APAC Reporting in Health Policy & Analysis
Explore the intricacies of APAC reporting within the realm of health policy and analysis, focusing on REALD, SOGI, and data reporter needs in a strategic effort to address health inequities by 2030. Learn about the unique requirements and processes involved in APAC reporting compared to other reporting standards.
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Presentation Transcript
REALD & SOGI and APAC discussion group Session 1 Introduction to REALD & SOGI refresher Early identification of data reporter needs April 16, 2024
Acronyms APAC All Payer All Claims program; within Health Policy & Analysis in OHA CMS Centers for Medicare & Medicaid Services E & I Equity and Inclusion Division in OHA HSRI Human Services Research Institute (APAC s vendor) OHA Oregon Health Authority OMB Office of Management and Budget; determines federal standards on race, ethnicity, language and other items REALD Race Ethnicity (and) Language and Disability SOGI Sexual Orientation and Gender Identity TAG (APAC s) Technical Advisory Group 2
Brief background Activities in this area are directly related to the Oregon Health Authority s (OHA) strategic goal of eliminating health inequities by 2030 HB 3159 (2021) directs Equity & Inclusion (OHA) to adopt sexual orientation and gender identity (SOGI) questions and to expand race categories This same bill makes insurers mandatory reporters on REALD & SOGI SB 966 (2023) authorizes APAC to follow state law in the reporting of race, ethnicity, disability, sexual orientation, gender identity and primary language Two divisions with separate authority to require reporting means coordination between two divisions to use expertise (E & I) and data pathway (APAC) to avoid duplicate work for reporters 3
How is this different from other APAC reporting (high level)? 1 of 3 1. APAC, as a secondary data set, has required submission of information reporters already gather in the creation and execution of insurance contracts a. Demographics have been limited to OMB and CMS standards b. Insurers (and other APAC reporters) were not required to gather information directly from the member c. Requesting an exemption from validation rules based on not available (confirmed by compliance officer) have generally been approved APAC acknowledges that PAF submissions require different analysis of existing data on contract payments 4
How is this different from other APAC reporting? High level 2 of 3 2. APAC will act as a pass-through to E & I to ensure that all data processing occurs under one set of code for validations and value- added programming (for example, rarest race hierarchy) a. There will be basic validations at HSRI before forwarding the files to E & I b. E & I has the expertise to understand the data and process open text fields c. Processed files that APAC (HSRI) can match at the member level will be returned to APAC for use with APAC data 5
How is this different from other APAC reporting? High level 3 of 3 3. Data must be collected in a uniform (highly structured) way a. The survey tool to collect data must follow the official E & I survey tool procedures, including skip logic b. Asking questions using the same wording, response options and order is essential to collecting reliable data c. APAC will have a file format that follows the E & I file structure for reporting to the repository - Some fields around reporting entity might be blank or hard coded - E & I is still finalizing the new content (added race categories and SOGI information) d. Extensive use in the survey design of Don t Know , Don t want to answer and I don t know what this question is asking ; each of these is a valid response from the member 6
What are the goals of these discussions? Enhanced planning for reporters from deeper consideration of laws, rules, collection devices and reporting REALD and SOGI questions and potential answers Data collection, storage and possibly use Files sent to APAC 7
What resources are needed to meet REALD & SOGI reporting? Preparing for success on a project by having sufficient details Request to members for data Data receipt (web site, machine readable paper, other) Data storage and lack of edits Early identification of problem or not problem High missing any response? E & I might have suggestions on communication to increase data through the door High don t want to answer (or similar)? Absolutely acceptable as purpose is to collect data from the member E & I might have suggestions or alternatives to increase member comfort with reporting data 8
Resources more to be developed REALD Implementation page for E & I Presentation by E & I for January 2024 TAG meeting Coming soon, APAC REALD & SOGI web page for up to date information Draft Appendix J presented to March 2024 TAG meeting Fields and values still under review in E & I rulemaking Basic structure, length, reference lists useful in planning now 9
Questions, comments or concerns to share today? Comments, etc. at any time to APAC.admin@odhsoha.Oregon.gov 10
