Current Data Requests

The Maine Health Data Organization has, in accordance with Rule Chapter 120: Release of Data to the Public, instituted a process for the purpose of notifying users and providers of health care data when the MHDO receives a request for health data and accepts that request. In addition to sending electronic notification to interested parties and to providers that are responsible for the submission of the data, we provide the summary page of data requests below.

For all data requests, the data providers or other interested parties may submit comments related to the data request to the Executive Director. To be considered, comments must be received by the Executive Director in writing or by electronic notification no later than thirty business days after the initial posting of the data request on the MHDO web site. If the Executive Director determines that (a.) the comments received are of significant enough importance to delay the release of data and/or (b.) additional information is required from the requesting party to address the comments; then the data shall not be released until the additional information has been received from the requesting party and an additional review is conducted by the Executive Director or the MHDO Data Release Subcommittee, as applicable, to ensure that the requesting party conforms to all applicable requirements of this chapter.

The Executive Director will bring all comments received from the data providers and or other interested parties for the release of Level III Data to the MHDO Data Release Subcommittee for consideration.

Individuals who want to opt out of a specific Level III data request may do so by completing this MHDO Choice Disclosure Form no later than 30 business days after the initial posting of the data request. If you opt out of Level III data requests, you will remain opted out unless you choose to opt back in via completion of the MHDO Choice Disclosure Form.

NOTE: If you would like to be notified when new data requests are posted, please email your request.

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Request NumberRequesting PartyAffiliationDate Posted Comment Close DateSpecific Data RequestPurpose Of Request
2017081602Chawla, ChiahuiNH DHHS11-25-20201-12-2021Level II CY2012 thru CY2020 Hospital Inpatient and Outpatient with City/Zip and DOB.Level II data request: On-going surveillance of hospital encounters plays an important role in understanding and reacting to disease and injury. NH Division of Public Health Services (NH DPHS) has several programs that address: acute disease, chronic disease, and injury. NH DPHS is the lead agency responsible for detecting and responding to health emergencies such as infectious disease out breaks and exposure to health hazards. Discharge and outpatient visits data on NH residents from hospitals in Maine are important especially for the border towns. Without out of state hospital data, public health analysis will not be reliable. This request is to obtain hospital encounters for both inpatient and outpatient on NH residents treated in hospitals in Maine. The purpose for the collection of such data is to assess the health of the citizens of NH, to identify specific health threats in NH, to support research into the cause of disease or injury and to generally improve the public health of the State. In order to accomplish its statutory mission, DPHS must analyze selected data from MHDO. Several NH DPHS programs have collaboration projects with state/local agencies or programs in Maine. Benefits to Citizens of Maine: Having prior years of MHDO hospital discharge data has allowed us to better understand incidence of inpatient admissions and emergency department visits for many health outcomes including heart disease, diabetes, asthma, COPD, as well as drug and alcohol related visits. When NH has a clear understanding of health burdens or trends, that information can be also used to help neighboring states - including Maine - understand what burdens or trends they may be facing as well. Many NH communities that border Maine have similar demographics and socio-economic statuses of their neighbor communities across the state line. From what we know of social determinants of health, it is likely that the health status of the NH community is similar to the health status of the Maine neighbor. NH can and does help inform Maine of those concerns using the hospital discharge data. Because of the data sharing and collaboration, people of Maine are benefited from the project results in terms of determining vulnerabe areas and impacts on public health.
20190620012Kraut, Peter, Manager of Rate SettingOffice of MaineCare Services, State of Maine10-9-202011-20-2020Level I CY 2019 Medical Claims and Dental Claims data including Payer Name/ID released at the County and Age level.Level I Data Request: MaineCare is engaged in a study of its rate methodologies for health care services. This work includes comparing existing MaineCare rates to Medicare and other commercial payers for the purposes of establishing comparative benchmarks. All commercial payments would be shown in aggregate -- e.g., an average payment or weighted average payments across all commercial payers - so no individual payers' payments will be shown. Benefits to the citizens of Maine: The project will benefit the people of Maine by contributing to a more rationale and effective MaineCare rate setting system.
2020070701Kwon, Minjung, Assistant Professor of MarketingSyracuse University10-7-202011-20-2020Level I CY2014 thru CY2017 Medical Claims, Pharmacy Claims, including Practitioner Identifiable and Anonymous Payer Name/ID data released at the County and Age level.Level I Data Request: Researchers at Syracuse University and the University of Maryland propose to conduct a quantitative analysis of the healthcare costs in Maine. Since the launch of CompareMaine.org, patients in the state of Maine now have access to detailed price information from various providers, which can help patients make more informed decisions in the healthcare market. This project aims to estimate the casual effects of price disclosure on consumers' health care choices and the resulting cost savings across different groups of patients including expenses on medical procedures and pharmaceutical products. The project will also examine how the impacts vary across a number of factors such as geographic areas, patient demographic groups, different medical procedures, types of facilities, and insurance plans. The analysis outcomes can provide implications of the competition intensity among facilites, the financial incentives of price search, and patients' ability to shop around for different procedures. Note: MHDO will only be releasing anonymous payer identifiers as requested and will not be releasing payer specific identifiers. The Benefit to Citizens of Maine: Our project will empirically quantify how much healthcare price reduction in Maine is realized through the launch of CompareMaine.org as well as how much of the reduction goes to patients' out-of-pocket costs. Furthermore, our outcomes will indicate to what extent, after controlling for service quality, the implementation of healthcare price transparency website allowed the residents of Maine to choose less expensive providers. Policy makers in Maine can also use our results to identify the patient groups who benefit the most from searching for healthcare prices, so that they can target these groups to encourage the utilization of the website.
2020073001Arik, Murat, DirectorMiddle Tennessee State University10-6-202012-9-2020Level I CY2018 Medical Claims and Dental Claims data released at the County and Age level.Level I Data Request: The purpose of this project is to determine the costs and scope of temporomandibular disorders (TMDs or TMJ) for a large portion of the U.S. population. This project will measure the unnecessary costs of ineffective treatments for TMDs and compare them with the costs of a new medical device (the Urbanek Splint). As TMDs are varied, symptoms (for example, pain) are treated by both medical and dental health providers. Benefit to Citizens of Maine: TMDs are widespread, and the people of Maine would benefit from the existence and promotion of the Urbanek Splint in comparison to other ineffective TMD treatments.
2020081102Jonk, Yvonne, Associate Research ProfessorUniversity of Southern Maine10-6-202012-9-2020Level II Q1 2012 - Q4 2020 Medical Claims and Medical Eligibility data released at the County and Age level.Level II Data Request: Researchers at USM will conduct a multi-payer study of trends in telehealth use by children in Maine from 2012 - 2019. The study will use Maine's All-Payer Claims Database (APCD) to develop a descriptive overview of telehealth use in Maine, examining how telehealth use has changed over time among rural and urban children and whether there are discernable patterns in those changes by telehealth modality, payer, provider type, diagnosis and service. We will be documenting the potential need for expanded use of telehealth services among rural pre-school and school aged children in particular within the state of Maine. Benefit to Citizens of Maine: This project will benefit the people of Maine by informing and facilitating the development of targeted telehealth training programs that will help fill gaps in telehealth workforce shortages throughout the state and improve access to health services by expanding telehealth workforce capacity.
2020072901Gilbert, Joel, Data & CQI ManagerMaine Department of Corrections8-10-20209-22-2020AD Hoc report on the Effects of Implementing Medication Assisted Treatment (MAT) at Maine Department of Corrections Adult Correctional Facilities. Data sources will include Level II CY 2018 to CY 2020 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility data released at the City/Zip and Date of Birth level and possibly Hospital Inpatient and Hospital Outpatient data released at the City/Zip and Date of Birth level.Level II Data Request: MHDO’s APCD and Hospital inpatient/outpatient data will be used to assist the department assess the outcomes of the MAT program implemented by the Maine Department of Corrections, initially as pilot and then as a system-wide effort. The study will also compare addiction related health care utilization patterns among formerly incarcerated persons on MAT and the non-incarcerated population on MAT. As well as determine pre- and post-release effectiveness of MAT induction during incarceration; and to determine a return on investment for MAT induction during incarceration which includes recidivism and reduction in opioid related deaths. This project would benefit the people of Maine by making it possible to demonstrate that MAT administration during incarceration may ultimately create a safer community by reducing recidivism and decreasing post-release overdose deaths. It may also make it possible to demonstrate that access to MAT during incarceration, in conjunction with comprehensive release planning efforts, may be associated with increased continuity of care and ongoing use of recovery resources and other health care services which are often associated with community health.
2020050101Tripp, Merica, Planning & Research Associate IIME DHHS, ME CDC7-7-20208-18-2020Level II Q1-Q4 2019 Hospital Inpatient Encounters & Hospital Outpatient Encounters including Practitioner Identifiers and Anonymous Payer Name/ID released at the City/Zip and Date of Birth level.Level II Data Request: With the potential closing of or reduction in services at hospitals and/or other health care facilities in rural areas, there is interest in examining what the impact on access to various services currently based at those facilities would be for populations in surrounding communities. Using a similar zip code level Origin-Destination appraoch, similar to the MHDO All Payer Claims Data Analysis for Primary Care, we will utilize hospital and ED discharge data to examine what services the residents of each zip code currently access at the hospital, their typical access pattern for such services, and what proportion of care from each zip code utilizes which hospital provider resources. This data will then be utilized to estimate the accessibility of such services and the increased demand on other resources, in the potential of their absence. Closure or reduction of services at health care facilities can be devastating for the surrounding communities. Many of its residents must make a difficult choice between uprooting and moving to another community or driving longer distances to obtain the health care that they need. A heart attack or stroke becomes lethal. Benefits to Citizens of Maine: Residents will benefit if, through data analysis, plans are developed to mitigate the potential for loss of services and strategies can be implemented to ensure the availability and accessibility of health care for all. Note: MHDO will only be releasing anonymous payer identifiers as requested and will not be releasing payer specific identifiers.
2019062502Harrington, Karynlee, DirectorMaine Quality Forum6-1-20207-29-2020Level II 2016 Q1 - 2019 Q4 (with 6 months runout) Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, including Practitioner Identifiable and Payer Name/ID data released at the City/Zip level.Level II Data Request: MQF (and their consultant Muskie) is working with the New England States Consortium Systems Organization (NESCSO) and their data vendor Onpoint who is developing a multi-state report on primary care investments. A core objective of the initiative is to look at the percent of primary care investments relative to total healthcare spending in six New England states - Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, and Vermont - using a standardized methodology. Under the project, states will produce summary claims reporting based on specifications developed by Onpoint. The report will not include payer names. The report will be shared publicly with a broad group of stakeholders. This work and data will also help inform and support the development of the MQF's 2020 Annual Report on Primary Care Spending in Maine as required by Public Law Chapter 244, An Act to Establish Transparency in Primary Care Spending. Benefits to the citizens of Maine: This effort with NESCSO will help inform the development of the second annual report on Primary Care Spending that the Maine Quality Forum is required to produce and submit to the joint standing committee of the Legislature having jurisdiction over health coverage and health insurance matters and to the Department of Health and Human Services pursuant to Public Law Chapter 244.
2020011601Matusovich, Becca, Executive DirectorPartnership for Children's Oral Health3-12-20204-23-2020Level II Q1 2018 - Q4 2019 Medical Claims, Medical Eligibility, Dental Claims, Dental Eligibility including Practitioner Identifiable data released at the City/Zip and Date of Birth level.Level II Data Request: The Partnership for Children's Oral Health is a broad network of oral health stakeholders who are collaborating toward a shared mission: eradicating dental disease among Maine children. A key piece of this work is to strengthen the capacity of Maine's oral health service delivery systems to reach all children in Maine with effective preventive and restorative dental care. In order to create a shared understanding of the strengths and challenges of the current delivery system, we propose an analysis of all-payer claims data that will provide a snapshot of current patterns in utilization of preventive and restorative dental services and look at variations in utilization and cost across payer/insurer type, age group, location/geography, provider type, and setting of care. Additionally, summary data will be reported on children's dental health use to the Kids Count Project. Benefit to Citizens of Maine: This project will benefit the people of Maine because it will help to build shared understanding of ways in which the current delivery system is able to meet the needs of Maine children, and what gaps remain. This will allow for collaborative planning to align resources and coordinate efforts to fill the gaps and increase children's access to recommended oral health care.
2020020401Kingsbury, Rebecca, Dir., Planning and AnalyticsMaineGeneral Health3-11-20204-22-2020Level II 2019 Q1 to 2020 Q4 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, Dental Claims, Dental Eligibility, Hospital Inpatient Encounters, Hospital Outpatient Encounters including Practitioner Identifiable data released at the City/Zip and Date of Birth level.Level II Data Request: As the third largest healthcare system in the state, MaineGeneral Health is entrusted with the responsibilities of both safeguarding the health of residents in 86 communities in central Maine, and for providing them with the healthcare services they need. Decisions on optimal allocation of our resources to best serve this population can be informed by access to MHDO data. This data would enable us in achieving our goals of improving health and wellbeing, enhancing treatment outcomes, offering timely access to quality care, and providing seamless care coordination across our system. Specifically, MHDO data will be used to effect improvements in the quality and safety of our services and identify cost-saving opportunities, providing tangible benefits to our patients. It would also enable reporting of market share data with our member organizations or prospective affiliates with the goal of improving care for all Maine residents. Data will also assist us in supporting member organizations taking on the responsibilities and risks of Accountable Care Organizations and Medicare Share Savings Program participation, as well as commercial payer contracts. Supporting MaineGeneral Health and its members' Certificate of Need applications, and Maine Shared Community Health Needs Assessment, as well as strategic and service line work, medical staff development, and facility planning are all additional important uses of this data. Note: MaineGeneral did not request payer specific identifiers and therefore MHDO will not be releasing payer specific identifiers. Benefit to Citizens of Maine: Explained in the purpose of request.
2019100801Argue, David, Corporate VP and PrincipalEconomists Inc11-18-20191-2-2020Level II CY2018 Hospital Inpatient Encounters data.Level II Data Request: The hospital industry is undergoing significant consolidation and restructuring which can potentially affect the well-being of consumers in Maine and neighboring states. This study focuses on two announced mergers of hospitals in southeastern NH near the Maine border that serve Maine residents. The two transactions are the merger of Wentworth Douglass Hospital in Dover with Exeter Hospital and Portsmouth Regional Hospital's acquisition of Frisbie Memorial Hospital in Rochester. Economic theory predicts that consumers receive the lowest prices and highest quality in markets with sufficient competing providers, but it does not identify how many providers is enough for each market. Our econometric modeling identifies how well hospitals serve as substitutes for each other in commercial health plan networks. The model requires information about actual hospital choices made by residents in southern Maine and southeastern NH to predict patients' first-best and second-best alternatives prior to a merger. Benefit to Citizens of Maine: Our analysis of hospital markets along the Maine-NH border will benefit Maine residents because it will allow us to precisely quantify how many Maine patients stand to benefit from the healthcare transactions occurring across the state border. Antitrust regulators in Maine may find this information helpful to understand the potential benefits to Maine residents that could arise as a result of the transactions.
2019100802Mellett, JeanNorthern Light Health10-25-201912-8-2019Level II CY2019 Q1 - CY2020 Q4 Hospital Inpatient Encounters, Hospital Outpatient Encounters data released at the City/Zip, Date of Birth, Practitioner Identifiable level.Level II Data Request: Northern Light Health will use the inpatient and outpatient hospital encounters data to support its members' planning efforts around the State, as well as to advance initiatives that are important to the System and to the State as a whole. The mission of Northern Light Health is to improve the health of the people and communities we serve. Our brand promise is 'We make healthcare work for you.' In order to fulfill the mission, we must have access to data regarding: -Patient origin and demographics (zip code and birth date included) -Locations of healthcare services and providers around the state -Healthcare utilization rates and volumes -Healthcare services provided, including diagnoses and procedures. It is important to have zip code level data so that we may fully understand what distances patients are traveling to receive services. Birth date data enables us to refine program planning to meet the needs of patients in specific age groups, e.g., pediatrics, geriatrics, etc. Provider identification data rounds out these data points to inform decision-making regarding future placement of services and/or collaborative efforts to improve access to health care services. This is becoming ever more important as we recognize that the population age 65 and over is increasing in Maine. This population segment is projected to make up almost a third of the State's total population and typically exhibits a higher utilization rate for healthcare services in general. Benefit to Citizens of Maine: MHDO data is used to appropriately optimize resource allocations. Northern Light Health planning staff will conduct these analyses and others as needed to support individual projects and help provide a strategic framework with the ultimate goal of providing the people of Maine with the right care, at the right time, in the right place.
2019102201Bourbeau, Brian, Director, Business Metrics and AnalysisAmerican Society of Clinical Oncology10-25-201912-8-2019Level II CY2018 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, and Practitioner Identifiable data, Payer Name/IDLevel II Data Request: This request is an extension of previously approved request 2019010401, adding 2018 medical and pharmacy claims and eligibility records. The American Society of Clinical Oncology (ASCO) is engaged with providers, payers, employers, and healthcare policy experts to develop an alternative payment model for oncology care. ASCO will conduct multiple projects using MHDO data to electronically capture quality metrics, quantify opportunties for cost-of-care savings, and to model potential alternative payment mechanisms. Deliverables from these projects will include an analysis of potential cost savings for the state of Maine, a whitepaper detailing an alternative payment model for oncology providers, and specifications for quality metrics that may be calculated with MHDO and other APCD data. The projects will also result in an application to the US Health and Human Service's Physician-Focused Payment Model Technical Advisory Committee, for consideration as a Center for Medicare and Medicaid Innovation alternative payment model. Benefit to Citizens of Maine: Deliverables from these projects will be made available to community stakeholders in Maine - providers, payers, employers, patient advocates, and Maine Quality Counts, to implement quality measurement and alternative payment model initiatives. Data may also be used to assist communities in Maine who desire to implement the resulting alternative payment model and quality metrics developed as part of these projects.
2019102301Hawkins, Summer, Associate ProfessorBoston College10-23-201912-5-2019Level II CY2009 to CY2015 Medical Claims and Medical Eligibility including Practitioner Identifiable data released at the City/Zip, Date of Birth levelLevel II Data Request: A growing body of research has demonstrated the importance of provider characteristics in the quality of care that patients receive and the subsequent implications for health outcomes. Some of these characteristics include provider-patient concordance/discordance, availability, access and referrals. Thus, we aim to assess the supply-side effects of the Affordable Care Act (ACA) and other recent health policy changes on cancer screening. Specifically, we will assess whether the number, type and location of providers offering cancer screenings changed after the implementation of the ACA and Medicaid/marketplace expansions. This project will use the provider NPI to assess where women are receiving care during the delivery as well as during the postpartum period. Benefit to Citizens of Maine: Since the ACA came into effect in September 2010, additional health policy changes have occurred at the state level that may affect preventive health services and subsequent health outcomes, including postpartum care. We aim to examine the impact of changes in Medicaid parental income eligibility levels on continuity of insurance coverage, visits for postpartum care, contraceptive use, and birth spacing in the one year following a delivery. Our results based on the APCD will be directly applicable to current policies and practices in ME, which we hope will contribute to the discussion about health insurance and Medicaid coverage of preventive items and services.
2019071701White, Chapin, Adjunct Sr. Policy ResearcherRAND Corporation7-17-20198-28-2019Level II CY2016 to CY2018 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, and Practitioner Identifiable data released at the City/Zip level.Level II Data Request: Researchers at the RAND Corporation will reprice commercial medical claims from MHDO using Medicare's groupers and pricing algorithms, and will release a public research report that includes commercial prices as a percent of Medicare prices for hospitals and hospital systems identified by name. This research report will update and expand on the findings in a RAND report released in May, 2019 (https://www.rand.org/pubs/research_reports/RR3033.html). The public research report will include hospitals from around the country, and will be created using claims data from three sources: self-insured employers, state-based all payer claims databases (APCDs), and health plans. Benefit to Citizens of Maine: This project will benefit the people of Maine by providing them with a detailed hospital price report for hospitals in Maine, as well as comparisons among hospitals in Maine versus hospitals in other states. Key audiences for the report will be (1) self-insured employers that participate in the study and that are assessing the reasonableness of the prices they are paying for hospital care, (2) other employers that are struggling with high and rising health care costs and that want to better understand patterns and trends in hospital prices, and (3) policymakers and researchers who are concerned with hospital pricing and price transparency.
2019062501Harrington, Karynlee, Director Maine Quality ForumState of Maine6-28-201912-8-2020Level II CY2016 to CY2019 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, and Practitioner Identifiable data released at the City/Zip levelLevel II Data Request: With the passage of LD 1353, An Act to Establish Transparency in Primary Care Spending, the Maine Quality Forum is required beginning January 15, 2020 and annually thereafter, to submit to the Department of Health and Human Services and the joint standing committee of the Legislature having jurisdiction over health coverage and health insurance matters a report on primary care spending using claims data from the Maine Health Data Organization. The report must include the percentage paid as a percentage of their respective total medical expenditures for primary care by commercial insurers, the MaineCare program, Medicare, and the state employees and the Maine Education Association benefits trust; as well as the average percentage of total medical expenditures paid for primary care across all payors.
2019062001Probert, Michelle, Director, MaineCareState of Maine6-20-20198-2-2019Level II CY 2013 to CY 2019 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, and Practitioner Identifiable data released at the City/Zip level Hospital Encounter Inpatient Level II CY 2016 to CY 2019 with Patient’s ZIP code; Hospital Encounter Outpatient Level II CY 2016 to CY 2019 with Patient’s ZIP code Level II Data Request: DHHS is interested in gaining a better understanding of the current and anticipated MaineCare expansion population by generating a profile of newly eligible Mainers based on demographics, likely health conditions, service needs, critical events, and anticipated costs. Both the APCD and MHDO hospital encounter data will be used as sources to build a profile of the newly eligible Medicaid Expansion population and their anticipated health status and healthcare needs. The initial focus of the analysis will be on the population likely eligible for expansion and their health care services in recent years prior to becoming eligible using MHDO’s Hospital Encounter Database, given the presence of the charity / uncompensated care and self-pay populations. MHDO APCD and Hospital encounter data may be used to better understand MaineCare expansion population including topics like: General demographics; Prevalence of chronic disease/ number of chronic conditions; Utilization of preventive services; Utilization of acute care services; Average PMPM cost; Months of coverage on MaineCare; Number of medications/ medication adherence; Previous insurance status. Similar data will be pulled for populations covered under Medicare and Commercial insurance to use as the comparison groups.
2019040902Ahrens, Katherine, Assistant Research ProfessorUniversity of Southern Maine5-10-20196-4-2019Level II CY2009 to CY2019 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility data released at the Cit/Zip levelLevel II Data Request: Researchers at USM will conduct a quantitative analysis of the health outcomes of women with opioid use disorder during pregnancy in Maine during 2010 - 2017. They will estimate the number and proportion of these women who receive treatment during pregnancy and the average treatment duration by treatment type. They will compare health care use and health outcomes throughout pregnancy and the first year postpartum by treatment type and treatment duration. They will also identify stakeholders and permissions needed in order to link the Maine All-Payer Claims Database with vital records (birth and death certificates). The results from Maine will be presented alongside similar results from Vermont. At no point will data sets from the two states be combined. This project will benefit the people of Maine because it addresses a pressing public health issue: opioid use disorder. By estimating the number of women with opioid use disorder during pregnancy and the association between treatment duration/type and health care use and outcomes, we can inform interventions to help women achieve recovery. This is important not just for the health of women with opioid use disorder, but also for the health and well-being of their current and future children.
2019041802Harrington, Karynlee, DirectorMaine Quality Forum4-19-20196-4-2019Level II CY2013 to CY2017 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, and Practitioner Identifiable data released at the City/Zip levelLevel II Data Request: The Milliman HWC is a claims software grouper, like a DRG or Risk grouper that has been designed to use claims data to identify low value health care services including inappropriate antibiotic prescribing (currently 47 measures in total). Seven of the forty-seven measures are specific to inappropriate antibiotic prescribing measures. The plan is to run the MHDO APCD data through the Milliman HWC to generate a baseline of information specific to the inappropriate prescribing of antibiotics to help support the work of the HAI/AR Collaborating Partners Committee that are working on executing the States HAI plan which includes strategies specific to antibiotic resistance (AR). One of which is building a data infrastructure that will help focus the strategies on actionable AR initiatives. In addition, MQF will share the results of running the data through the HWC with the various state health plans, including MaineCare and the State Employee Health Plan to assist these programs with their value based purchasing strategies.
2019041601Cates-Carney, Maya, Data Integration & Policy AnalystOffice of MaineCare Services4-18-20196-3-2019Level I CY2016 to CY2018 Hospital Inpatient dataLevel I Data Request: The MOM Model would provide wrap-around OUD and prenatal services to pregnant women with OUD around Maine. The model would extend from whenever the pregnant women enrolls during the prenatal period to 12 months postpartum, and include Medication Assisted Treatment, group counseling, and group sessions that would include topics like parenting, relapse prevention, pain management during birth, and the importance of pediatric visits. MHDO data will be a critical component to MaineCare's application to the federal government to be able to secure the funding to meet the above goals.
2019041801Moylan, Christina, Assistant Attorney GeneralMaine Attorney General's Office4-18-20196-3-2019Level II Q1 CY2015 to Q3 CY2018 Medical Claims and Practitioner Identifiers released with City/Zip. Q1 CY2015 to Q2 CY2018 Inpatient and Practitioner Identifiers released with City/Zip. Q1 CY2015 to Q4 CY2017 Outpatient and Practitioner Identifiers released with City/Zip.Level II Data Request: The data will be used to conduct competitive analysis for mergers and potential anticompetitive agreements in healthcare pursuant to state and federal antitrust laws. Antitrust law's goal is to preserve competition in order to constrain costs, maintain or improve quality and maintain or increase access to healthcare. Additionally, we intend to use these data to study the use of Maine hospitals by residents of the state, and competition between these hospitals to provide those service. Patients’ ZIP Code information will allow us to analyze how far patients are willing to travel to receive inpatient and outpatient care, and to identify the hospitals in each patients' local area that compete to provide care to residents of that area. The practitioner identifiers will allow us to analyze the physicians who have privileges at each hospital in Maine, and what other hospitals those physicians may also have privileges. These overlaps in medical staff may be informative about the extent to which—depending on the patient's choice of physicians—those hospitals compete to provide care to patients. The APCD data will allow us to study competition between physician groups in Maine, and competition between hospital outpatient departments and freestanding facilities to provide outpatient care to residents of Maine.
2019010301Wang, Jun, Principal Data ScientistArchway Health Advisors, LLC3-29-20195-13-2019Level II CY2016 to CY2017 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, Practitioner Identifiers, and Payer Name/ID released with City/Zip and DOB.Level II Data Request: Maine has one of the most progressive payment landscapes in the United States with the proliferation of value-based payments, but continues to struggle with increasing costs. Episode of care models are part of the answer to reducing cost growth without sacrificing the quality of care. It has been proven to help control specialist-driven spending which accounts for 60-70% of total healthcare spending and reduce cost variation. Medicare has developed several comprehensive episode payment initiatives, but the commercial market for episode payment is underdeveloped as no forcing mechanism exists to bring payers and providers together to develop episode payment arrangements. A key barrier to the initiation of episode payment contracts is the lack of data necessary to create payments and evaluate quality. The APCD is necessary to enable providers of Maine to understand the opportunities and risks and promote episode payment to payer partners. Benefits to Citizens of Maine: This episode analysis using APCD data will identify the best performing hospitals and physicians in the state of Maine and encourage Maine people to seek care from those providers with higher quality care and lower cost, which will greatly increase both the efficiency of care delivery and the quality of care delivered. Specifically, we plan to use Maine APCD data to: Understand what are the key drivers that lead to the high episode cost and quality variation among Maine healthcare providers; Understand what are the potential and achievable quality improvements if Maine providers can align the performance with the best performers; Understand what are the potential saving opportunities if Maine providers can improve the quality performance to align the best performers; Create provider performance benchmarks to identify best performers and help Maine providers build high-value, low-cost physician networks and prioritize efforts to promote high-value care with limited resources; Produce analytical prediction models to identify high-risk high-cost patients of Maine for immediate interventions.
2018121801Bodwell, Erica, VP and General CounselNortheast Delta Dental3-1-20194-12-2019Level II CY2016 to CY2018 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility, Dental Claims, Dental Eligibility, Hospital Inpatient, Hospital Outpatient data and Practitioner Identifiers.Level II Data Request: Northeast Delta Dental (NEDD) board is reviewing opportunities to improve dental access to the underserved in Maine. As a mission driven organization, they sought out DentaQuest, an experienced government program dental administrator to partner on this initiative. We are requesting the data to research utilization and other trends of the Medicaid population, for potential enhancement of dental services and access to services for Maine Medicaid beneficiaries. Benefits to Citizens of Maine: We are requesting the data to research utilization and other trends of the Medicaid population, for potential enhancement of dental services and access to services for Maine Medicaid beneficiaries.
2019010401Bourbeau, Brian, Dir. Business Metrics and AnalysisAmerican Society of Clinical Oncology2-20-20194-29-2019Level II Q4 CY2015 to Q4 CY2017 Medical Claims, Medical Eligibility, Pharmacy Claims, Pharmacy Eligibility and Practitioner Identifiers and Payer Name/ID.Level II Data Request: The American Society of Clinical Oncology (ASCO) is engaged with providers, payers, employers, and healthcare policy experts to develop an alternative payment model for oncology care. ASCO will conduct multiple projects using MHDO data to electronically capture quality metrics, quantify opportunities for cost-of-care savings, and to model potential alternative payment mechanisms. Benefits to Citizens of Maine: Deliverables from these projects will include an analysis of potential cost savings for the state of Maine, a whitepaper detailing an alternative payment model for oncology providers, and specifications for quality metrics that may be calculated with MHDO and other APCD data. The projects will also result in an application to the US Health and Human Service's Physician-Focused Payment Model Technical Advisory Committee, for consideration as a Center for Medicare and Medicaid Innovation alternative payment model. Deliverables from these projects will be made available to community stakeholders in Maine - providers, payers, employers, and patient advocates - and in other states, to implement quality measurement and alternative payment model initiatives. Data may also be used to assist communities in Maine who desire to implement the resulting alternative payment model and quality metrics developed as part of these projects.
2018083001Kingsbury, Rebecca, Dir., Planning & AnalyticsMaineGeneral Health11-20-20181-1-2019Level II CY2015 – CY2018 Hospital Inpatient and Outpatient Encounter Data and Medical and Pharmacy Claims including Eligibility, Practitioner Identifiers, Date of Birth and City/Zip fields.Level II Data Request: As the third largest healthcare system in the state, MaineGeneral Health is entrusted with the responsibilities of both safeguarding the health of residents in 86 communities in central Maine, and for providing them with the healthcare services they need. Decisions on optimal allocation of our resources to best serve this population can be informed by access to MHDO data. This data would enable us in achieving our goals of improving health and wellbeing, enhancing treatment outcomes, offering timely access to quality care, and providing seamless care coordination across our system. Specifically, MHDO data will be used to effect improvements in the quality and safety of our services and identify cost-saving opportunities, providing tangible benefits to our patients. It would also enable reporting of market share data with our member organizations or prospective affiliates with the goal of improving care for all Maine residents. Data will also assist us in supporting member organizations taking on the responsibilities and risks of Accountable Care Organizations and Medicare Share Savings Program participation, as well as commercial payer contracts. Supporting MaineGeneral Health and its members' Certificate of Need applications, and Maine Shared Community Health Needs Assessment, as well as strategic and service line work, medical staff development, and facility planning are all additional important uses of this data.
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