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Data Science & Advanced Analytics

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DSAA Consists of Six Operational Areas:

    1. Federal Analytics

    2. Advanced Analytics

    3. Surveys

    4. Performance Measures
        and State Reporting

    5. State Analytics

    6. Data Science

 

 


 

 

 

 

The Federal Analytics Team supports the Centers for Medicare & Medicaid Services (CMS) Quality Strategy to Optimize Health Outcomes by Improving Quality and Transforming the Health System through Better Care, Healthier People/Communities, and Smarter Spending. This effort promotes patient-centered care and patient and family engagement at the provider level, encourages providers to implement improvements in healthcare delivery and patient safety, works to reduce disparities in care, collaborates with stakeholders to improve healthcare and health outcomes, and equips consumers with quality-of-care information to make more informed decisions about healthcare options.

Collaborating with several divisions and offices within HSAG, the Federal Analytics Team provides the data analyses to support teams' efforts in providing technical assistance, sharing best practices, conducting targeted improvement initiatives, providing patient and provider education services, investigating grievances, supporting policy, determining annual payment updates, and monitoring program performance.  

DSAA's Advanced Analytics Team develops and applies statistical methodologies and tools to address customer's questions regarding the impact and effectiveness of programs, interventions and policies. The multidisciplinary team provides a wide array technical assistance on topics such as:

  • Determining the impact of programs and policies on quality of care, access to care, timeliness of care, and healthcare costs.
  • Developing interactive dashboards and visualizations to identify and monitor the quality of care delivered by hospitals and managed care plans.
  • Building novel tools to identify chronic conditions of populations and determine the "risk" of members.
  • Developing risk-adjusted, clinician-level report cards.

HSAG is a CMS hospital improvement innovation network (HIIN) called HSAG HIIN. Complementary to and supporting the work of QIN-QIOs, HIINs work to continue patient harm reduction, help identify solutions already working, and disseminate solutions to other hospitals and providers.

HSAG's HIIN has helped over 270 hospitals achieve a 20 percent reduction in all-cause patient harm and a 12 percent reduction in 30-day readmissions. DSAA's ​Advanced Analytics Team is responsible for collecting and calculating measure rates on behalf of hospitals via standardized measures and creating a secure web-based portal to allow hospitals to:

  • Select the measures they wish to monitor and track. 
  • Submit measure data via file upload or web forms.
  • View, analyze, and track measure rates over time via an embedded visual dashboard and comprehensive downloadable reports.

 

DSAA's Surveys Team collaborates with a number of groups at HSAG, including HSAG's State & Corporate Services Division. The team oversees the administration and reporting of different surveys including the following Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surveys:

  • Medicaid Health Plan
  • Patient-Centered Medical Home
  • Home- and Community-Based Services
  • Medicare Advantage and Prescription Drug Plan (MA-PDP)
  • Experience of Care & Health Outcomes (ECHO)
  • Dental

In addition to the standard CAHPS surveys, the Surveys Team has worked with clients to develop and administer novel survey instruments to assess: providers, care management programs, and quality-of-life. The measurement and evaluation of patient and provider perception of care helps to determine efficiency, efficacy, and quality of care delivery systems, while guiding Medicaid agencies toward opportunities for targeted interventions.

DSAA's Performance Measures Team collaborates with a number of groups at HSAG, including HSAG's State & Corporate Services Division to calculate performance measure rates and perform analyses and reporting activities in an effort to improve quality, access, and timeliness of healthcare delivered to Medicaid recipients. The measurement and evaluation of performance helps to determine efficiency, efficacy, and quality of care delivery systems, while guiding customers toward opportunities for targeted interventions. DSAA also supports the California Department of Public Health (CDPH) to determine performance and annual awards for high-performing facilities participating in the Skilled Nursing Facility Quality and Accountability Supplemental Program (SNF QASP).

DSAA's State Reporting Team compiles required reporting activities to evaluate and attempt to improve the services provided by health plans to Medicaid beneficiaries. The measure rates provided by the state Medicaid plans and/or calculated by the Performance Measures and Surveys Team are compiled and often compared to various benchmarks to assess plan performance within the various deliverables. These deliverables evaluate the health plans individually, provide comparisons across health plans, and describe statewide performance, providing consumers with a more educated choice when selecting a health plan to meet their healthcare needs. DSAA currently produces a number of reports for 15 different states.

Additionally DSAA's State Reporting Team develops quality rating systems (QRSs) to improve healthcare quality and transparency and provide information to consumers to make informed decisions about their care. DSAA utilizes Healthcare Effectiveness Data and Information Set (HEDIS®) data and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey results to compare plans to one another in key performance areas. DSAA currently produces QRSs for Illinois, Iowa, Michigan, Ohio, and Virginia.

This operational area also supports the CMS Financial Alignment Initiative, leading cross-departmental teams to develop and update quality measure specifications for Medicare-Medicaid Plans (MMPs), monitor MMP performance on quality measures, and coordinate and assist with Performance Measure Validation activities for MMPs working with dual-eligible members in 12 states.

DSAA’s State Analytics Team provides analytic support for HSAG’s External Quality Review (EQR)-related services in 17 states, including assistance with identifying project requirements, defining project methodologies, planning and executing analyses, and preparing final reports. 

  • Encounter data validation for physical and mental health programs in multiple states
  • Clinical and non-clinical focused studies, including prenatal care and birth outcomes, foster care clinical services, assessment of tobacco cessation services, and utilization of long-acting reversible contraceptives (LARCs)
  • Evaluation of provider network adequacy using provider ratios, time distance analyses, and secret or direct shopper surveys            

Through several federal contracts, DSAA's Data Science Team supports CMS and the Agency for Healthcare Research and Quality (AHRQ) in the implementation, maintenance, and/or evaluation of several policy-driven initiatives, such as the CMS Financial Alignment Initiative Operations Support, and the Patient Safety Organization Privacy Protection Center (PSOPPC). In partnership with several divisions and offices within HSAG, DSAA's Data Science Team employs data-driven scientific methods to perform a wide variety of activities, such as:

  • Developing and updating quality measure specifications for Medicare-Medicaid Plans (MMPs)
  • Monitoring MMP performance on quality measures
  • Coordinating and assisting with Performance Measure Validation activities for MMPs working with dual-eligible members in 12 states
  • Developing Common Formats for Patient Safety Event (PSE) data collection
  • Ensuring the non-identification of PSE data
  • Certifying that vendor software are Common Formats compliant
*HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). NCQA HEDIS Compliance Audit™ is a trademark of the NCQA.
**CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality.