Medicare Claims Data Developer Challenge

Submission Deadline

Submissions are Closed

Contact

Challenge Team

Prizes

  • First Place $7,500 + 2 free passes to the Spring Health 2.0 Conference
  • Second Place $2,000
  • Third Place $500
First Place

Zenithech

Zenithech logo

Team Members

Valery Andrades & Deepak Srivastava

A Fairfax, Virginia-based developer of web and mobile applications created MEDZ, a dashboard that displays and lets users conduct in-depth analysis of all eight PUFs for comparative research and in-depth analysis.

Second Place

Avanade DataGnosis.org

Avanade DataGnosis.org logo

Team Members

Brent Nall, Roderick Escobar, Paul Daly, Othel Rolle, Sheetal Shah

Avanade, a business technology solutions and managed services provider, captured second place with a business intelligence reporting tool called DataGnosis that enables researchers to perform canned and ad-hoc reporting on all eight PUFs. Users also can tie those claims with U.S. Census data, positioning them to identify trends and patterns across each state.

Third Place

Big Yellow Star

Big Yellow Star logo

Team Members

Damien Leri

Big Yellow Star, a Philadelphia company (and familiar Health 2.0 Challenge winner) focused on health informatics, public health and health literacy projects, built a dashboard that makes hospice and outpatient PUFs accessible to users.

Background

IMPAQ International (IMPAQ) and NORC at the University of Chicago wish to promote the development of internet-based applications for users of the newly released Medicare Claims Public Use Files. IMPAQ and NORC, with support from Centers for Medicare and Medicaid Services (CMS), seek to develop web platforms suited for health services researchers, health policy researchers, data entrepreneurs, and/or other potential users who would like to access Medicare claims data. This online event challenges interdisciplinary teams to create a tool for researchers that will present two or more of the new Basic Stand Alone (BSA) Medicare Claims Public Use Files (PFUs) in a way that’s informative, interactive, and user friendly.

As of June 1st, 2011, CMS has released eight BSA Medicare Claims PUFs of Medicare claims data from calendar year 2008. CMS contracted with IMPAQ, NORC, and other partners, to pioneer the creation, dissemination, and support of Medicare claims data for public use. In creating and disseminating very sensitive data like medical claims data there are three often competing goals. The first is to provide an accessible and well documented data set that researchers can more easily access. The second goal is to create an analytically useful file, one that meets the needs of researchers. The final and most important goal is to ensure that the data remain confidential and that privacy for individuals is not breached through the public release of data.

To guarantee the confidentiality of Medicare beneficiaries’ Protected Health Information (PHI) and assure an overall low disclosure risk, the team used multiple de-identification methods (coarsening, categorization, rounding, and suppression) and rigorous re-identification analysis. Each PUF was certified by statistical experts and approved by CMS to be compliant with the HIPAA Privacy rule.

IMPAQ specializes in providing research and consulting services to domestic and international clients in the areas of impact evaluation studies, applied research, policy analysis, quantitative and qualitative data analysis, and technical assistance. IMPAQ supports multiple federal departments and agencies including Health and Human Services, Labor, Education, and Agriculture as well as the U.S. Agency for International Development, the World Bank, and the Millennium Challenge Corporation.

NORC is a 70 year old independent research organization headquartered in downtown Chicago with additional offices in the D.C. Metro area. With clients throughout the world, NORC collaborates with government agencies, foundations, educational institutions, nonprofit organizations, and businesses to provide data and analysis that support informed decision making in key areas including health, education, economics, crime, justice, energy, security, and the environment.

The Data

CMS accumulates and maintains claims data for all fee-for-service Medicare beneficiaries (about 80% of the 48 million Medicare population in 2008 had one or more claims) in different settings and types of care. Each of the new BSA PUFs consists of claims from one type of service for a 5% random sample of beneficiaries from 2008: Inpatient, Outpatient, Carrier, Part D, Skilled Nursing Facility, Durable Medical Equipment, Home Health Agency, and Hospice.

Each BSA PUF is based on a unique, disjoint 5% sample of 2008 Medicare beneficiaries. For example, there is no overlap in beneficiaries between the sample used for the CMS 2008 BSA Inpatient Claims PUF and the 5% sample upon which any of the other seven BSA PUFs are based nor with the sample used for the widely used 5% CMS research dataset. The disjoint quality of each sample helps to protect the confidentiality of Medicare beneficiaries.

The BSA PUFs and related documentation are freely available for download at http://www.cms.gov/BSAPUFS.

While Medicare claims often contain detailed demographic, clinical and financial data, IMPAQ and NORC have de-identified these data sets such that they are HIPAA compliant and primed for data-play. The BSA PUFs are now freely available without the costs and time delays that previously impeded researchers access to Medicare claims data.

Description

The challenge being put forth is to develop an online dashboard for researchers or other relevant end-user group (data entrepreneurs, students, health publications/press, etc.) attempting to identify and examine comparative effectiveness, health services, and health policy research topics within the American health system. The dashboard should capture data from two or more of these new Basic Stand Alone (BSA) Medicare Claims Public Use Files in a way that addresses the needs and interests of the chosen target end-user group.

Because no beneficiaries are represented in more than one of the eight BSA PUFs, there is no possibility of linking records across two or more of the files. One of the objectives of the challenge is to design and demonstrate a creative mechanism for combining the information in two or more files in a meaningful manner. You can draw upon statistical matching techniques; create synthetic or derived variables based on data in the PUF and related documentation; or use existing variables that are common across the PUFs to create the associations and relationships.

By developing innovative data tools and fostering creative analytic approaches for the BSA Medicare Claims PUFs, teams will be contributing to the process of informed health care decision-making. Armed with the information from this process, health care providers and patients can select treatments that are most likely to lead to improved health among the American population. Focusing on treatments that are more effective will result in program savings over time.

Review Panel

    • Todd Park
    • Chief Technology Officer - HHS
    • Anthony Rodgers
    • Deputy Administrator and Director - Center for Strategic Planning Centers for Medicare & Medicaid Services
    • Barbara Frank
    • Director of Workshops, Outreach, and Research - Research Data Assistance Center University of Minnesota
    • Craig Coelen
    • President - IMPAQ International
    • Daniel S. Gaylin
    • Executive Vice President - NORC Research Programs

Evaluation Criteria

Submitted entries will be evaluated against the following criteria:

  1. Concept
  2. Creativity
  3. Number of PUFs used
  4. External data sources used
  5. Linking approach
  6. Visualization techniques
  7. Social media integration
  8. Incorporation of geographic elements
  9. Exporting data findings and/or API

Submission Requirements

Submissions should include a link to a working web application incorporating the required CMS data. Please also prepare an overview of your application in the form of a PDF cover letter, YouTube video link and/or PowerPoint presentation. On the final submission form that Health 2.0 will issue to registered teams, there will be a space to upload these files, links and any login instructions to apps hosted on protected servers. The winning team will be officially announced before the Spring Health 2.0 Conference in Boston and will get a chance to demo the application live on the main stage.

Participating Teams

Zenithech
Big Yellow Star
Locust Tech
Avanade

Terms & Conditions

ELIGIBILITY CRITERIA

  • The Challenge is open only to teams based in the United States.
  • A Team must include no less than 2 people and no more than 5.

ENTRIES

  • By submitting a technology product as an entry in response to this Challenge, each Team and each Team member represents and warrants that:
    • The Team and its members are the sole authors, creators, and owners of the technology product submitted as an entry;
    • None of the intellectual property rights in the technology product, or any portion thereof, submitted in the entry has been assigned or transferred to anyone that is not a member of the Team;
    • The technology product, through its creation and its submission as an entry, does not violate any applicable laws including patient re-identification;
    • The technology product, through its creation and its submission as an entry, does not infringe upon or violate intellectual property rights held by any third person or party;
    • The technology product submitted as an entry complies with appropriate policies, procedures and protections for access to relevant data sets to ensure all privacy requirements, intellectual property considerations, and sponsor restrictions are met; and
  • By submitting an entry in response to this Challenge, each Team and each Team member agrees to:
    • Comply with and be bound by the official rules and decisions of the Sponsor; Indemnify, defend, release and hold harmless the Sponsor, its officers, employees, and agents (including but not limited to, any judges or evaluators of the entries) from and against any claims, expenses, and liability, including but not limited to infringement of patent, copyright, trademark, or other intellectual property rights, property damage, or death or personal injury arising out of or relating to the Challenge or to the development, marketing, commercialization, distribution, use or other exploitation of any technology product submitted as an entry.

CHALLENGE SUBMISSION DEADLINE

  • The submission deadline for entries is October 17th, 2011.
  • Once an entry is submitted, a Team is prohibited from making any changes or alterations to the technology product described in its submission until the evaluation of the entries is completed. The date for completing the evaluation and judging is October 26th, 2011. This date may be extended in the sole discretion of the Sponsor.

INTELLECTUAL PROPERTY OWNERSHIP AND LICENSE

  • By submitting an entry, any team selected as a winner grants the Sponsor a perpetual, royalty-free, non-exclusive, worldwide license to use and display publicly the submitted materials and any related intellectual property (including trademarks and tradenames), solely for purposes of the Challenge and related marketing and promotion.
  • The participating teams retain ownership of all software, technology and intellectual property developed by them for this Challenge.

 

LIMITS OF LIABILITY

  • The Sponsor, administrators, and judges are not responsible for:
    • Any incorrect or inaccurate information, whether caused by teams, data sources, Challenge administrators, printing errors, equipment failures or programming problems associated with this Challenge;
    • Technical failures, including, but not limited to, disconnections in network hardware, software, or phone lines, interruptions, or other malfunctions;
    • Unauthorized human intervention in any part of the entry process or the Challenge;
    • Technical or human error which may occur in the administration of the Challenge or the processing of entries; or
    • Any injury to person or damage to property which may be caused by participating in the Challenge, including but not limited to, receipt or use of any award.