apcd data privacy & security subcommittee

APCDDataPrivacy&SecuritySubcommittee

Meeting#2– May3,2019

Presentedby:CedarBridgeGroup

MeetingAgenda

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AgendaItem TimeWelcome&Introductions 9:00amPublicComment 9:05amRecapofMeeting1 9:10amContinuationofEnvironmentalScan 9:15amFollow-upItemsfromMeeting1 9:40amNextSteps 9:55am

TheSupportTeamStateofConnecticut

AllanHackney- OfficeofHealthStrategyHealthInformationTechnologyOfficer

RobBlundo– AccessHealthCTDirector,TechnicalOperations&Analytics

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CedarBridgeGroupCarolRobinsonMichaelMatthewsChrisRobinsonMarkHetz,MBADawnBonder,JDSheetalShah,MPH

CommitteeMembers:

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Ø Dr.RobertScalettar (Chair)– RESHealthStrategies/AccessHealthCTBoardMember

Ø TedDoolittle– OfficeoftheHealthcareAdvocate

Ø MatthewKatz– ConnecticutStateMedicalSocietyØ JoshuaWojcik– OfficeoftheStateComptroller

Ø PatChecko– RepresentingtheDataReleaseCommitteeØ JeanRexford- ConnecticutCenterforPatientSafetyØ JamesIacobellis – ConnecticutHospitalAssociationØ BernieInskeep – UnitedHealthGroupØ KristaCattanach – AetnaØ Dr.VictorVillagra – UniversityofConnecticutHealth,HealthDisparitiesInstitute

APCDDataPrivacy&SecuritySubcommitteeØAreviewofapplicablepoliciesandproceduresisrequiredtosupportthetransitionofAPCDprogramfromAccessHealthCT(AHCT)totheOfficeofHealthStrategy(OHS)

ØSubcommittee’sinitialchargeistoreviewandcommenton:▫ ExistingAccessHealthCT(AHCT)policies▫ APCDpolicypracticesfromotherstates▫ Currentoranticipatedconcernsfromdatarecipients,OHSstaff,etc.▫ Definepolicyrecommendationsandnextsteps▫ PresentrecommendationstotheAPCDCouncilforreviewandaffirmation

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RecapofMeeting#1

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RecapofMeeting#1ØIntroductionandMemberPerspectivesØEnvironmentalScan– Round1ØFollow-upActions▫ Statutory/regulatoryimplications▫ Creatingagridofstate-leveldata▫ Gettingmoreinformationfromneighboringstates,includingMA,NY,RIandVT▫ UseofAPCDdatatoassessquality▫ SummaryreviewofpreviousAPCDdatarequests

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ContinuationofEnvironmentalScan

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OverviewofEnvironmentalScanOnlineresearch

• Arkansas• Connecticut• Maine• Massachusetts• Minnesota• NewYork• RhodeIsland• Utah• Vermont• Virginia

Telephoneinterviewore-mailresponseand onlineresearch

• Colorado• Maryland• NewHampshire• Oregon• Washington• APCDCouncil• NationalAssociationofHealthDataOrganizations(NAHDO)

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States contactedforfurtherinformation

• Massachusetts• NewYork• RhodeIsland• Vermont

CharacteristicsAssessedüTreatmentofProtectedHealthInformationüDataReleaseGovernanceüDataReleaseProcessüTransparencyofDataRequest/Release

ØPublicationofSecurityMeasuresØConsumerOn-lineAccesstoDataØTreatmentofCost(Pricing)Data

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PublicationofSecurityMeasures

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MinimalDescription

ExtensiveDescription

Silent(orNearlySilent)onSecurity

CitesCompliancewithHIPAAand/orHITECH

25%

19%

25%

31%

=Connecticut

ØStatesaretrendingtowardlessspecificityintheirpublishedmaterialsaboutsecuritymeasuresemployedbyAPCDprograms;mostciteadherencetoindustrystandardsand/orregulations

ØThistrendcutsacrossindustriesandisnotlimitedtoAPCDprogramsorhealthcaredatasystems

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TrendsandObservations:PublicationofSecurityMeasures

ConsumerOnlineAccesstoData

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PublicUseFiles

On-lineInteractiveToolsNoneorNearly

None

LibraryofReportswithSomeAbilitytoSortand

Filter

=Connecticut

25%

25%19%

31%

ØSomestatesareprovidinginteractiveonlinetoolsforconsumerstoassesscostandqualityofcareofferedbyprovidersforspecificprocedures

ØSomestateshavefoundthatbyprovidingpreparedreportsandalibraryofpapers,datarequestsarereduced§ Thiscouldhaveanunintendedconsequenceforprogramsustainabilitybyreducingthecollectionoffees

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TrendsandObservations:ConsumerOnlineAccesstoData

TreatmentofCost/PricingDataAPCDLegislativeMandate– ConnecticutPublicAct13-247

EnabledtheExchange’screationoftheConnecticutAll-PayerClaimsDatabase(“APCD”).PursuanttoPublicAct13-247,variousDataSubmittersarerequiredtoreporthealthcareinformationtotheExchangeforinclusionintheAPCD.

TheActallowstheExchange:

(i)toutilizehealthcareinformationcollectedfromDataSubmitterstoprovidehealthcareconsumersinConnecticutwithinformation concerningthecostandqualityofhealthcareservicesthatallowssuchconsumerstomakemoreinformedhealthcaredecisions;and

(ii)todiscloseDatatostateagencies,insurers,employers,healthcareproviders,consumers,researchersandothersforpurposesofreviewingsuchDataasitrelatestohealthcareutilization,costsorqualityofhealthcareservices.

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TrendsandObservations:ReleaseofCost/PricingDataØStateshavebeguntomakecost/pricingdataavailabletoconsumersØEffortsvary:§ Pre-preparedreports§ Regionalreportswithsomecustomizationpossiblethroughaninteractivewebsite

§ RobustcostdatabyproviderandprocedureØConsumerusabilityvariesacrossAPCDprogramwebsitesØBestefforts(CO,ME,NH,WA)offerrobustdata(costandquality)onconsumer-friendly,interactivewebsitesthatprovideinformationconsumerscanusetomakehealthcarechoicesbaseduponcostandqualityforspecifichealthcareprocedures

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ØThereappearstobeatrendthatovertime,healthcareorganizationsbecomemoreacceptingofthepublishingofpricedataforspecificproceduresbyanAPCDprogram§ Thisislikely aresultofbuildingtrustandofsharedrecognitionofthevalueoftheinformation

ØThosestatesreleasingpricingdatatothepublicaredoingsoinahighlycuratedwaytoaddresspayor/providerconcerns,andalsotohelpensurethedataiseasilytounderstandandunlikelytobemisconstruedbyconsumers

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TrendsandObservations:TreatmentofCost(Pricing)Data

AdditionalTrendsandObservations

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Ø Theenvironmentalscanhighlightedtheneedforstatestobecognizantofthelevelsofstakeholdertrust,confidence,andcommitmenttoanAPCDprogram

Ø Trustofstakeholdersisessentialinordertofindconsensuspositionsondatacollectionandondataavailabilityforavarietyofpurposes§ TrustinAPCDdataquality§ TrustinaccuracyofdatareportsfromtheAPCDprogram§ TrustintheprocessesusedtodeveloppoliciesandproceduresfortheAPCDprogram§ TrustintheapplicationofpoliciesandproceduresbytheAPCDprogram§ TrustinthefairnessofAPCDdataavailabilityanddatausepoliciesandprocedures

Ø AsstakeholdertrustandconfidenceinanAPCDprogrambuilds,newopportunitiesforexpandingtheuseofAPCDdatacanbeconsideredandsourcesoffundingofanAPCDprogrammayincrease

TRUSTinPRIVACY,SECURITY,andACCURACYofDATA=VALUE

VALUE=SUSTAINABILITY

Follow-upActionItems

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StatutoryandRegulatoryImplications

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State-levelGridofResponses:

Adetailedbreakoutofcharacteristicshasbeenprovidedwiththemeetingmaterials

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21

UseofAPCDDataforQualityMeasurement

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SummaryofDataRequestsandDisposition

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Meet and Discuss Submit Review &

Consult

Committee Review & Approval

Sign Agreement

Submit Payments

Data Request Fulfilled

OverviewoftheDataReleaseProcess

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25

12

1

2

1

Approved Not Approved Scheduled for DRC Review Submitted to APCD

*15 applications received to date

ApplicationDispositionOverview

Organization ProjectName Objectives Date Disposition

UConnHealthCenter SIMEvaluation

1. HowishealthcaredeliverychangingunderSIM2. Creationofanonlinescorecardtodisplayhealthcarequalityratingsandcreatequality

transparency.3. Developmentofaphenotypicalgorithmforsuicideriskprediction.

Jul-17 Approved

Altarum Institute PrometheusAnalytics

1. Whatepisodesofcareprovidebestopportunitiesforimprovementincostandquality2. HowdoesCT’smedicalcostandqualitycomparetootherstatesforsimilarepisodesof

care3. Extentofprovidervariationincostsandquality

Dec-17 Approved

UConnHealthCenter

HealthCareCostandUtilizationof

CommerciallyInsuredDiabetesPatientsin

Connecticut

1. OverallhealthcareutilizationpatternsandassociatedcostsforindividualscommerciallyinsuredinConnecticutanddiagnosedwithdiabetesatanytimeduring2012-2016

2. Differencesinprevalenceofdiabetesrelatedhealthcareutilizationandcostsforpatientsbasedondemographics(e.g.agegroup,gender,townofresidence)

3. ComparisonofhealthcarecostsandcosttrendsforpatientsdiagnosedwithdiabeteswhoreceivedDSME

Dec-17 Approved

MMSAnalytics,Inc.d/b/aMyMedicalShopper

MyMedicalShopperConnecticutExpansion

1. UseCTAPCDdatatoaugmenttheMyMedicalShopper platform2. UseCTAPCDdatatogenerateanestimateofproviderquality,takingintoaccount

marketshareandspecializationFeb-18 Approved

SouthernCaliforniaUniversityofHealth

SciencesAtlasofIntegrativeHealth1. Howpatientaccesstohealthcareservicesdifferbyspecialty

2. Utilizationofchiropracticservicesassociatedwithreduceduseofprescriptionopioids Feb-18 Approved

DataRequestSummary

26


YaleUniversityCervicalCancerScreening

TrendsinConnecticutandNewHavenCounty

1. CervicalcancerscreeningrateinConnecticutandNewHavenCounty2. Whatcervicalcancerscreeningguidelineslooklikeovertime Mar-18 Approved

YaleNewHavenHealthSystemandYaleSchool

ofMedicine

PopulationHealthTotalCostofCareandCareContinuity

Enhancement

1. Identifyandunderstandgapsincareforpatientswehavetreated2. Understandpatternsincarethatmaypresentopportunitiestoimprovefollowup,enhance

qualityofcare,andreducetotalcostofcare Aug-18 Approved

ConnecticutChildren’sMedicalCenter

HealthcareUtilizationAssessment

1. Pediatriccareutilizationinfree-standingurgentcarecentersandwhatmightbebetterservedbyincreasedprimarycareorsubspecialistaccessthroughroutinemaintenanceandprevention

2. Withaknownbehavioralhealthcareshortage,wherearepatientsseekingcarecurrentlyandwhatisthefullcourseoftheirhealthcarepathwayandtreatment

3. Whereisgreatestopportunityfortelemedicinetoreducecostsandimproveaccessinpediatrics

Oct-18 Approved

FreedmanHealthcare(FHC)

CostandMarketImpactReports(CMIR)forHospitalAcquisitions,

2018-2019

1. Understandcurrentmarketshareforservicesprovidedbythepartiesandifacquisitionwillleadtodominantmarketsharefortheseservices

2. Understandcurrentrelativepricesofthepartiesandifrelativepriceswillincreasebecauseoftheacquisition

3. Understandthecurrenthealth-statusadjustedtotalmedicalexpenses(HSATME)forpartiesandiftheacquisitionwillresultinHSATMEthatishigherthantheCTmedianHSATME

Oct-18 Approved

HMS DigitalHeatlhCooperativeResearchCenter(DHCRC)

1. Developpredictivemodelforthosemostlikelytoabuseopioidsandthosemostlikelytobecomere-abusiveaftertreatment

2. Compareefficacyofcurrentopioidtreatments3. Developpredictivemodeltoidentifythosemostlikelytorequirereadmissionafterinitial

inpatienthospitalstay

Oct-18 NotApproved

DataRequestSummary

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RemedyPartnersInc.

ProviderLevelPriceandQualityTransparencyThroughtheLensofEpisodesofCareinPublicand

CommerciallyInsuredPopulations

1. HowdoesprovidercostandqualitydifferamongpublicandcommerciallyinsuredpopulationswithinConnecticutandnationwide Mar-19 Approved

UConnAnalyticsandInformationManagement

Solutions

HealthcareAnalyticReportingfortheOfficeofHealth

Strategy

1. AnalyticsonbehalfoftheHealthCareCabinetregardinghealthcareutilizationandassociatedcosts

2. AnalyticsonbehalfoftheOHSandtheOfficeoftheStateComptrollerregardingprescriptiondrugcostsandimpacts

3. AnalyticsonbehalfoftheOHSregardinghealthcareutilizationandafacilities,services,andequipmentinventory,aswellastoaidintheCostandMarketImpactReview.

Mar-19 Approved

TheMiriamHospital/BrownUniversity

UsingBigDatatoDeterminePre-exposureProphylaxis(PrEP)UptakeandPersistenceinSouthernNewEngland

1. DeterminePrEP uptakeandpersistenceusingAPCDsinSouthernNewEngland2. ConductaGISanalysistoassessrural-urbandisparitiesinPrEP uptakeandpersistence

acrossSouthernNewEnglandApr-19 ScheduledForDRC

Review

TheStateofConnecticutOfficeoftheStateComptroller

(OSC)andTheSesal Group

HealthCareOptionforSmallGroup

1. EvaluatehistoricalclaimsdataforConnecticut’ssmall-group,fully-insuredpopulationtodetermineexperienceandtrends.

2. Testfeasibilityofcreatingapubliclysponsoredhealthcareoptionforthesmallgrouppopulationthatcanprovideratereliefforsmallemployerplansponsorsandcoveragefortheiremployees

Apr-19 ScheduledForDRCReview

UniversityofConnecticutSchoolofMedicine

EpidemiologyofChronicIllnessamongConnecticutResidents

1. CharacterizetheepidemiologyofchronicillnessamongConnecticutresidentsfrom2012to2019. Apr-19 SubmittedtoAPCD

DataRequestSummary

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NextMeetingØAdditionalinputfromneighboringstates

ØUseofAPCDdataformeasurementofquality

ØAssessmentofCTPrivacyPolicy� Components� Comparisonstootherstates/bestpractices� Firstpassidentificationofareasforimprovement

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apcd data privacy & security subcommittee

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