Freedman HealthCare APCD Clients
FHC’s team oversaw the system implementation and project management for the MA APCD, including building the MA Healthcare Quality and Cost Council’s private insurance claims dataset. The firm also helped design and launch the Council’s website, the first in the nation to display provider-specific quality and cost information simultaneously. For the website, FHC’s team researched existing quality and cost measures (inpatient and outpatient), assessed how well each measure met the Council’s principles for public measures, and facilitated discussions in public meetings to select measures. FHC also created reporting options for the website, drafted consumer-friendly text related to each measure, and helped design the display of the results for an audience with different levels of health literacy. After the state’s initial launch, the FHC team brought the MA APCD in-house from an outside vendor, and oversaw the quarterly data refreshes for the website including the upload process. FHC continues to provide ongoing advisory input on the selection of quality and cost measures for the MA website.
FHC is now supporting the Massachusetts Connector, the state’s health insurance exchange, in their first-in-the nation use of the APCD to meet data collection requirements for an alternative risk adjustment methodology. FHC’s work includes project management, business process development, data specifications, and carrier engagement.
The Center for Improving Value in Health Care (CIVHC) selected FHC to provide strategic planning, project oversight, and subject matter expertise to plan and launch its APCD. FHC led CIVHC’s Advisory Committee to decisions about APCD structure and operations, as well as the creation of data specifications that support CIVHC’s strategic goals. In addition, FHC drafted the regulations for data submission by carriers, guided the vendor procurement and selection process, and advised on elements of a consumer- and provider-friendly reporting and website portal.
FHC drafted the Advisory Committee’s report to the Legislature for 2011 and contributed to the 2012 report. More recently, FHC staff served as the interim project coordinator when the Colorado APCD:
- Completed its initial data submission phase, collecting historical data for 2.4M Coloradans, and did so only 22 months after statutory authorization;
- Launched the COhealthdata.org website;
- Implemented a data release process; and
- Developed a data compliance strategy.
In 2010, the RI Quality Institute and the RI Department of Health selected FHC to provide strategic planning and subject matter expertise for the development of the RI-APCD, laying much of the ground work for the Project Management Vendor role awarded to FHC in 2012. Since that time, FHC has worked closely with the State and its stakeholders to ensure that all APCD milestones and deliverables complete on time, on budget, and with an eye towards sustainability.
FHC has provided exploratory analyses, technical and subject matter expertise, and customized project management support as the APCD program embarked on an aggressive timeline to systematically collect and aggregate enrollment, medical claims, pharmacy claims, and provider data from eight commercial payers, Medicare, and Medicaid. With FHC assistance, the RI-APCD achieved all statutory and operational milestones required to begin full implementation by 2013, and procured a data intake and analytic vendor. Test data submissions to the RI APCD began in May 2014 and initial reports of population-based variations in healthcare costs and utilization, on more than one million commercial and Medicaid covered lives, will be available to state agencies by the end of this year. FHC is currently in the process of helping the state develop a comprehensive reporting program which includes a clear vision of the analytics it will run against the APCD data, the desired functionality of the reports generated from these analytics, and a process by which stakeholders can gain access to these data and reports
FHC advised the Tennessee Office of Health Planning (OHP) through its critical exploratory process as it determined the extent to which its APCD data could meet its health insurance exchange requirements related to risk adjustment. Through a focused strategy engagement, the FHC team examined the design of the data elements in the context of developing an alternative risk adjustment methodology under the Affordable Care Act. FHC then developed a list of recommendations as to how Tennessee could transform its APCD to support risk adjustment, documenting its findings and recommendations in a written report to OHP.
FHC is currently assisting Access Health CT, the Connecticut Health Insurance Exchange, with APCD design and implementation. FHC staff provided technical assistance during legislative deliberations in the spring of 2012. With passage of the law in May 2012, FHC assisted with drafting regulations and advising the state during public comment periods; project plan development; developing a successful budget proposal for federal consideration; and designing an approach to reporting that is consistent with stakeholders’ needs (see attached presentation). FHC will now assist the state with designing a data submission guide, preparing a scope of work for a data management vendor, and developing a sustainability plan.
The Alaska Health Care Commission, the state’s health planning and coordinating body charged with providing recommendations to the governor and the legislature on statewide health care policy and strategies for improving the health of Alaskans, engaged FHC to assess the feasibility of an APCD to support a range of analytic, management and reporting goals. A key component of this engagement was a comprehensive stakeholder process in which FHC conducted interviews and focus groups to understand the AK healthcare landscape. FHC met with AK providers, payers and consumers of care; state employees in the areas of administration, insurance and health; representatives from the Alaska eHealth Network, Alaska State Hospital & Nursing Home Association, and Alaska Native Tribal Health Consortium; and researchers. These interviews have informed FHC of some of the needs and challenges the state currently faces. The FHC team attended the Alaska Health Care Commission’s meetings in October 2012 and March 2013 to present findings. The presentation materials are available at http://www.hss.state.ak.us/healthcommission/meetings/201210/APCD%20Presentation.pdf.