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Monthly APCD User Workgroup WebinarApril 22, 2014AgendaRelease 2.1Master Patient IndexApplying for Release 2.1Questions/SME Office HoursRelease 2.1 FeaturesSame data as in Release 2.0Dates of service (2009-12 paid thru June 13)No new data submissionsImportant data enhancementsHighest version flags for three more payersMaster Patient Index on CY 2011 and 2012 data (Including 6 months of run out).Master Patient Index – SummaryCustom probabilistic matching algorithm based on MA APCD data submissionsIBM Initiate SoftwareRefined by 12,000+ manual reviews of proposed matches by CHIA staffResulting data elementsMEID – Member Enterprise ID MCL - Matching Confidence LevelThe ProblemOver 100 sources of dataRolling 24 months of eligibility65M records/monthProbabilistic model:Low tolerance for false positivesMinimize false negativesNo manual reviewsData Elements Used in ModelPartial ListMember NameMember SSNMember DOBMember AddressMember GenderSubscriber SSNCarrierSpecificUniqueMemberID and Organization IDComparison ComponentsFalse negatives are often caused by variation in data – nicknames, spelling error, transpositions, etc.The comparison functions compare attribute values from two records and determine how closely they matchThey are empirically derivedWhen you compare attributes, what types of errors do you observe?How do you measure “close”?IBM Initiate has a library of these functions which include …General routines which can be applied to arbitrary attributesEdit distance – 555059552 and 554045952 are 2 apartResolution-based – postal codes agree exactly or on the first n digitsSpecific routines based on IBM experiencePerson names – Exact match, nickname match, phonetic match, name-to-initial match, edit distance – check all alignmentsAddress – Consider different weights for numeric tokens versus alpha tokensSource: IBMModeling Process The IBM MDM Weight Generation Process Manual Adjustment and Adding of Weights Based on feedback from Sample Pairs Review process Over 12,000 samples reviewed by handCreation of filters to reduce false positives, for example to assure the following types of matches can not be linked even with some similar data fields:Father/Son, Mother/DaughterSiblingsTwinsThe Matching & Linking ProcessThe MDS receives a record added to sourceThe MDS standardizes the record…… and creates derived dataThe MDS selects candidates from the DBThe MDS scores the comparisonsAnd links the inbound recordResult: Member Enterprise ID19 digit numberAssigned by the system to each “entity group”No embedded intelligence in the number Appears on the Member Eligibility and Claims filesEntity Group Simplified ExampleNameAddressDOBGenderMC Record 1Charles M Smith18 Main Street12/12/94MMC Record 2Charles Smith18 Main St12/12/95MMC Record 3CM Smith18MainSt12/12/94MME Record 1Charlie Smith19 Main St12/2/94UnknownME Record 2Charles Smith18 Main12/12/94FPC Record 1Charles N Smith18 Main Street12/12/84MMaster Patient ValidationDistribution of Member Enterprise IDs by Age YE 2011 and 2012Master Patient ValidationNumber or Org IDs for Member Enterprise ID in 2011 and 2012Master Patient ValidationMember Enterprise ID Compared to US Census Estimate by MA 3 Digit Zip CodeMatching Confidence LevelAssigned by CHIA to each entity groupBased on lowest match value…weakest linkThree valuesValueMeaning2High Confidence Level1Low Confidence Level0SingletonMember Enterprise ID appears in just one file typeAmong Topics CHIA is AnalyzingWhether singletons are more prevalent in certain payers and/or file typesLinkages between carve out vendors and primary risk holdersTurnover, persistency, etc.Among Topics CHIA is AnalyzingWhether singletons are more prevalent in certain payers and/or file typesLinkages between carve out vendors and primary risk holdersTurnover, persistency, etc.Receiving Release 2.1New documentation and application forms available on/around April 30thFulfillment times are not expected to change (3 months from initial application to delivery of data, on average)You can apply for Release 2.1 on current forms and start the review process nowMay Dates– Monthly APCD Technical Assistance Group Meeting– Monthly APCD User Workgroup Webinar– Data Release Committee (DRC) MeetingQuestions?General questions about the APCD:(CHIA-APCD@state.ma.us)? Questions related to APCD applications: (apcd.data@state.ma.us)Questions related to Casemix: (casemix.data@state.ma.us) ................
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