QAI Data Mart Overview
Dec 31, 2015
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