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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) ACA Enrollment Reporting. April 29, 2014. Agenda. Introductions Goals of Membership Reporting Game Plan Monthly Membership Report Reporting from MA APCD – Key Data Elements MA APCD Data Validation

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Massachusetts All-Payer Claims Database:Technical Assistance Group (TAG)

ACA Enrollment Reporting

April 29, 2014


Agenda

Agenda

Introductions

Goals of Membership Reporting

Game Plan

Monthly Membership Report

Reporting from MA APCD – Key Data Elements

MA APCD Data Validation

Summary

Questions


Introductions

Introductions

Aron Boros – Executive Director, CHIA

Lori Cavanaugh – Deputy Executive Director, HSP

Marilyn Schlein Kramer – Deputy Executive Director, HIT

Deb Schiel – Director of Analytics, HSP

Kathy Hines – Director of Data Compliance and Support


Goals of membership reporting

Goals of Membership Reporting

Quarterly reportto be shared broadly, including:

Governors office, A & F

CCA Board of Directors

CHIA website

Monitor changes in enrollment due to ACA, including

Enrollment thru Exchange and directly at carriers

Insured as well as self-insured


Game plan

Game Plan

Carriers requested to submit overall commercial membership counts – to be described by Deb Schiel

Through September 2014

After September, data to be sourced from MA APCD – to be described by Kathy Hines

Provided that plans can populate three data elements

ME045– Purchased on Exchange or Not

PR004– Qualified Health Plan

ME126- Risk Adjustment Covered Plan (RACP)



Timeline CHANGES. 5/1/2014

n

Note: Retroactivity should be reflected in your submissions. Meaning March membership reported in the June submission may be different than enrollment reported in May.


Submission to chia

Submission to CHIA CHANGES. 5/1/2014

Spreadsheet submitted monthly

SENDS+ not needed

Aggregate data no encryption needed

Submit directly to liaison


Key data elements in ma apcd

Key Data Elements in MA APCD CHANGES. 5/1/2014

  • Three fields are needed to determine whether a plan is a QHP, purchased inside/outside the MA Connector

    • Product Line of Business (PR004)

    • Purchased Through MA Exchange Flag (ME045)

    • Risk Adjustment Covered Plan (ME126)



How chia will use ma apcd data elements to capture enrollment on off of exchange

How CHIA Will Use MA CHANGES. 5/1/2014APCD Data Elements to Capture Enrollment On/Off of Exchange

* Will use values of 1 or 3 per Connector.


Ma apcd data validation
MA APCD Data Validation CHANGES. 5/1/2014

  • Insured lives for carriers reporting to DOIDOI/CHIA visits scheduled for May-June as part of reconciliation of MA APCD with DOI Quarterly Membership report submissions

  • Carriers not reporting to DOI and self insured livesCHIA process over the summer


Summary
Summary CHANGES. 5/1/2014

  • Monthly membership report (total number) beginning in May thru September

  • MA APCD used beginning in September

  • MA APCD validation in the interim, in part in conjunction with DOI


Questions

QUESTIONS? CHANGES. 5/1/2014


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