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Select the Frequently Asked Question to view answer.
What is the purpose of this data set?
This data set was developed to assist potential care coordination partners in understanding the healthcare needs of their population(s) of interest, identifying potential provider-partners, developing pricing for a care coordination proposal, and initiating the planning process for care management delivery – generically described as ‘preparation of a Care Coordination Innovations proposal’ in the Data Use Agreement.
Why are recipient identities masked?
Potential partners are neither business associates of Healthcare and Family Services (HFS) nor covered entities under the Health Insurance Portability and Accountability Act (HIPAA) for healthcare services, payments, or operations. Therefore potential partners are not entitled to identified Protected Health Information. For planning and pricing purposes, we have created data sets which do not have any directly identifiable information and which have a relatively low risk of identification. (Per HIPAA, these are ‘limited data sets.’) Because there is some risk of identification, potential partners must sign a Data Use Agreement (please see the Solicitation, Attachment D, Section C).
Why is detailed enrollment and claims data not provided?
Data Set I contains summarized enrollment and claims data. The enrollment and claims data is summarized in such a way that analysts should be able to very quickly gain population-level and sub-population insights into their population of interest for preparing a Care Coordination Innovations proposal. Were we to pass detailed enrollment and claims data to potential partners, it would likely take months for the potential partners to sort the data and create meaning. Additionally, every potential partner would do it their own way, creating proposals that are impossible to compare. We want our partners to have an easy and consistent understanding of the data. Data Set II will contain more detailed claims information than Data Set I – essentially ‘drill-down’ data detailing what is summarized in Data Set I. In the interests of usability and HIPAA, Data Set II still will not provide full claims detail.
Why is calendar year 2010 summarized?
It takes approximately a year before we can more or less reliably describe a year of enrollment and claims. Therefore the calendar year 2010 summarized in Data Set I is the most current year for which we can provide reliable data.
Why is only one year of data summarized?
We acknowledge that additional historical years may provide marginal additional insights. We are considering providing additional years in future data releases. However, for now, one year was the most that we could prepare and test on such a short timeline. We believe that potential partners would rather get started with one year than wait for multiple years.
Will identified, detailed claim data be provided in the future?
Yes. Care coordination partners (as opposed to potential partners) will be able to access identified, detailed enrollment and claims data for the purposes of care coordination. The data required for analyzing a population for preparing a Care Coordination Innovations proposal is very different than the data required for actually coordinating individual-level care, as are the HIPAA constraints on the appropriate use of identified data.
What are the key deadlines for the current Solicitation?
Solicitation published: January 23, 2012
Data becomes available: February 15, 2012
Submission of a Letter of Intent and Data User Agreement: February 29, 2012
Proposal due: May 25, 2012, 2 p.m.
Proposal evaluation: Complete by September
Contract negotiation: September to November
Funded entities must begin enrollment: January 1, 2013, or before
What Illinois Medicaid policy changes underlie Care Cordination Innovations Project (CCIP)?
PA96-1501 (also known as "Illinois Medicaid Reform") requires that 50% of Medicaid clients be enrolled in coordinated care programs by 2015. Please see the Section of
PA96-1501 Relevant to Coordinated Care (pdf)
Can I give feedback on these data sets?
Please note that Healthcare and Family Services (HFS) considers this data release a pilot. Also, we appreciate your questions and feedback on how data contents, format, and exclusions impacted a proposal. Please contact the HFS contact identified in the cover sheet accompanying your data.
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