Data Matters - January 2023 Edition Email

DATE : January 31, 2023

In this Issue:  

Opening Message 

News You Can Use  

Data User Profile  

Publications and Data Releases    

Upcoming Events and Resources     

Join Our Team   

Opening Message   

Happy 2023! CHIA has been busy, as we wrap up the first month of the new year. In early January, I started my new role as CHIA’s executive director. While Ray leaves big shoes to fill, I am grateful for his service and leadership. Over the last ten years, I have had the privilege of working with CHIA in various capacities while at the Health Policy Commission, the Executive Office of Administration and Finance and—most recently—the Executive Office of Health and Human Services, in addition to serving on CHIA’s Oversight Council. I’m excited to now officially join the CHIA team and look forward to working with you in my new role in the coming months.

In other news, CHIA was excited last week to announce the release of its first dashboard evaluating the performance of primary care in Massachusetts. This dashboard, developed with Massachusetts Health Quality Partners (MHQP), measures the health of primary care through four domains: finance, capacity, performance, and equity. Also new, CHIA has developed an interactive dashboard of its hospital and health system financial performance data, which is highlighted in the “News You Can Use” section below.

As always, the “Publications and Data Releases” and “Upcoming Events” sections of DataMatters will keep you up to date on reports CHIA has released recently and events of interest to the local health data community.

We hope you enjoy this newsletter today and learn something new. If there’s something you enjoyed or if you have suggestions for improvement, we appreciate your feedback at newsletter@chiamass.gov.

Lauren Peters
Executive Director
Center for Health Information and Analysis

News You Can Use 

Last month CHIA released its first interactive Hospital and Health System Financial Dashboard. As part of CHIA’s continued effort to present data in more accessible ways, this dashboard provides a new visual and interactive means to view the financial performance metrics and trends that CHIA reports on a quarterly and annual basis. It currently displays quarterly data through June 30, 2022, and annual trend data through hospital fiscal year 2021.

 

The dashboard utilizes a new index layout, which allows the user to see the full range of data and a description of each metric or trend available before selecting a graphic to view. Once selected, the graphics can be filtered to view the data by hospital, health system, cohort, or hospital type.

The dashboard will be updated with new quarterly data in March 2023 to reflect fiscal year data through December 31, 2022. It will continue to be updated regularly with the most recent data available.

Visit the Hospital and Health System Financial Performance webpage to use the interactive dashboard or read CHIA’s quarterly and annual reports.

 

 

 

Data User Profile

Please describe BerryDunn’s role in conducting mandated benefit reviews and what the reviews entail.

BerryDunn assists CHIA with evaluation of health benefit mandate bills (mandates) referred by legislative committees for review. Most of the mandates we review require carriers to cover specific services or provide benefits to members with specific conditions. Another smaller set of mandates requires carriers to cover the services of specific types of providers. Most provider-centered mandates are similar in effect, essentially providing that carriers must pay for the services of the specified provider type.

These evaluations (also called mandated benefit reviews or MBRs) include a medical efficacy review and an actuarial estimate of a bill’s cost should the bill become law. BerryDunn estimates the bill’s impact for the commercial fully insured market. Our MBRs generally follow these steps:

(1) During the statutory analysis stage, BerryDunn reviews state and federal laws that might affect the bill’s impact. For example, federal law might supersede the state-mandated benefit and erase any potential cost. During the statutory analysis stage, BerryDunn:

• Drafts questions for the legislative sponsors to clarify any questions pertaining to the bill’s intent.
• Surveys Massachusetts carriers. For example, BerryDunn may ask carriers about current coverage or request information on the procedure codes carriers use that are related to the proposed mandated service.

(2) During the efficacy review, BerryDunn:

• Summarizes how the subject matter of the mandate is currently regarded by medical literature.
• Researches information helpful to the cost estimates.

(3) To perform the cost estimates for the first five years of enactment, BerryDunn:

• Develops analytical model(s) specific to the mandate being evaluated.
• Develops model assumptions (informed by sources such as literature review, interviews with medical experts, and claim detail information from the MA APCD).
• Develops SAS code needed to pull necessary information from the MA APCD data extract.
• Performs quality checks and validates findings with other data sources, as appropriate.
• Uses model membership and claims data, in addition to model assumptions, to estimate the mandate’s incremental impact on carriers’ medical expenses and each mandate’s effect on health insurance premiums, accounting for administrative loads.
• Writes draft and final reports with oversight and reviews by CHIA.

Which CHIA data did you regularly use?

BerryDunn regularly uses the MA APCD All-Payer Claims Database (MA APCD) and CHIA Enrollment Data. Depending on the topic of the benefit mandate, we might also use:

• Massachusetts Acute Care Hospital Inpatient Discharge Data (Case Mix)
• Emergency Department Database (Case Mix)
• Various other publicly available reports produced by CHIA

What was your experience using CHIA data?

Our data experts enjoy working with the MA APCD. Our team appreciates how streamlined the process is to access CHIA data while maintaining the highest levels of data security. Our team has confidence in the robustness and accuracy of the data that results from consistent carrier submissions. We appreciate the willingness of CHIA’s data experts to assist us when our analysts have questions.

What other data or research materials do you reference in your work?

The type of research needed varies by the subject matter of the proposed mandated benefit. The following describes the types of information that might be researched, depending on the topic:

• Publicly available carrier information (e.g., carrier policies)
• Massachusetts Department of Insurance membership data
• Other state MBRs, as appropriate
• Policy literature (published by foundations, research groups, or government agencies)
• Scholarly and practice-oriented literature as well as media
• Publicly available federal and state data
• Administrative data from public programs
• Stakeholder input in the form of interviews or written requests for information from the following:
• Legislative sponsors
• Health insurance carriers
• Medical experts, providers, and representatives from healthcare facilities

What type of information do you look for as you are analyzing the data?

BerryDunn most often utilizes the following fields: procedure and diagnosis codes, drug codes and names, provider information (specialties, credential levels, location, etc.), dates of service, units of service, unique users of service, allowed amounts, plan paid amounts, member paid amounts (e.g., deductible coinsurance and copays), member residence ZIP code, member age and gender, insurance type or product, service type (medical versus pharmacy), coverage type (self-only, self and spouse, family coverage, etc.), primary coverage indicator, and market category (individual, small group, large group).

BerryDunn may validate or compare MA APCD findings with other sources, such as the following:

• U.S. Census Bureau Data
• Medical Expenditure Panel Survey
• MassHealth Claims and Eligibility Data
• CDC Data

Publications and Data Releases

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Upcoming Events and Resources

Events and announcements of interest to our community, organized by CHIA, our data partners, and others

Department of Public Health Public Health Council Meeting
Wednesday, February 8, 2023, 9:00 AM
The Public Health Council of the Department of Public Health promulgates regulations, advises the Department on certain major policy decisions and actions and is responsible for voting Determination of Need applications submitted by health facilities. It meets once per month at DPH’s Boston office.

 

Boston Business Journal State of Healthcare Luncheon
Tuesday, February 14, 2023, 11:30 AM – 1:30 PM
Hear from key executives and professionals in Greater Boston health care as they explore the multiple facets of the industry and its economic impact. Each of the speakers will share their outlook on the healthcare sector with a BBJ journalist and then will be available for a Q&A panel with attendees. Come learn about what 2023 has in store for the people, the companies and the issues moving the business of health care forward. Register here.

 

CHIA Data User Workgroups
Tuesday, January 24, 2022, 3:00 PM
These ongoing meetings are designed for data users and other interested parties to connect with CHIA to discuss analytical techniques and best practices in research using CHIA's MA APCD and Case Mix databases.

The next virtual workgroup meeting will be on Tuesday, February 28, 2023 at 3:00 p.m. For more information including past presentations and user support materials, visit the information page. To learn more about CHIA data, please visit https://www.chiamass.gov/chia-data/.

 

Massachusetts Health Policy Commission
Benchmark Hearing
Wednesday, March 15, 2023, 12:00 PM
The HPC holds a public hearing to determine whether the health care cost growth benchmark should be adjusted for calendar year 2024. Under the framework set forth in Chapter 224, from 2023 through 2032, the health care cost growth benchmark will be set equal to potential gross state product (PGSP), or 3.6%, unless the HPC determines that an adjustment to the benchmark is reasonably warranted.

 

Pulse Center for Patient Safety Education & Advocacy Annual Symposium
March 15 – March 16, 2023
The Current Landscape of Patient Safety: Where We’ve Been, Where We’re Going is a virtual event featuring presentations and discussions led by patient safety experts across the U.S. The keynote speaker is Tejal Gandhi, MD, MPH, CPPS, Chief Safety and Transformation Officer at Press Ganey. Register here.

 

CHIA Oversight Council
Tuesday, March 21, 2023, 2:00 PM
CHIA’s appointed Oversight Council meets quarterly to discuss agency priorities and agenda-setting. The next meeting is scheduled for Tuesday, March 21, at 2:00 p.m and will stream live on CHIA’s YouTube channel.

 

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Join Our Team

A selection of open positions at CHIA. Please feel free to share broadly with your network. Follow CHIA on LinkedIn for more regular updates.

Research Analyst
Strategy and Research Team

Senior Research Analyst
Strategy and Research Team

Researcher
Strategy and Research Team

Research Intern
Strategy and Research Team

Senior Health Policy and Data Analyst
Health Informatics and Reporting Team

Health Policy and Data Analyst
Health Informatics and Reporting Team

Manager, Health Informatics and Reporting
Health Informatics and Reporting Team

 

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www.chiamass.gov