Rnwl IBM Health Plan Data Modl EE Per RVU for System z Lic + SW S&S 12 Mo IBM Health Plan Data Modl EE Per RVU for System z SW S&S Reinstate 1 E0J93LL D1406LL D1407LL IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 8

9 description Project Edition IBM Health Plan Data Mod P E Per Resource VU for System z Lic + SW S&S 12 IBM Health Plan Data Mod PE Per Resource VU for System z Annual SW S&S Rnwl IBM Health Plan Data Mod PE Per Resource VU for System z SW S&S Reinstate D1408LL E0J94LL D1409LL description IBM InfoSphere Business Glossary Pack for Health Plan Enterprise Edition IIBG Pack for Health Plan EE Per RVU for System z Annual SW S&S Rnwl IIBG Pack for Health Plan EE Per RVU for System z Lic + SW S&S 12 Mo IIBG Pack for Health Plan EE Per RVU for System z SW S&S Reinstate E0J95LL D140ALL D140BLL Cross-platform product for use on System z IFL engines or zenterprise BladeCenter Extension Order the part s that follow when the product is intended to run on the zenterprise BladeCenter Extension or Linux TM operating system on System z IFL engines. If the product is not intended to run in these environments, order from the other set of part s in this announcement. This set of part s provides the identical supply and authorization as the other set in this announcement. Trade-up licenses for cross-platform products Precursor product Trade-up product Enterprise Edition IS Business Glossary Pack IBM Health Plan Data Modl D14DALL for Health Plan Ent Ed RVU for System z Fr BG PK HPEE Trade Up Lic + SW Terms and conditions The information provided in this announcement letter is for reference and convenience purposes only. The terms and conditions that govern any transaction with IBM are contained in the applicable contract documents such as the IBM International Program License Agreement, IBM International Passport Advantage Agreement, and the IBM Agreement for Acquisition of Software Maintenance. Licensing IBM International Program License Agreement including the License Information document and Proof of Entitlement (PoE) govern your use of the program. PoEs are required for all authorized use. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 9

10 products only, offered outside of Passport Advantage, where applicable, are license only and do not include Software Maintenance. License Information Program Program name LI 5724-V45 L-MTEN-98SH8S The program's License Information will be available for review on the IBM Software License Agreement website Limited warranty applies Yes Limited warranty IBM warrants that when the program is used in the specified operating environment, it will conform to its specifications. The warranty applies only to the unmodified portion of the program. IBM does not warrant uninterrupted or error-free operation of the program or that IBM will correct all program defects. You are responsible for the results obtained from the use of the program. IBM provides you with access to IBM databases containing information on known program defects, defect corrections, restrictions, and bypasses at no additional charge. For further information, consult the IBM Software Support Handbook found at IBM will maintain this information for at least one year after the original licensee acquires the program (warranty period). Money-back guarantee For clarification, note that if for any reason you are dissatisfied with the program and you are the original licensee, you may obtain a refund of the amount you paid for it, if within 30 days of your invoice date you return the program and its PoE to the party from whom you obtained it. If you downloaded the program, you may contact the party from whom you acquired it for instructions on how to obtain the refund. For clarification, note that for programs acquired under the IBM International Passport Advantage Agreement, this term applies only to your first acquisition of the program. Volume orders (IVO) No Passport Advantage applies Yes, and through the Passport Advantage website at This product is only available via Passport Advantage. It is not available as shrinkwrap. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 10

11 Usage restrictions Yes. For additional information, refer to the License Information document that is available on the IBM Software License Agreement website IBM Operational Support Services -- SoftwareXcel No System i Software Maintenance applies No Educational allowance available Not applicable. Statement of good security practices IT system security involves protecting systems and information through prevention, detection, and response to improper access from within and outside your enterprise. Improper access can result in information being altered, destroyed, or misappropriated or can result in misuse of your systems to attack others. Without a comprehensive approach to security, no IT system or product should be considered completely secure and no single product or security measure can be completely effective in preventing improper access. IBM systems and products are designed to be part of a comprehensive security approach, which will necessarily involve additional operational procedures, and may require other systems, products, or services to be most effective. IBM does not warrant that systems and products are immune from the malicious or illegal conduct of any party. Prices For additional information and current prices, contact your local IBM representative. Passport Advantage For Passport Advantage information and charges, contact your IBM representative or authorized IBM Business ner for Software Value Plus, Additional information is also available at IBM Global Financing IBM Global Financing offers competitive financing to credit-qualified customers to assist them in acquiring IT solutions. Offerings include financing for IT acquisition, including hardware, software, and services, both from IBM and other manufacturers or vendors. Offerings (for all customer segments: small, medium, and large enterprise), rates, terms, and availability can vary by country. Contact your local IBM Global Financing organization or visit IBM Global Financing offerings are provided through IBM Credit LLC in the United States, and other IBM subsidiaries and divisions worldwide to qualified commercial and government customers. Rates are based on a customer's credit rating, financing terms, offering type, equipment type, and options, and may vary by country. Other restrictions may apply. Rates and offerings are subject to change, extension, or withdrawal without notice. IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 11

12 Financial benefit Financing from IBM Global Financing helps you preserve cash and credit lines, enables more technology acquisition within current budget limits, permits accelerated implementation of economically attractive new technologies, offers payment and term flexibility, and can help match project costs to projected benefits. Financing is available worldwide for credit-qualified customers. Order now To order, contact the Americas Call Centers or your local IBM representative. To identify your local IBM representative, call 800-IBM-4YOU ( ). Phone: 800-IBM-CALL ( ) Fax: 800-2IBM-FAX ( ) For IBM representative: Mail: IBM Teleweb Customer Support ibm.com Sales Execution Center, Americas North 3500 Steeles Ave. East, Tower 3/4 Markham, Ontario Canada L3R 2Z1 Reference: YE001 The Americas Call Centers, our national direct marketing organization, can add your name to the mailing list for catalogs of IBM products. Note: Shipments will begin after the planned availability date. Trademarks IBM PureData is a trademark of IBM Corporation in the United States, other countries, or both. IBM, InfoSphere, DB2, Cognos, Passport Advantage, System z, zenterprise, BladeCenter, System i and ibm.com are registered trademarks of IBM Corporation in the United States, other countries, or both. Microsoft and Windows are trademarks of Microsoft Corporation in the United States, other countries, or both. Linux is a registered trademark of Linus Torvalds in the United States, other countries, or both. Other company, product, and service names may be trademarks or service marks of others. Terms of use IBM products and services which are announced and available in your country can be ordered under the applicable standard agreements, terms, conditions, and prices in effect at the time. IBM reserves the right to modify or withdraw this announcement at any time without notice. This announcement is provided for your information only. Additional terms of use are located at For the most current information regarding IBM products, consult your IBM representative or reseller, or visit the IBM worldwide contacts page IBM United States Software Announcement IBM is a registered trademark of International Business Machines Corporation 12