RE: Medicaid types

[Theresa L. Walunas]

Are you just looking for a simple breakdown... e.g. 50% FFS, 25% MCO, 25% Other 
Variant?

I might be able to help with that.  Unlikely to be able to get to actual claims.

From: Kho, Abel [mailto:abel@nm.org]
Sent: Friday, January 20, 2017 1:25 PM
To: Bernard Black ; Dan Connolly 
; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney ; Marc Brian Rosenman 
; Laura Jarmila Rasmussen-Torvik 
; Theresa L. Walunas 
Subject: Re: Medicaid types


I'm going to pull in Theresa who works most closely with Medicaid office in our 
group.




From: Bernard Black 
>
Sent: Friday, January 20, 2017 1:24 PM
To: Kho, Abel; Dan Connolly; 
gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney; Rosenman, Marc (NU); Rasmussen-Torvik, Laura (NU)
Subject: RE: Medicaid types

Abel and Marc:  March may be able to tell us for Northwestern, but what do we 
know about Medicaid in Illinois?
In some states, Medicaid is all/essentially all capitated, in some it is mostly 
fee for service, in some states, there is more variance.
What is known about Illinois Medicaid?


Bernie

*
Bernard S. Black
Chabraja Professor, Northwestern University
Pritzker Law School and Kellogg School of Management
375 East Chicago Ave., Chicago IL 60611
bbl...@northwestern.edu
tel:  law:  312-503-2784; Kellogg 
847-491-5049; cell: 847-807-9599
papers on SSRN at:  
http://ssrn.com/author=16042


From: Kho, Abel [mailto:abel@nm.org]
Sent: Friday, January 20, 2017 10:27 AM
To: Bernard Black 
>; Dan 
Connolly >; 
gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney >; Marc Brian 
Rosenman >
Subject: Re: Medicaid types


I don't know the answer to this but I suspect Marc may be able to know this 
based on the work he is doing now to get a handle on the diversity of insurance 
types.


From: Bernard Black 
>
Sent: Friday, January 20, 2017 8:55 AM
To: Dan Connolly; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney; Rosenman, Marc (NU); Kho, Abel
Subject: Medicaid types

Medicaid is sometimes capitated and sometime not.
Is this information available from the GPC sites?  It would be useful to have 
this, if knowable.
Abel:  Same question for the Capricorn sites.

Capitated plans can be called "managed care", or "health maintenance 
organization (HMO)" and perhaps other names.

Thank you,
Bernie
*
Bernard S. Black
bbl...@northwestern.edu
Nicholas J. Chabraja Professor, Northwestern University
 Pritzker School of Law
 Institute for Policy Research
 Kellogg School of Management, Finance Dep't
Law School:  375 East Chicago Ave., Chicago IL 60611
IPR:  2040 Sheridan Road, Evanston IL 60208 (my office:  2046 Sheridan)
Kellogg:  2001 Sheridan Road, Evanston IL 60208
tel:  law:  312-503-2784; IPR:  847-491-8730; cell: 847-807-9599
papers on SSRN at:  
http://ssrn.com/author=16042



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Where are UTSW Glucose labs? (#551)

[Dan Connolly]

Phillip, while you're in the Next-D neighborhood...

Where are your glucose labs? i.e. what LOINC codes and/or i2b2 paths do you use?

We looked on babel and couldn't find any UTSW labs.

--
Dan


From: furmanc...@icnanotox.org [furmanc...@icnanotox.org] on behalf of Al'ona 
Furmanchuk [alona.furmanc...@northwestern.edu]
Sent: Wednesday, January 18, 2017 7:40 AM
To: Nathan Graham
Cc: phillip.ree...@utsouthwestern.edu; Dan Connolly; Lindsey Lynne Cook
Subject: Re: Phillip's e-mail copied for Al'ona


Hello, Phillip.
Dan Connolly suggested you might be the right person to ask about location of 
lab information in utsw_terms schema or elsewhere else in i2b2 database on 
babel.
Recently I was doing initial assessment of data from different GPC sides 
participating in the Next-D project.  I was trying to extract information on 
labs from  i2b2metadata schemas by using sql.
Here is an example of commands I tried:
select c_name, c_totalnum, c_basecode from utsw_terms where c_basecode like 
'LOINC:%' and UPPER(c_name) like '%GLUCOSE%' order by c_basecode
or
select c_name, c_totalnum, c_basecode from utsw_terms where UPPER(c_name) like 
'%LOINC:%' and UPPER(c_name) like '%GLUCOSE%' order by c_basecode

Dan’s search with the i2b2 web UI also ended up with no information on labs for 
this side.
I wonder if you could help us or suggested right person to ask about how to 
find labs’ information (names and LOINC codes) for UTSW side.

With respect,
Alona.

On Tue, Jan 17, 2017 at 4:28 PM, Nathan Graham 
> wrote:
Al’ona,

Phillip is copied (phillip.ree...@utsouthwestern.edu).

--
Nathan



--
Al’ona Furmanchuk, Ph.D.
Research Associate

Department of Electrical Engineering and Computer Science
Northwestern University
2145 Sheridan Road, Tech L359
Evanston, IL 60208
Web: http://furmanchuk.com/
E-mail: alona.furmanc...@northwestern.edu
Phone: 847-467-2299
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Re: Medicaid types

[Marc Brian Rosenman]

Hi all,



Bernie's question (8:55 a.m. in the thread below) -- "Medicaid is sometimes 
capitated and sometime not. Is this information available from the Capricorn 
sites." -- may be divided into two questions:



  1) What level of granularity and accuracy is available in the payor 
(and/or "financial class") fields in each CAPriCORN institution's source 
database (EHR or related repository)?



  2) What level of granularity might each institution be willing to provide 
for our city-wide mapping project?



In my experience, even the most granular values stored by an institution in its 
EHR/repository are not always clear-cut as to whether the patient's Medicaid 
coverage was capitated or not.



Some records are clear-cut:  e.g., "ILLINICARE HEALTH PLAN MEDICAID MCO" is 
Medicaid managed care.



Some records are clear-cut as long as one knows the local environment well:  
e.g., "NEXTLEVEL HEALTH MCO" is Medicaid managed care even though it does not 
say the word "Medicaid."



But some records have insurance labels that are vague (intentionally or 
unintentionally) as to capitation: e.g., "MEDICAID IL - STATUS PENDING."  Also, 
values are sometimes truncated, etc.



Also some Medicaid records, in my view, should be placed into a third category 
(an "other" category): e.g., "MEDICAID SPENDDOWN."





Some health care institutions have financial/reimbursement offices and systems 
that may have more detailed information than the EHR/repository does about the 
insurance status for each encounter, but those separate systems (if not already 
being used in the ETL processes) would require substantial work (and local 
approvals) to access.



thank you,

marc






From: Kho, Abel 
Sent: Friday, January 20, 2017 1:25 PM
To: Bernard Black; Dan Connolly; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney; Marc Brian Rosenman; Laura Jarmila Rasmussen-Torvik; 
Theresa L. Walunas
Subject: Re: Medicaid types


I'm going to pull in Theresa who works most closely with Medicaid office in our 
group.



From: Bernard Black 
Sent: Friday, January 20, 2017 1:24 PM
To: Kho, Abel; Dan Connolly; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney; Rosenman, Marc (NU); Rasmussen-Torvik, Laura (NU)
Subject: RE: Medicaid types

Abel and Marc:  March may be able to tell us for Northwestern, but what do we 
know about Medicaid in Illinois?
In some states, Medicaid is all/essentially all capitated, in some it is mostly 
fee for service, in some states, there is more variance.
What is known about Illinois Medicaid?


Bernie

*
Bernard S. Black
Chabraja Professor, Northwestern University
Pritzker Law School and Kellogg School of Management
375 East Chicago Ave., Chicago IL 60611
bbl...@northwestern.edu
tel:  law:  312-503-2784; Kellogg 
847-491-5049; cell: 847-807-9599
papers on SSRN at:  
http://ssrn.com/author=16042


From: Kho, Abel [mailto:abel@nm.org]
Sent: Friday, January 20, 2017 10:27 AM
To: Bernard Black ; Dan Connolly 
; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney ; Marc Brian Rosenman 

Subject: Re: Medicaid types


I don't know the answer to this but I suspect Marc may be able to know this 
based on the work he is doing now to get a handle on the diversity of insurance 
types.


From: Bernard Black 
>
Sent: Friday, January 20, 2017 8:55 AM
To: Dan Connolly; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney; Rosenman, Marc (NU); Kho, Abel
Subject: Medicaid types

Medicaid is sometimes capitated and sometime not.
Is this information available from the GPC sites?  It would be useful to have 
this, if knowable.
Abel:  Same question for the Capricorn sites.

Capitated plans can be called "managed care", or "health maintenance 
organization (HMO)" and perhaps other names.

Thank you,
Bernie
*
Bernard S. Black
bbl...@northwestern.edu
Nicholas J. Chabraja Professor, Northwestern University
 Pritzker School of Law
 Institute for Policy Research
 Kellogg School of Management, Finance Dep't
Law School:  375 East Chicago Ave., Chicago IL 60611
IPR:  2040 Sheridan Road, Evanston IL 60208 (my office:  2046 Sheridan)
Kellogg:  2001 Sheridan Road, Evanston IL 60208
tel:  law:  312-503-2784; IPR:  

Next-D Cohort

[Phillip Reeder]

Is there a query somewhere that defines the Next-D cohort?  We need preliminary 
numbers for our IRB and I was hoping there was one already created.

Thanks,
Phillip

Sent from my iPhone



UT Southwestern


Medical Center



The future of medicine, today.


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RE: unstructured text notes: refining the target (#431)

[Dan Connolly]

I broke #431 into 
two targets as I see them:

  *   #572  
enterprise scale unstructured text notes de-identified, in 
i2b2
  *   #573   
de-identified text notes for on a cohort-by-cohort 
basis

Most of what is involved in the cohort-by-cohort approach is also needed for 
the enterprise scale approach, but it's a smaller lift and it meets 
requirements for some known use cases. Rolling out #573 in the medium term with 
#572 as a stretch goal is something I can get my head around.

The tickets include use cases; for enterprise scale:

  *   Investigator works on an i2b2 query for a genetic marker, in 
collaboration with an honest broker at a site such as Maren at KUMC
  *   Maren distributes the query to GPC sites via babel and the investigator 
submits a GPC DROC request
  *   each honest broker executes the query against their i2b2 and so on as 
described in RC11 of the GPC phase 1 
proposal
 *   
DataBuilder 
query results from each site include relevant de-identified notes

And for cohort-by-cohort:

Main use case identified at 
HackathonFour
 was de-identified chart review.


Feasibility of this approach is supported by Tim's success at deploying 
​de-id-docker in a matter of hours 
after George's presentation at 
HackathonFour.

Note that the underlying technology is the same as KUMC adopted from MCW for 
enterprise scale use:

  *   
​MCW_BMI/unstructured-notes-deidentification

Another use case is distributed query a la popmednet. Running federated queries 
"lights out" would involve something like:

  1.  using 
PortQuery to 
run the i2b2 cohort query locally and noting the resulting patient set id
  2.  Invoking the docker container to extract the notes
  3.  Running the distributed analysis code

Combining 2 and 3 into a Jenkins job seems straightforward.

--
Dan


From: Dan Connolly
Sent: Wednesday, January 18, 2017 5:19 PM
To: Russ Waitman; Taylor, Bradley
Cc: 
Subject: RE: unstructured text notes: refining the target (#431)

Russ, Brad, w.r.t. figure figure 4 of our proposal, what is "NLP derived 
concepts"?

http://frontiersresearch.org/frontiers/sites/default/files/Phase%20II%20Proposal.pdf

--
Dan


From: Dan Connolly
Sent: Tuesday, January 17, 2017 12:24 PM
To: Russ Waitman; Taylor, Bradley
Cc: 
Subject: unstructured text notes: refining the target (#431)

Russ, Brad (when you get back),

I'd like to get a few concrete use cases as targets for this deliverable so 
that we can get tangible experience with what's required and what would be 
nice-to-have.

MCW and IU both report trying the approach of de-identifying all their notes 
and putting them in i2b2 and coming to the conclusion that it was unwieldy. MCW 
now does de-identification on a cohort by cohort basis. I'm not sure how to 
characterize the IU approach.

The cohort-by-cohort basis suffices for GPC needs, as far as I can tell.

For example: suppose investigators specify, in their GPC DROC request, that 
progress notes are part of the data that they want. Then each site runs their 
cohort query and delivers notes for that cohort. The MCW process should work 
well as a recommended method but other methods would be acceptable if a site 
(such as IU) already has a suitable process.

Perhaps one concrete case would be: progress notes for the ALS cohort, since 
it's small, then try the breast cancer cohort. Or are there other cohorts where 
we have a customer demand for notes?

For reference: #431

--
Dan

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Re: Medicaid types

[Kho, Abel]

I don't know the answer to this but I suspect Marc may be able to know this 
based on the work he is doing now to get a handle on the diversity of insurance 
types.


From: Bernard Black 
Sent: Friday, January 20, 2017 8:55 AM
To: Dan Connolly; gpc-dev@listserv.kumc.edu
Cc: Sparapani, Rodney; Rosenman, Marc (NU); Kho, Abel
Subject: Medicaid types

Medicaid is sometimes capitated and sometime not.
Is this information available from the GPC sites?  It would be useful to have 
this, if knowable.
Abel:  Same question for the Capricorn sites.

Capitated plans can be called "managed care", or "health maintenance 
organization (HMO)" and perhaps other names.

Thank you,
Bernie
*
Bernard S. Black
bbl...@northwestern.edu
Nicholas J. Chabraja Professor, Northwestern University
 Pritzker School of Law
 Institute for Policy Research
 Kellogg School of Management, Finance Dep't
Law School:  375 East Chicago Ave., Chicago IL 60611
IPR:  2040 Sheridan Road, Evanston IL 60208 (my office:  2046 Sheridan)
Kellogg:  2001 Sheridan Road, Evanston IL 60208
tel:  law:  312-503-2784; IPR:  847-491-8730; cell: 847-807-9599
papers on SSRN at:  http://ssrn.com/author=16042


This message and any included attachments are intended only for the addressee. 
The information contained in this message is confidential and may constitute 
proprietary or non-public information under international, federal, or state 
laws. Unauthorized forwarding, printing, copying, distribution, or use of such 
information is strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify the sender of the 
delivery error by e-mail.
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Medicaid types

[Bernard Black]

Medicaid is sometimes capitated and sometime not.
Is this information available from the GPC sites?  It would be useful to have 
this, if knowable.
Abel:  Same question for the Capricorn sites.

Capitated plans can be called "managed care", or "health maintenance 
organization (HMO)" and perhaps other names.

Thank you,
Bernie
*
Bernard S. Black
bbl...@northwestern.edu
Nicholas J. Chabraja Professor, Northwestern University
 Pritzker School of Law
 Institute for Policy Research
 Kellogg School of Management, Finance Dep't
Law School:  375 East Chicago Ave., Chicago IL 60611
IPR:  2040 Sheridan Road, Evanston IL 60208 (my office:  2046 Sheridan)
Kellogg:  2001 Sheridan Road, Evanston IL 60208
tel:  law:  312-503-2784; IPR:  847-491-8730; cell: 847-807-9599
papers on SSRN at:  http://ssrn.com/author=16042


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