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Projects |
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EMS Ambulance Run Report System
Since 1980, the MHIC has been responsible for logging, coding, entering, and editing emergency medical services (EMS) patient/run forms from over 300 ambulance services across the state of Maine. Through a MHIC developed PC data entry program, MHIC staff codes, enters, and interactively edits over 210,000 state-mandated EMS patient/run forms annually. The forms are loaded into a calendar year database and quarterly and annual service reports are generated and distributed to each EMS service and region in the state. Copies of the database are provided to the Maine Office of EMS on a monthly basis. For more information, please contact: Suanne Singer (ssinger@mhic.org). MHMC Claims Data Base
The Maine Health Management Coalition (MHMC) data warehouse includes paid claims for all provider settings from 1994 to the present. The database includes claims over this entire period for approximately 200,000 lives. Members of the Coaltion receive extensive reports throughout the year that are used to make benefit design changes and support quality improvement projects, wellness and health improvement initiatives. Data flows from 15 different payer computer systems and are mapped to standardized data sets and coding structures developed for MHMC.
Payers also submit a provider reference file each quarter. On an ongoing basis, MHIC staff link the various provider reference files to develop a unique identifier for each individual provider across all MHMC payers.
Maine Employers' Mutual Insurance Company
The MHIC is assisting Maine's largest workers' compensation insurer in examining medical costs and utilization patterns among injured workers. The MHIC has developed a data warehouse that includes all medical and prescription drug claims paid by MEMIC since 1998. In addition to the development of standard reports for use in underwriting, safety program development, and utilization review, the MHIC has worked closely with MEMIC's Medical Advisory Committee to explore topics of special interest such as depression and emergency room utilization. For more information, please contact: Bill Perry (bperry@mhic.org).
MSIGA
The Maine Self-Insurance Guarantee Association (MSIGA) has statutory responsibility to collect summary financial data at a claim (injured worker) level for all indemnity workers' compensation claims. MHIC has been the data manager for MSIGA since 1997.
MHIC receives paper and machine readable data from 45 different entities representing more than 400 self-insured employers. Following a data set defined by regulation, data are filed on a quarterly basis and merged with a data extract from the Workers' Compensation Board. The submissions are edited each quarter with telephone follow-up by MHIC staff when problems are identified. Once the quarter is complete, a standard file is transmitted to the Bureau of Insurance.
MEA BENEFITS TRUST
The MHIC has entered into a contract with the MEA Trust to provide claims database information system services. The MHIC will receive membership and claims data from the Trust's insurer after payment. The MHIC will merge data files and maintain a claims data warehouse to be used for standard and special data reporting activities.
In addition to generating reports, the MHIC will provide technical assistance identifying regional variations in utilization by selected procedures, growth in outpatient charges by diagnostic category/specialty, costs associated with specific disease categories, and comparative analysis of the Trust's utilization and cost performance compared with other members of the Maine Health Management Coalition.
State Employee Health Commission
The MHIC provides data and information services to the State Employee Health Commission, which has oversight responsibility for State employee health benefits. The MHIC has enjoyed a relationship with the State of Maine since the early 1990s and has developed a data warehouse with medical and prescription drug claims for the 40,000 member plan. The data warehouse has been an indispensable source of information for the Commission in evaluating plan design and benefit levels as well as for the development of wellness and prevention programs. On a regular basis, the MHIC provides in-depth analyses, presentations, and written reports to the Commission. For more information, please contact:Suanne Singer (ssinger@mhic.org). New Hampshire Hospital Discharge Database
Since 1991 the MHIC has been under contract to build and maintain statewide hospital inpatient and outpatient databases for New Hampshire's 26 acute care hospitals and a statewide specialty database for 6 specialty hospitals. Data are received electronically in standard formats defined by NHHA on an ongoing basis. MHIC staff loads and edits the data, generating error listings for hospital correction. Summary tables for each coded data element are provided to the hospitals for validation of the completeness and the integrity of the data submitted. MHIC is also responsible for assigning HCFA and, using MHIC developed software, for encrypting the social security number, the patient level identifier crossing all hospitals.
There are approximately 122,000 inpatient records, 665,000 outpatient records, and 7,000 specialty records processed annually for NHHA. Due to NHHA's low tolerance for errors in the data, the correction process is often repeated multiple times for a single submission. The end result yields a high quality statewide database with an error rate of less than .5%.
Maine Refined DRG Project
The Maine Refined DRG is a project developed by Maine hospitals through the Maine Health Information Center. The project offers case-mix and severity-adjusted inpatient hospital statistics. Hospitals are compared on length of stay and charges. Participating hospitals receive detailed information by specialty, DRG, and physician, on charges, length of stay, and quality indicators (surgical complication, readmission, ambulatory care sensitive admissions, and in-hospital mortality). A CD-ROM with a "drill-down" interface allows each hospital to further explore the unit record data. Additional reporting compares each of the hospitals in the state on charges and length of stay adjusted for case-mix and severity and a community utilization report compares hospital service area discharge rates, days per 1,000, and charges per capita by specialty (e.g. cardiology medicine, orthopedic surgery). Reports are analyzed by MHIC staff and an executive summary with graphics is provided to each of the participating hospitals. For more information, please contact: Karl Finison (kfinison@mhic.org). Maine CODES: Crash Outcome Data Evaluation System
Maine and nine other states (Connecticut, Maryland, Nebraska, New Hampshire, Oklahoma, Pennsylvania, South Carolina, Utah, and Wisconsin) are currently working with the National Highway Traffic Safety Administration (NHTSA) to generate reports and analysis from CODES linked data. Police crash report information is linked to statewide EMS, hospital inpatient, and death certificate records to provide more accurate reporting of the severity of injuries resulting from motor vehicle crashes. For over 180,000 persons involved in crashes during a two-year period, the MHIC linked over 20,000 to the medical record data.
The project is a continuation of previous work by the MHIC which included studies of seat belt use, young driver crashes, and crashes involving vehicles that ran off the road. Results have been used to develop fact sheets for public release. The MHIC also prepared a model management report format for NHTSA. Current work includes studies of motorcycle crashes and child restraint use.
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