Title Xx Study:
Minnesota
Subtitle Xx
State-Based
Risk-Adjustment
Webinar
Presentation
Presenter,
Title
June 4, 2015
Date
Proprietary and Confidential
11
Agenda
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•
•
•
•
•
•
•
•
Welcome & Introductions – Stefan Gildemeister
Project Overview – MDH
Data Submission Guide – Onpoint
Hashing Application – Onpoint
Establishing SFTP Connectivity – Onpoint
Data Quality Assurance – Onpoint
Timelines – Onpoint
Next Steps – Onpoint
Q&A – MDH
Minnesota Study: State-Based Risk-Adjustment (June 4, 2015)
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Introductions
•
•
•
•
•
•
Stefan Gildemeister – MN Dept. of Health
Anne Krohmer – MN Dept. of Health
Janice Bourgault – Onpoint Health Data
Joanna Duncan – Onpoint Health Data
Rong Yi – Milliman
Howard Kahn – Milliman
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Project Overview
MDH
Project Overview
• MDH has been charged by the Legislature to conduct a study of
the feasibility and potential costs and benefits associated with a
state-based risk adjustment program in the individual and small
group markets
• MDH was specifically directed to:
– Evaluate the extent to which the MN APCD could be used
– Collect data needed for the study
– Determine if a state-based risk adjustment model can perform
better and be more cost effective than the federal model
– Submit a report to the Legislature outlining the study
recommendations
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Project Overview
• MDH is legislatively authorized to collect additional data needed
for conducting risk adjustment with standard risk adjusters
• The MN APCD does not currently contain some data elements
necessary for risk adjustment, for example:
– Metal level tier
– Small group and individual market indicator
– Geographic rating region
• Additional data that will be collected is high-level enrollment data
and will be used solely for the purpose of this study
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Data Submission Guide
Onpoint
Submission Specifications
• Collection of supplemental enrollment data
• Submitter IDs
– Onpoint assigned
– Current submitter ID with additional suffix
• File format: Asterisk delimited
• Population reported
– Required: active members from 10/1/2013-12/31/2014
– Encouraged: active members from 1/1/2013-12/31/2014
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Layout of Data Submission Guide
Col. #
ID Name
Hash
Type
Max.
Length
Description
X12
Thresh. Denom.
REF
• Column Number
– Order of data elements
• ID
– Onpoint-assigned ID to each data element
– Used for communication between payers and Onpoint
• Name
• Hash
– Patient identifiers
– Consistent with MN APCD submissions
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Layout of Data Submission Guide
Col. #
ID Name
Hash
Type
Max.
Length
Description
X12
Thresh. Denom.
REF
• Type
– Date (CCYYMMDD)
– Integer
– Text
• Maximum Length
• Description
– Clarification on data to be submitted
– Tips
– Valid codes
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Layout of Data Submission Guide
Col. #
ID Name
Hash
Type
Max.
Length
Description
X12
Thresh. Denom.
REF
• X12 REF
– Provided as a reference for data mapping
• Threshold
– Assessment of completeness and validity
• Denominator
– Evaluation of threshold
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Data Submission Guide
Specifications
• Header and Trailer record
– Submitter
– Time period reported
– Record counts
• Data elements required for risk adjustment study
• Data elements required to link to the MN APCD
– Patient identifiers
– Hashed
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Hashing Application
Onpoint
Hashing Application
Specifications
• Onpoint to supply hashing application
– Required to link to the MN APCD
– Data reported must be consistent with MN APCD reported
data
– Hashed data elements must also be hashed consistently with
MN APCD hashed data
– Onpoint instructions will be provided
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Establishing SFTP Connectivity
Onpoint
Establishing SFTP Connectivity
Provide SFTP Registration Form
• Onpoint will provide each submitter with an SFTP registration form.
Return Required Materials
• Each submitter must then return all requested information to Onpoint,
including submitter’s public PGP key
Communicate User Credentials
• Upon receiving and processing a submitter’s SFTP registration materials,
Onpoint will then assign user name and temporary password. A copy of
Onpoint’s public key and a test file will also be sent to the submitter.
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Establishing SFTP Connectivity (cont.)
Encrypt & Upload Test File
• The submitter must then encrypt the provided test file and upload the file
to Onpoint’s SFTP portal (sftp.onpointhealthdata.org)
Decrypt & Validate Test File
• Onpoint will attempt to decrypt the received test file using the submitter’s
public key; if successful, Onpoint will validate the test file to ensure integrity
Notify Submitter – Clear to Send Submissions
• Once Onpoint has finished validating the test file, the submitter will be
notified that (a) their SFTP registration has been completed and (b) they will
soon be cleared to send submissions through the Onpoint SFTP portal
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Data Quality Assurance
Onpoint
Data Quality Assurance
Testing Protocol
• Feedback to submitters
– Ensure applicable data elements are hashed
– Data completeness assessed against thresholds
– Evaluate validity of data submitted
– Data quality validations
– Percentage member match to MN APCD
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Timelines
Onpoint
Project Timeline
Submission Due Date: 7/30/2015
Onpoint provides
hashing application
and documentation Submitters and
Onpoint complete
6/5/15
SFTP testing
MDH provides data
6/19/15
submission guide
5/21/15
5/1/2015
5/21/2015
6/10/2015
Submitter
webinar
conducted
6/4/15
6/30/2015
Final due date for
data submissions
7/30/15
7/20/2015
8/9/2015
Submitters may
begin submitting
files 7/1/15
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Next Steps & Q&A
Onpoint & MDH
Next Steps
• Things to do
– Review Data Submission Guide
– Complete SFTP testing with Onpoint
– Begin submission of files to Onpoint
• For data submission questions, contact Onpoint:
– Joanna Duncan
• Email: [email protected]
• Phone: (207)430-0640
– Janice Bourgault
• Email: [email protected]
• Phone: (207)430-0647
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Next Steps
• For study questions, feel free to contact MDH
– Anne Krohmer
• Email: [email protected]
• Phone: (651)201-3764
• http://www.health.state.mn.us/divs/hpsc/hep/riskadjustment/d
atacollectionrequest.html
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Q&A
• Please submit questions
directly to the presenter by
clicking on the chat button in
the top of the webex
• Under the “Send to” dropdown menu, please select the
presenter
• Any questions that cannot be
answered immediately will
be answered in an FAQ
document that will be posted
following the call
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