Slide 1: One Care Implementation Council Meeting
Executive Office of Health & Human Services
MassHealth Demonstration to Integrate Care for Dual Eligibles
July 12, 2022, 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
Slide 2: Integrated Care Performance Management: Future State Vision
Current State
•	Reporting formats may vary; not structured for easy trending
•	Measures of interest may lack desired depth and stratification (detail by race/ethnicity/language/disability (RELD), rating categories, etc.)
•	No “one stop shop” to quickly access a snapshot of overall program health
Future State
•	Accessible, dynamic dashboards showing key program performance metrics, 
o	Updated, well-organized reporting requirements in contracts
o	Standard formats and submission process to support pulling and using reported data
•	Data and performance management tools for MassHealth to guide oversight and inform program/policy decisions
•	Ability to stratify priority HEDIS measures by health equity factors
•	More data-based performance feedback for plans
•	Increased transparency for stakeholders

How Do We Get There?
Use interim reporting of Care Model Key Performance Indicators (KPIs) to gauge overall health of the care model

Engage consultants to assist MassHealth in developing back-end reporting tools and standardized templates that enable us to gather, store, and analyze data in a more streamlined, meaningful way

Develop internal- and external-facing performance dashboards, using KPIs informed by stakeholder feedback

Prioritize advancing collection of RELD data to facilitate stratification of certain quality measures, including One Care quality withhold measures, through a health equity lens
Slide 3: Expected Timeline
Note: The headings for each stage below are shown in a shaded bar at the top of the slide with the bulleted details below each stage. This illustrates the process of connecting one to the other and shows movement from one stage of the process to the next stage.

Reporting Overhaul Initiative
MassHealth Internal: 
Infrastructure Development

Goal:
•	Revise key plan performance reporting templates 
•	Expand the universe of available data, with more meaningful stratifications

Timeline:
•	Q2-Q3 2022: development and feedback
•	Q3-Q4 2022: training
•	CY 2023: begin collecting plan-reported data in new formats
Dashboard Development 
MassHealth Internal and Public External: 
Sharing Data and Insights
Goal:
•	Use Tableau* to create One Care performance dashboards
•	Easy-to-access snapshot of new and existing measures that are most meaningful to program health
•	Provide public-facing data that is easy to digest and comprehend

Timeline:
•	Q1-Q2 CY 2023: MassHealth Internal dashboard
•	Q3-Q4 CY 2023: Public External dashboard (version 1.0)
•	Note: we expect dashboards to evolve over time
Management Technology Aids
MassHealth Internal: 
Infrastructure Development
Goal:
•	Explore options for contract and performance management technology tools, to assist MassHealth in organized data submission, storage, and access

Timeline:
•	TBD

*Tableau is an interactive data visualization software company focused on helping people see and understand data 
Slide 4: Reporting Overhaul Initiative
MassHealth Internal: Infrastructure Development

Step 1: Document What We Have Today 	Complete	 
•	Catalogue inventory of current reporting requirements

Step 2: Internal Needs-Gathering and Program Team Interviews 	Wrapping Up	 
•	What works / doesn’t work today
•	Where are the gaps that impede ideal level of management and transparency 

Step 3: Feedback On Priority Areas for Overhaul 	We Are Here 
Recommendation:
•	Focus initial phase of Report Overhaul Initiative on the below reports:
o	Care Coordination Staffing
o	Assessment and Care Plan Completion
o	Appeals & Grievances
o	Authorizations, Modifications, & Denials

Rationale:
•	Reports include content areas with greatest opportunity for guiding data-driven program updates
•	Opportunities for consistency and comparisons across One Care and SCO
•	Answers highest-priority questions, tells the cleanest “end-to-end” performance story when looked at together

Step 4: Finalize Requirements 	Summer-Fall 2022	
•	Develop detailed requirements specifications for priority reports 
•	Operational feedback from plans
•	Directional feedback from Implementation Council and stakeholders
Step 5: Implement 	Late 2022-Early 2023 	
•	Develop Internal and External user guides
•	Communication: final feedback sessions, user trainings, contract updates
Step 6: Learn and Revise 	Ongoing	 
Slide 5: Goals for External Dashboard
Goal: to publicly share with stakeholders (including Enrollees and potential Enrollees, advocates, providers, and others) current information that provides a broad view of One Care, both as a program and across individual plans.

External dashboard should reflect:
•	Status and health of programs/plans (enrollment, finance)
•	Performance of Health Plan functions (timely payment, appeals & grievances)
•	Member satisfaction (voluntary disenrollment, CAHPS, care coordinator staffing, member experience measures)
•	Program goals (hospital/ED use, timely assessment, PCA use, rebalancing, BH metric)
To be effective, external dashboard needs to be:
Attainable
•	Measures address goals and are collectable​
•	Tells us something useful about the program / plans

Replicable
•	Measures can be refreshed regularly
•	Definitions are consistent

Useable and Audience-Friendly
•	Balanced; not overwhelming in scope or detail
•	Measures are of interest to all relevant stakeholders
Slide 6: Dashboard Development 
MassHealth Internal and Public External: Sharing Data and Insights
Proposed Dashboard 1.0 Measure Areas

Generally well-defined in a standardized, accessible way today
Enrollment
Disenrollments - Voluntary
Disenrollments - Involuntary
Financial Performance
Select HEDIS and CAHPS Quality Measures  
Timely Claims Payment
Hospitalizations and ED Use

Data exists today, but would benefit from more detail, expanded measures, and additional trending / linkages to tell the full story 
PCA Hour Changes
Timely Assessment Completion
Appeals/Grievances
Care Coordinator Staffing
Member Experience

Dashboard measure still in development
Behavioral Health Metric TBD
Rebalancing Metric TBD

Internal dashboards may contain more detail and potentially sensitive information

External dashboards may focus more on targeted measures of highest member and stakeholder interest
External dashboards are not a replacement for more in-depth reporting to Implementation Council and other stakeholders. Rather, this will be a subset of high-impact measures available to all One Care members and the general public

Discussion Question: What measure areas are most important to consistently share and update in a public external dashboard?
Slide 7: Thinking Ahead
Note: this slide includes a graphic with the words BUILD, LEARN, and ADJUST in a circle. There are arrows between the words illustrating the process involved in  developing the dashboard.

•	First dashboard iteration is not final – we expect it will evolve over time, especially as we advance measure development, gain better insight into health equity and disparities, and develop improved internal tools to collect, store, analyze, and share performance data

•	It takes time to build, stress-test, and implement new reporting infrastructure
•	Updating IT systems can be a multi-year process, especially for non-critical updates
•	Need additional 6 months to 1 year of timeline for training, tweaking, and baseline data collection
Slide 8: Discussion Questions
•	Do we have the right set of Dashboard 1.0 measurement areas? Is anything missing?
•	What measures addressing Behavioral Health care would be most valuable to pursue?
•	What measures addressing Rebalancing would be most valuable to pursue?
•	What measures for Social Determinants of Health would be most valuable to pursue?
•	What measure areas (or specific measures) are most important to consistently share and update in a public external dashboard?
•	Where should we be thinking ahead? What would we like to see consistent, actionable, trend-oriented data on, a few years from now?
•	Health equity (RELD SOGI)
o	Housing access and stability
o	Rare conditions
o	Others?
Slide 9: One Care MassHealth + Medicare
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