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

• 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Examples of Available Data

• 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

• 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

Examples of Available Data

• Age group• Diagnosis• County / Region /

MRA• Ethnicity / Gender• Month and Year

• Level of Care• Level of Need• Program• Residence Type• Service Code• Slot Type

• Ways in which information may be filtered or grouped in the Data Mart

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?

Future Plans

• 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

• Establish measures for additional topic areas

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

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