Enhancing Maine’s All-Payer Claims Database
Since 2003, the Maine Health Data Organization (MHDO), one of the first all-payer claims databases in the nation, has been mandated by state legislature to collect healthcare claims data. In 2012, MHDO looked to improve customer service and experience and leverage more advanced technologies to refresh its warehousing functions. As a result, MHDO engaged HSRI (Human Services Research Institute) and NORC to achieve its goals.
With the goal of producing more timely and higher quality data, the HSRI NORC team worked with project partners, data submitters, and end users to help inform the redesign of the Maine APCD, submission portals, and data warehouse. This effort resulted in the creation of innovative processes for collecting and utilizing the state’s healthcare claims data, including hospital encounter data, hospital financial data, and information related to all physical health, dental, pharmacy, behavioral health, and disability-related services.
We also developed a public reporting website (CompareMaine.org), which is one of the only health transparency sites in the nation that presents quality ratings alongside cost information. The site, for which MHDO was awarded the distinguished 2016 Data Dissemination Award by the National Association of Health Data Organization (NAHDO), shows how patients rank their overall experience and how Maine hospitals compare with one another across nearly 250 medical procedures from 240 healthcare facilities, including hospitals, surgical centers, diagnostic imaging centers, labs, and clinics. What’s more, the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute’s jointly released report card on price transparency laws identified Maine as one of only three states in the nation to receive a grade of “A” in 2016.
NORC supports HSRI in performing core project management, reporting and quality assurance functions, and web platform development and maintenance. The Maine APCD is hosted in the NORC Data Enclave®, the industry-defining high-performance computational, storage, and analytical environment for secure research of sensitive and confidential data. NORC ensures regulatory compliance with FISMA, HIPAA, and QECP standards and is responsible for security of the data and protecting patient privacy.
NORC provides managed and professional services for the core engineering and maintenance of the Maine APCD warehouse infrastructure, tiered access to the data, user support and technical assistance, and disclosure controls. Recently the NORC team built and deployed a new data request portal to supplement MHDO’s service offering to stakeholders. Finally, NORC is the CMS DUA Custodian on behalf of MHDO.
Several state initiatives to improve the health and health systems for the residents of Maine were directly informed by APCD and hospital encounter data. These initiatives are providing:
- Information for Maine’s Opioid Task Force on opioid treatment in the state
- Data to inform Maine’s comprehensive annual report of the physical, social, economic, and educational well-begin of Maine children, the annual Maine KIDS COUNT Data Book
- Information for state legislature to evaluate costs of surgical procedures across hospitals in Maine