The Department of Health Care Finance Medicaid Data Warehouse MDW – Release 1.1
The DHCF Medicaid Data Warehouse (MDW) went live on Saturday, September 30, 2017, marking the culmination of 3 years and 9 months of design, development and implementation (DDI) activity under the MDW implementation advanced planning document (IAPD) funding agreement established between DHCF and the Centers for Medicare and Medicaid Services (CMS). The DDI portion of information technology (IT) projects are funded at a 90% federal financial participation (FFP) rate (states contribute 10%), and at the end of the DDI period, projects enter the maintenance and operations (M&O) phase where federal support funding is provided at 50-55% and states must provide 45-50% funding until the system is certified by CMS. All Medicaid IT systems must be certified by CMS before they can be financially supported by CMS at the regular state FMAP, which is 75% (CMS) to 25% (DC) in our case. This release of the MDW (1.1) adds a broad range of functionality and features to the DHCF end-user experience. The overall purpose of the data warehouse is to provide easy and timely access to more claims-based data, reports and functionality than were previously available, and to do so in a secure way so that private and sensitive information are protected as required by various federal and local statutes and regulations. With this release, DHCF management, staff and end-users will have controlled access to a number of pre-built reports, dashboards and MDW core functions that, in the Director’s words, “will change (improve) the way we do business.” All reports, dashboards and core MDW functionality are currently undergoing a rigorous testing and validation process that is designed to ensure the highest degree of accuracy, finely-tuned performance and reliability of each MDW product. Fully-validated MDW products will be made available to end users who have completed required training sessions (described below under MDW training).
Pre-built Reports and Dashboards
Pre-built Reports MDW Release 1.1 (MDW.R.1.1) gives DHCF management, staff and authorized end users access to a large number of requirements-driven, pre-built reports designed to reduce the time spent producing over 75% of frequently-requested reports to minutes and seconds as opposed to weeks and days. Some of these pre-built reports are static (canned reports) that are updated weekly in concert with the weekly updates to the MMIS data source. A significant majority of the pre-built reports are dynamic and respond to the selection of specific selection criteria, such as individual or multiple years and time periods, demographics, claims types, service categories, provider types and specialties, and program codes. Among the pre-built reports available in this release are the following federal reports (required by CMS): • CMS-9710 • CMS-64 • CMS-416 • CMS-372 Pre-built Dashboards Dashboards are combinations of separate-but-connected reports on the same visual screen. Dashboards can be static and designed to tell a particular story on a visual screen or dynamic, where the selection of specific report criteria on one chart results in the repopulation of other charts on the dashboard to reflect data associated with the selection. This MDW release provides access to pre-built, subject-specific local reports dashboards representing frequently-used and requested subject areas, such as: • Enrollment • Provider and Provider Specialty • Beneficiary Demographics & Use Profiles • Service Utilization • Spending • Claims Analysis & Profiling • Quality Metrics • Outcomes Analysis • Predictive Analytics • High-Cost vs. Low-Cost Claims Analytics • Long Term Care Profiles • Program Integrity Profiles • MCO Profiles
MDW Core Functionality
With the current release, users can expect the following internal data functions and features • Data Extracts • Queries • Reports • Dashboards • Forecast Analytics • Predictive Analytics
Roll-Out Strategy and Process
To ensure that the MDW is used optimally by DHCF managers, staff and authorized end users, the following roll-out processes will be implemented: • Train and prepare DHCF Management, staff and end users to navigate MDW features and functionality; • Provide detailed end-user guidance and instructions to avoid misuse and incorrect results; • Provide internal and formal training in analytics tools (SAS & SAS VA, Tableau and Power BI); • Test, validate and provide controlled and secure access; • Prepare for CMS certification by December 31, 2017; • Invite CMS to begin and complete certification during the first quarter of CYT 2018; and, • Provide controlled external access between Q1 and Q2 2018. Why controlled access? Due to the privacy and security requirements for providing access to and sharing sensitive data and the complex nature of Medicaid claims, the MDW will operate on certain principles. Each DHCF manager, staff, and end user will have defined roles and responsibilities that determine their access to various components of the MDW. The following is a likely scenario of how this will work: • Managers of our business units will identify the kinds of information and data their staff are allowed access to and our Data Governance Committee will also play a role in verifying or authorizing such access. • The MDW administration will enable such access as identified by management and approved by the Data Governance Committee. • End users will be provided information on their MDW access roles and responsibilities. • Each end user will be required to undergo HIPAA training and also basic MDW training before access is granted according to their approved roles. • Some end users (“Power Users”) who may have volunteered to perform “testing” and “validation” functions will be required to receive training and acquire proficiency in the use of at least one of our deployed business intelligence tools (e.g. Tableau, SAS Visual Analytics, or Power BI). These users will have the ability to develop reports and functionality for the data warehouse according to their demonstrated ability.