Minnesota All Payer Claims Database
Workgroup Meeting #5
Data Access Fees and Resources
November 4, 2014
Kris Van Amber
Senior Management Consultant
Management Analysis & Development
Minnesota Management & Budget
Linda Green
Vice President, Programs
Freedman HealthCare
Agenda
Welcome and Introductions – Kris Van Amber
10 minutes
Agenda Overview – Linda Green and Kris Van Amber
10 minutes
Discussions to Date
40 minutes
Break
15 minutes
Data Access Fees and Resources
60 minutes
Next Steps
15 minutes
Adjourn
© Freedman HealthCare 2014
November 4, 2014
2
SUMMARY OF DISCUSSIONS TO DATE
October Discussion: Data Access for New Uses
Strong support for creating and releasing a Public Use dataset.
• De-identified
• Broadly accessible
• Not yet discussed: how the file will be defined and who will create the file
Divergent points of view about Limited Datasets
• Some members support highly controlled access and narrowly defined uses.
• Some members support broader access and a wide range of uses.
• Unclear benchmarks that, if met, would ease restrictions.
Files containing data about named payers and providers
• Use in internal quality improvement purposes that would never be made public?
• Academic research projects?
• Other uses
© Freedman HealthCare 2014
November 4, 2014
4
October Discussion: Governance of New Uses
Recognition that governance has several components:
• Policy making
• Technical insight into submitted data
• Decisions about specific data use requests
Strong support for a governance structure with broad stakeholder representation;
diverse views about the role of governance.
• Some members prefer that the stakeholder group acts as a decision making body.
• Some members prefer that the stakeholder group acts in an advisory capacity to MDH.
Senator Lourey indicated that a non-legislative decision-making body is unlikely to
win Legislative support.
The Legislature will draw on the Workgroup’s report in deciding:
• Whether to allow broader uses of the data and
• Whether to create a technical group to make recommendations to the Legislature or to
the MDH
© Freedman HealthCare 2014
November 4, 2014
5
Emerging Recommendations
The APCD is a valuable resource that should be made available to users
beyond state agencies.
The APCD should create and make available a Public Use dataset (no
person level identifiers).
A technical advisory group should develop the format and structure of a
Limited Dataset (two indirect identifiers such as date of service and zip
code).
The process of making data more broadly accessible would benefit from a
formal governance structure.
© Freedman HealthCare 2014
November 4, 2014
6
PROPOSED APPROACH TO LEGISLATIVE
REPORT
Approach
Legislation called for workgroup to review six topics:
•
•
•
•
•
•
Data Uses
Governance
Fees
Access to data
Privacy and security
Expanded use resources
Consensus is not required
• Some areas of agreement
• Some areas with differing points of view
Provide context for any recommendations
Record group’s opinions on other topics
© Freedman©HealthCare
Freedman 2014
HealthCare
November
2014 4,November
2014
4, 2014
8
8
Report to the Legislature
Executive Summary
Charge from the Legislature: MN Statutes 2012 Section 62U.04
What is the MN APCD?
Summary of Workgroup’s Guidance
• Provide recommendation where one has been developed
• Report on topic-specific discussion for those with multiple points of view
Appendices
• Meeting materials
• APCD FAQ
• Data Quality FAQ
© Freedman HealthCare 2014
November 4, 2014
9
Proposed Schedule for Report Review
SEND TO
WORKGROUP
COMMENTS DUE
DRAFT 1
[1. Executive Summary placeholder]
2. Charge from the Legislature
3. History of the MN APCD
4. Summary of Workgroup’s Guidance
November 21,
2014
December 1,
2014
DRAFT 2
All Sections
December 20,
2014
January 9, 2015
VERSION
SEND TO LEGISLATURE
© Freedman HealthCare 2014
November 4, 2014
FEBRUARY 1, 2015
10
DATA ACCESS FEES AND RESOURCES
Questions from the Legislature
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?
What type of funding or fee structure would be needed to support the
expanded use of all-payer claims data?
© Freedman©HealthCare
Freedman 2014
HealthCare
November
2014 4,November
2014
4, 2014
12
12
Topics in Data Fees and Resources
What types of data might be available
What may or may not be in the files
Options to provide access to data
© Freedman HealthCare 2014
November 4, 2014
13
Generic APCD Extracts
Public Use Files: available from a public website without further permission
or reviews, including but not limited to:
•
•
•
•
Reports with analysis
Tables of aggregated data
Downloadable spreadsheets or excel tables with varying levels of detail
Simple online filtering and selection tools
Limited Datasets: requires a formal application process and signing a data
use agreement. Usually needed for research, public policy and other state
agency analysis.
Subscriptions: time limited access to (usually) tools allowing custom queries,
allowing user to take out aggregated information without direct identifiers.
User signs a data use agreement.
© Freedman©HealthCare
Freedman 2014
HealthCare
November
2014 4,November
2014
4, 2014
14
14
Generic File Distribution Options
PUBLIC USE FILE
LIMITED DATASET
SUBSCRIPTION/ DATA
ENCLAVE
Shows claim
lines
YES
YES
[1]
Member Name
NO
NO
NO
Unique patient
identifier
NO
YES
NO
Payer Name
NO
YES
[1]
Provider Name
NO
YES
[1]
Dates of Service
MM-YY
MM-DD-YY
MM-YY
NO
NO
NO
Date of Birth
© Freedman©HealthCare
Freedman 2014
HealthCare
November
2014 4,November
2014
4, 2014
15
15
Delivering/Accessing data
All data distribution methods require: tools and infrastructure to create
queries for each type of data use; drafting data use agreements; receiving
and tracking applications; delivering data.
Low tech, less expensive: Data manager creates a set of extracts according
to the state’s specifications, including timeframe and data elements.
•
•
•
•
Summary tables – available on public website.
Public use files – may be downloadable or, if large files, via secure file transfer.
Upon approval, limited datasets are distributed via secure website transfer points.
Aggregated data files – state-defined data sets to support analysis of specific topics.
Higher tech, higher initial start up costs:
• Subscriptions providing access to a data enclave or other online data analysis tool
allow users to create custom summary files and remove only the aggregated results.
• Data enclaves
• Online query tools
© Freedman HealthCare 2014
November 4, 2014
16
Administration of a Data Access Process
Start Up
• Data access committee management: policies and procedures, conflict of interest,
non-disclosure
• Data use application and data use agreement
• Public notice capacity regarding data requests being reviewed
• Technology infrastructure for delivering data (e.g., query tools to create files or on-line
data access portals)
• Prepare data dictionary and documentation
Operations
•
•
•
•
•
•
•
Track and review incoming applications
Committee meeting scheduling and materials distribution
Conduct meetings, distribute minutes
Applicant communications
Fee collection and financial management
Data delivery
Track DUA renewals and data destruction documentation
© Freedman HealthCare 2014
November 4, 2014
17
Data Fee Revenues
MA
ME
CO
Application
Fees
$300
$0
$0
Total fees for
all available
files
One-Time Researcher: $5,000$10,000
One-Time Other: $15,000 $37,500
Multi-Use Subscription:
$100,000-$185,000
Commercial $20,000$28,500
Assessed Provider or
Payer $10,575-$12,800
Nonprofit/Academic:
$9250-$11,400
Redistributor $37,800$42,500
De-Identified Custom
Reports: ~$30,000/each
Limited Data Sets:
~$50,000/each
Annual Subscription: ~
$150,000
2013 Annual
Revenue
~$50,000
~$70,000
$350,000
© Freedman HealthCare 2014
November 4, 2014
18
Questions for the Workgroup
What types of data should be free to users? How should this be decided in
light of as yet undefined uses?
How and who should design the types of files that might become available?
Should the fee schedule vary by:
•
•
•
•
Use?
User?
File size?
Included data elements?
Should data access be funded by fees? If not fees, what other sources?
© Freedman HealthCare 2014
November 4, 2014
19
Next Steps
Draft report to workgroup on November 20
December: Review recommendations and report comments
Adjourn
© Freedman HealthCare 2014
November 4, 2014
20
Appendix --- Data Access Fees and Resources
APCD Council’s collection of Data Access Rules: http://apcdcouncil.org/claims-datarelease-rules
State Specific Information:
Colorado APCD: http://www.civhc.org/All-Payer-Claims-Database/Data-Release-ReviewCommittee.aspx/
Maine APCD
• Data Release Process: https://mhdo.maine.gov/data.htm#requestData
• Fee Schedule: https://mhdo.maine.gov/data.htm#pricing
• Example of Data Documentation:
Https://mhdo.maine.gov/_docs/Medical%20version%201.2.doc
Massachusetts APCD
Data release flow chart: http://www.mass.gov/chia/docs/p/apcd/release2/data-releaseregulation-flowchart-final-pdf.pdf
Fee Schedule: http://www.mass.gov/chia/docs/g/chia-ab/1311.pdf
Example of Data Documentation: http://www.mass.gov/chia/docs/p/apcd/release2/release2medical-claims.pdf
© Freedman HealthCare 2014
November 4, 2014
21