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Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) ACA Enrollment Reporting PowerPoint PPT Presentation


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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

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Massachusetts all payer claims database technical assistance group tag aca enrollment reporting

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)


Massachusetts all payer claims database technical assistance group tag aca enrollment reporting

*NOTE: THIS SLIDE WAS UPDATED AFTER THE TAG. INCLUDES FINAL CHANGES. 5/1/2014


Massachusetts all payer claims database technical assistance group tag aca enrollment reporting

Timeline

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

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

  • 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)


Key data elements june 2013 guidelines

Key Data Elements – June 2013 Guidelines


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

How CHIA Will Use MA APCD 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

  • 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

  • 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?


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