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QAI Data Mart Overview

QAI Data Mart Overview. What is a Data Mart? Purpose of the QAI Data Mart Examples of Available Data Future plans. What is a Data Mart?. A data mart is a snapshot of operational data from one or many sources that facilitates analysis of trends and comparisons of data

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QAI Data Mart Overview

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  1. QAI Data Mart Overview • What is a Data Mart? • Purpose of the QAI Data Mart • Examples of Available Data • Future plans

  2. What is a Data Mart? • A data mart is a snapshot of operational data from one or many sources that facilitates analysis of trends and comparisons of data • A data mart is designed to support decision making over a well defined set of topics • A data mart is meant to serve one or two departments rather than the entire enterprise

  3. The Need for Data Marts • Operational systems are built to serve day-to-day administrative tasks • Enrollment • Service Authorization • Billing • Often designed without considering management reporting needs • Operational systems emphasize availability of current data over historical data

  4. The Need for Data Marts • Data marts are optimized for analyzing the data recorded by other systems • Data marts can merge data from different systems (and different organizations) for comparison and cross-referencing • Data marts focus on a historical data perspective that allows data from different time periods to be compared

  5. Accuracy of Information in a Data Mart • A data mart relies completely on source systems for data • No data entry in a data mart • Not intended to correct errors in data found in the source systems • Reports and analytical results only as good as the quality of data in the source systems

  6. Relationship to Other Systems • A data mart does not replace the operational reporting provided by source systems, which provide an up-to-the-minute picture of operations • Several data marts may coexist within the enterprise, each with a different purpose • A data mart is intended as an investigatory tool rather than a means to get everyday business done

  7. Purpose of the QAI Data Mart • Designed as a tool for DADS Quality Assurance and Improvement • Find areas to improve the quality of service provided to participants in DADS programs • Provide a platform for the analysis of program performance and participant outcomes • Fulfill evidentiary report requirements mandated by CMS for waiver renewal

  8. Purpose of the QAI Data Mart • Designed to provide better access to information generated by DADS • Intended to allow reporting on topics not currently available from other DADS systems • Combines data to allow comparison and cross-referencing between program areas, such as waiver program information from both legacy MHMR and legacy DHS

  9. Relationship to A&D Data Warehouse • Does not replace the A&D data mart • Not structured or intended for budgetary or accounting reporting or decision making like A&D • QAI Data Mart will implement measurement definitions differently than A&D in order to support program quality assurance and improvement

  10. Relationship to Operational Systems • Does not replace reports produced by operational systems like SAS and CARE • Operational reports generally focus on the present state of programs and participants • QAI Data Mart will focus on historical data to uncover trends and measure the affects of policy over time • QAI data is always at least one month old, not meant for up-to-the-minute reporting

  11. Benefits of the QAI Data Mart • Provides analysis and reporting capabilities not found in the agency today • Direct comparison of programs from legacy DHS and legacy MHMR • Measures utilization of services by comparing service authorizations with service payments on an individual basis

  12. Benefits of the QAI Data Mart • Allows QAI to take vague questions and turn them into more specific questions • Facilitates conversations about how to improve performance of programs and quality of life for program participants • Will help DADS management to formulate goals for program improvement and measure program performance against those goals

  13. Integration with CMS Quality Framework • Intended to provide measures of program quality based on the CMS quality framework • CMS quality framework identifies quality measures such as • Measure • Measure • Measure • QAI datamart provides the following

  14. Integration with CMS Quality Framework • The system may be used to identify the current state of program effectiveness and help management set goals for improvement • System can help measure program performance before and after policy changes to measure impact of new policy on program performance

  15. Examples of Available Data • The QAI Data Mart transforms data from its source systems into a structure with many relationships between pieces of information • The relationships allow users to look at the information from different points of view • The basic set of information building blocks can be used to remix many different reports • Data may be filtered, grouped and organized very efficiently to help answer questions

  16. Examples of Available Data • Average time between enrollment and receipt of first service for HCS for the last year • Service utilization per month over the last year across programs and services • Count of discharges per month for CBA over the last five years • The number of participants with downs syndrome or autism in ICFMR waivers (both MHMR and DHS) • Average plan of care cost per region/MRA • Counts deaths per program filtered by diagnosis

  17. Authorized Units Billed Dollars Paid Dollars Paid Units Utilization Count of Deaths Counts of Enrolled Participants Counts of Participants Receiving Services Plan of Care Dollars Permanent Discharges Temporary Discharges Examples of Available Data • Types of measures implemented in the first 2 out of 15 planned topic areas • We can take any measure and sum, average, or find the highest or lowest value

  18. Age group Diagnosis County / Region / MRA Ethnicity / Gender Month and Year Level of Care Level of Need Program Residence Type Service Code Slot Type Examples of Available Data • Ways in which information may be filtered or grouped in the Data Mart

  19. Examples of Available Data • Other questions we can address with the QAI Data Mart • What is the average time between enrollment and receipt of first service? • What percentage of participants receive all the services in their plan? • What percentage of services do consumers receive compared to amount authorized? • What services go unused?

  20. Enrollments Interest list Level of Care Level of Need Plans of Care CDS/SRO Options Programs Providers Abuse, Neglect and Exploitation Compliance and Oversight Complaints Critical Incidents Recoupments Participant Discharges Participant Transfers Future Plans • Establish measures for additional topic areas

  21. Future Plans • Integrate other program areas in addition to Medicaid waiver programs • Nursing Facilities • ICF/MR Facilities • Non-waiver Community Care • Hospice • Pace • STAR+PLUS • Integrated Care Management (ICM) • Title XX funded programs

  22. Future Plans • May be able to integrate additional data sources • Contract monitoring database (Shelly Swisher) • Utilization Review/Utilization Control database (Paul Zanetti) • Acute care data from TMHP • Additional eligibility data from TMHP

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