Minnesota All Payer Claims Database
Workgroup Meeting #6
Review Draft Report
December 2, 2014
Kris Van Amber
Senior Management Consultant
Management Analysis & Development
Minnesota Management & Budget
Linda Green
Vice President, Programs
Freedman HealthCare
Agenda
Welcome and Today’s Agenda – Kris Van Amber & Linda Green
10 minutes
Reflections on Writing the Report – Linda Green
10 minutes
Review and Discussion of Feedback/Recommendations
60 minutes
Break
15 minutes
Conclude Discussions
60 minutes
Public Comment
10 minutes
Adjourn
2
Purpose of Today’s Meeting
Review our feedback and recommendations to the
Legislature before finalizing the report
3
Reflections on Workgroup Discussions
Making recommendations
•
•
•
•
•
Consensus was desired but not required
Lively and wide-ranging discussions reflecting diverse expertise
Members expressed divergent points of view
Areas of agreement were narrowly structured
Limited opportunities for next steps
Providing feedback to the Legislature
• Convey the sense of the Workgroup
• Offer the spectrum of views
4
Responses to Legislative Questions
5
Question 1 from the Legislature
What should the parameters be for allowable uses of the all-payer claims data
collected under Minnesota Statutes, section 62U.04, beyond the uses authorized in
Minnesota Statutes, section 62U.04, subdivision 11?
Workgroup Recommendation:
• Envision a broad range of potential uses
• Allow access to noncontroversial data
• Wait and see about expanded uses, especially
• Data that includes payer and provider names
• Reports that might affect finances or reputation
• Set “guardrails” against inappropriate uses
Question for the Workgroup:
• What are the benchmarks for allowing expanded uses?
6
Question 2 from the Legislature
What type of advisory or governing body should guide the release of data from the allpayer claims database?
Workgroup Feedback:
• High concern, low agreement on roles and responsibilities
• Need for data access request review process is unclear at this point
Extensive discussion about structure and roles
• Independent body vs. state-convened committee
• Decision making vs. advisory on:
• What data will or won’t be made available
• Specific data access requests
• Freedom of research vs. review/redaction of report findings
• Managing conflicts of interest if stakeholders are involved in reviewing
policy for new access or for specific uses
7
Question 4 from the Legislature
What should the mechanisms be by which the data would be released or accessed,
including the necessary information technology infrastructure to support the
expanded use of the data under different assumptions related to the number of
potential requests and manner of access?
Workgroup Recommendations:
• Broadly accessible “Public Use File”
• Emphasis on iterative approach
•
•
•
•
Begin with initial non-sensitive information
More types of access may follow
“Limited Data Sets”
Data Enclave
8
Question 5 from the Legislature
What are the appropriate privacy and security protections needed for the expanded
use of the All-Payer Claims Database?
Workgroup Feedback:
• If the legislature approves expanded access to the APCD, then
MDH should establish policies and procedures that align with
HIPAA data privacy standards
Discussed current privacy protections
• Compliant with HIPAA privacy standards for de-identified data
but limit ability to audit and verify the accuracy of the
information
Discussed that data use agreement (“DUA”) would
specify security provisions
9
Questions 3 and 6 from the Legislature
Question 3: What type of funding or fee structure would be needed to support the
expanded use of all-payer claims data?
Question 6: What additional resources might be needed to support the expanded use
of the all-payer claims database, including expected resources related to information
technology infrastructure, review of proposals, maintenance of data use agreements,
staffing an advisory body, or other new efforts?
Workgroup Recommendation:
• Public Use files and aggregate data tables - freely available at
no charge to the public
• If other types of files are permitted:
• Set fees to cover the costs of file production
• Different fee schedules for different user types
10
Questions 3 and 6 from the Legislature (cont.)
Workgroup Feedback:
• Additional resources would be required to support expanded
access to the data
Discussed potential for custom reports and analysis
Areas that would require additional resources
Developing the de-identified and limited use files
Supporting the APCD governance process
Creating a data use application and process
Providing user support
Updating documentation
Annual or quarterly updates and refreshes
Developing and operating the data enclave
11
Other Considerations for Expanded APCD Use
Workgroup Overall:
• MN APCD should implement emerging techniques around data
protection in order to build utility and confidence in the data
• Aligning the MN APCD with clinical data
• Adopt other states’ methodologies to build a “unique identifier” for
each person in the data set
• Data quality
• Issue an annual report that describes data quality activities and
improvement strategies
Auditing and verification of provider-specific reports was
a major obstacle for the expanded use of the data for
some members
Exploring ways to align the MN APCD with clinical data
could be beneficial
12
Action Plan
Legislature should authorize development of a Public Use
file
•
•
•
•
•
Detailed data and summary tables
Downloadable
No fee
No formal permission process required
No person, provider or payer names or identification numbers
13
Next Steps
Incorporate today’s discussion into the report
Distribute for comment on December 12
Responses due January 5
Submitted to Legislature on February 1
Thank you!
14