Attachment A 12 9.docx
DOCX document 98 KB Posted
- Solicitation number
- BD-22-1052-7000-7000-67023
- Issued by
- Suffolk County, Massachusetts
About this file
This document appears to be an overview of the data assets and reports produced by the Center for Health Information and Analysis (CHIA), a government agency in Massachusetts. The document outlines CHIA's various data collection efforts, including the All-Payer Claims Database, Case Mix data, Hospital Cost Reports, and the Massachusetts Health Insurance Survey, among others. It also summarizes the types of reports CHIA publishes, such as the Annual Report, Enrollment Trends, Healthcare Equity Report, and Prescription Drug Report, which cover topics related to uninsurance, underinsurance, healthcare affordability, quality, utilization, and social determinants of health.
The related state and local contract opportunity is an RFR (Request for Response) issued by the Commonwealth of Massachusetts, seeking research and analytics support for CHIA's programs of continuing studies. The RFR does not provide specific details about the project scope, quantities, response dates, or contract term, as this information is not included in the overview document provided.
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Attachment A – Overview of CHIA Work and Data Assets
CHIA Reports
| Topic |
| Publication |
| Latest Report |
| Area(s) of Interest |
| Data Used |
| APM Adoption |
| Annual Report |
| https://www.chiamass.gov/annual-report/ |
| Uninsurance and Underinsurance (affordability) |
| TME |
| Enrollment Trends |
| Enrollment Trends |
| https://www.chiamass.gov/enrollment-in-health-insurance/ |
| Uninsurance and Underinsurance (affordability) |
| APCD |
| Health Care Equity |
| Health Care Equity Report |
| To be released |
| Health Care Equity |
| MHIS |
| Health Care Quality |
| Quality Report |
| https://www.chiamass.gov/quality-of-care-in-the-commonwealth/ |
| Health Care Equity |
| Multiple sources |
| Health Care Quality |
| Selected Clinical Quality Measures |
| https://www.chiamass.gov/a-focus-on-provider-quality-selected-clinical-measures/ |
| Health Care Equity |
| HEDIS (via MHQP) |
| Healthcare Affordability |
| An Inside Look: Healthcare Affordability Findings from MHIS |
| https://www.chiamass.gov/massachusetts-health-insurance-survey/ |
| Uninsurance and Underinsurance (affordability) |
| MHIS |
| Hospital Financial Performance |
| Hospital Financial Performance Report |
| https://www.chiamass.gov/hospital-financial-performance/ |
| Health Care Utilization |
| Hospital Financial Performance |
| Hospital Profiles |
| Hospital Profiles |
| https://www.chiamass.gov/hospital-profiles/ |
| Health Care Utilization |
| Hospital Cost Report |
| Insurance Premiums and Member Cost Sharing |
| Annual Report |
| https://www.chiamass.gov/annual-report/ |
| Uninsurance and Underinsurance (affordability) |
| Premiums |
| Prescription Drug Use and Spending |
| Prescription Drug Report |
| https://www.chiamass.gov/prescription-drugs/ |
| Uninsurance and Underinsurance (affordability) |
| APCD |
| Primary Care and Behavioral Health |
| TBD |
| To be released |
| Behavioral Health |
| PC/BH |
| Readmissions and Revisits |
| BH Readmissions |
| https://www.chiamass.gov/behavioral-health-and-readmissions-in-massachusetts-acute-care-hospitals/ |
| Health Care Utilization; Behavioral Health |
| Case Mix |
| Readmissions and Revisits |
| ED Revisits |
| https://www.chiamass.gov/emergency-department-visits-after-inpatient-discharge/ |
| Health Care Utilization |
| Case Mix |
| Readmissions and Revisits |
| Hospital Readmissions |
| https://www.chiamass.gov/hospital-wide-adult-all-payer-readmissions-in-massachusetts-sfy-2011-2018/ |
| Health Care Utilization |
| Case Mix |
| Readmissions and Revisits |
| Readmissions Profiles |
| https://www.chiamass.gov/hospital-specific-readmissions-profiles/ |
| Health Care Utilization |
| Case Mix |
| Readmissions and Revisits |
| Social Risk Factors and Readmissions |
| https://www.chiamass.gov/assets/docs/r/pubs/2020/Social-Risk-Factors-and-Readmissions-report-February-2020.pdf |
| Health Care Utilization; Social Determinants of Health |
| Case Mix |
| Relative Price |
| Relative Price Report |
| https://www.chiamass.gov/relative-price-and-provider-price-variation/ |
| Health Care Utilization; Behavioral Health |
| RP |
| Rx Rebates |
| Annual Report |
| https://www.chiamass.gov/annual-report/ |
| Uninsurance and Underinsurance (affordability) |
| Rx Rebates |
| Total Health Care Expenditures |
| Annual Report |
| https://www.chiamass.gov/annual-report/ |
| Health Care Utilization, Uninsurance and Underinsurance (affordability) |
| Multiple sources |
| Total Medical Expenses |
| Annual Report |
| https://www.chiamass.gov/annual-report/ |
| Uninsurance and Underinsurance (affordability) |
| TME |
| Unmet Health Related Social Needs |
| Research Brief on Unmet Health Related Social Needs |
| https://www.chiamass.gov/assets/docs/r/pubs/2021/Unmet-HRSNs-Research-Brief.pdf |
| Health Care Utilization; Social Determinants of Health |
| MHIS |
CHIA Data Assets
| Data Collection |
| Data Specs |
| Databooks or Data Documentation |
| Description |
| All-Payer Claims Database (APCD) |
| https://www.chiamass.gov/apcd-data-submission-guides/ |
| https://www.chiamass.gov/assets/docs/p/apcd/apcd-8.0/APCD-Release-8-Documentation-Guide.pdf |
| The bulk of the records in the MA APCD are medical, pharmacy, and dental claims submitted by commercial insurance carriers and public programs (Medicare and Medicaid/ MassHealth). These claims come both from medical carriers and from specialty carriers and administrators of “carved-out” services including pharmacy, mental health/chemical dependency, dental, and vision. The database also contains records about individual plan members (e.g., demographics and enrollment), providers, and insurance products (e.g., product type and coverage type). |
| Case Mix |
| https://www.chiamass.gov/hospital-data-specification-manuals/ |
| https://www.chiamass.gov/case-mix-data/ |
| The Case Mix data includes detailed information on inpatient discharges, emergency department visits and observation stays at acute care hospitals in the Commonwealth. For each of these patient encounter types, hospitals submit detailed information, including: patient demographics, admission and discharge information, diagnostic and procedural coding, provider details, expected primary and secondary payer information, and detailed charge information. For comprehensive documentation on these data sets, please see the documentation manuals. |
| Hospital Cost Reports |
| https://www.chiamass.gov/assets/docs/p/hospital-reports/Hospital-Cost-Report-Filing-Instructions.pdf |
| https://www.chiamass.gov/hospital-cost-report-data-access-tool/ |
| CHIA collects annual hospital cost reports for both acute care and non-acute care hospitals. The Massachusetts Hospital Cost Report leverages data already reported by hospitals to Medicare on the CMS 2552-10 filing, while still collecting data specific to Massachusetts hospitals. |
| Hospital Financial Performance |
| https://www.chiamass.gov/assets/docs/p/hospital-reports/AHFPR-Instructions.pdf |
| https://www.chiamass.gov/multi-source-acute-hospital-financial-dataset/ |
| The Multi-Source Acute Hospital Financial Dataset is an integrated dataset that combines available acute hospital financial data from a variety of CHIA data assets. This consolidation of data includes the available financial information for acute care hospitals in Massachusetts, including cost, revenue, financial performance, payer mix, utilization, and hospital characteristics. Sources include the Hospital Cost Report Data, Hospital Standardized Financial Statements, and the Massachusetts Hospital Profiles. |
| Massachusetts Employer Survey (MES) |
| N/A |
| https://www.chiamass.gov/massachusetts-employer-survey/ |
| The Massachusetts Employer Survey asks Massachusetts employers to share their experiences and challenges in offering health insurance to their employees. This survey is a way for CHIA to gather information about employer-sponsored health insurance coverage in Massachusetts. |
| Massachusetts Health Insurance Survey (MHIS) |
| N/A |
| https://www.chiamass.gov/massachusetts-health-insurance-survey/ |
| The Massachusetts Health Insurance Survey (MHIS) is a statewide, population-based survey of households and individuals. It provides information on health insurance coverage, health care access and use, and health care affordability for Massachusetts residents as part of CHIA’s Continuing Study on Insurance Coverage, Underinsurance and Uninsurance. The MHIS is used to track and monitor the experiences of Massachusetts residents in obtaining timely and affordable health care. While national data sources can help to monitor some aspects of health insurance coverage and health care access, this survey provides the ability to track issues that are specific to Massachusetts. The MHIS additionally enables CHIA to track key populations that are of particular interest to the Commonwealth. In select survey years, additional recontact surveys provide deeper insights on unique or emerging health care topics. |
| Other Provider Cost Reports |
| https://www.chiamass.gov/information-for-data-submitters/ |
| N/A |
| CHIA collects and maintains cost report datasets from other health care providers across the Commonwealth, including: Adult Day Health; Adult Foster Care; Ambulance and Chair Car Services; Group Adult Foster Care; Community Health Centers; Nursing Services; Nursing Facilities; and Resident Care Facilities |
| Premiums Data |
| https://www.chiamass.gov/assets/docs/p/premiums/2021-Premiums-Data-Submission-Manual.pdf |
| https://www.chiamass.gov/annual-report/ |
| CHIA collects annual commercial health insurance premiums data from health care payers, allowing for insights into the costs borne by both Massachusetts employers and employees. CHIA also monitors high deductible health plan enrollment and consumer cost-sharing over time. |
| Prescription Drug Rebates (Rx Rebates) |
| https://www.chiamass.gov/assets/docs/p/prescription-drug-rebate/Prescription-Drug-Rebate-Data-Specification-Manual-2021.pdf |
| N/A |
| Prescription Drug Rebates data includes information from commercial insurers on pharmacy expenditures, prescription drug rebates, and coverage gap discounts for Medicare business in order to consider the impact of prescription drug rebates on cost growth trends |
| Quality Measures Catalog |
| N/A |
| N/A |
| CHIA collaborates with the HPC to collect annual information from payers on use of quality measures in global budget risk-based contracts. The catalogue includes which measures are in contracts, number of contracts, and whether they are pay-for-reporting or pay-for-performance. |
| Relative Price (RP) |
| https://www.chiamass.gov/assets/docs/p/tme-rp/relative-price/2021-Payer-Reporting-of-Relative-Prices-Data-Specification-Manual.pdf |
| https://www.chiamass.gov/relative-price-and-provider-price-variation/ |
| Relative Price (RP) facilitates comparison of average provider prices, accounting for differences in patient acuity, the types of services providers deliver to patients, and the different insurance product types that payers offer to their members. CHIA calculates both payer-specific RP, which enables comparison within a payer’s network, and cross-payer statewide relative price (S-RP), which enables comparison across commercial payers. |
| Selected Clinical Quality Measures |
| N/A |
| https://www.chiamass.gov/a-focus-on-provider-quality-selected-clinical-measures/ |
| CHIA contracts with MHQP to collect a subset of HEDIS clinical quality measures bi-annually. Only commercial HMO and POS enrollees are included in data samples. |
| Standard Quality Measures Set |
| N/A |
| https://www.chiamass.gov/sqms/ |
| CHIA uses multiple data sources to report on the SQMS and to ensure that performance can be compared to national standards. |
| Total Medical Expenses (TME) |
| https://www.chiamass.gov/assets/docs/p/tme-rp/2021-TME-APM-Data-Specification-Manual.pdf |
| https://www.chiamass.gov/annual-report/ |
| Total Medical Expenses (TME) represents the full amount paid to providers for health care services delivered to a payer’s member population. TME includes the amounts paid by the payer and patient cost-sharing, and covers all categories of medical expenses and all non-claims related payments to providers, including provider performance payments. |
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