Data and Implementation

Imposing a very low burden on your IT department, CPXTM participants work directly with Optum® to extract your EHR and billing data (adjudicated claims from two payers and outbound claims) and will map, normalize, and validate these data, allowing for “apples to apples” comparisons.

Once the data has been reviewed and validated, AMGA’s team works on generating your organization’s benchmarks, which we will provide via the AMGA benchmark data portal.

This interactive web portal allows you to drill down to site of care, enabling you to compare your current performance and the rate of improvement. The portal is updated every quarter for all the measures in each of the four domains.

The Implementation Process

Upon completion of the CPXTM contractual agreement with AMGA and data use agreement (including Business Associate Agreements with AMGA and Optum), participating organizations will work with Optum® Analytics on a standard implementation that will take place over the course of six months:

  1. Data Access/Extraction
    • Database credentials
    • VPN installation
    • Virtual machine setup
  2. Clinical Data Preparation and Review
    • Facility roll-up and site of care roll-up
    • Quality measure/ACO survey review
    • Custom configuration (identifying any custom code you utilize)
  3. Claims Data Preparation and Review
    • Gap analysis review and QA findings per source
    • Provider file/roster
    • Questions and resolution if any issues identified
  4. Data Review and Validation
    • Guided validation exercise over two to four weeks
  5. Progress Meetings
    • Weekly project meetings (about 30 minutes per week)

The Optum population health platform is not required for participation in AMGA’s Collaborative for Performance ExcellenceTM; however, participants who are also Optum clients will be able to further leverage the collaborative insights by creating ad hoc custom reports within the Optum platform.

More about Optum

With a first-of-its-kind integrated longitudinal data warehouse, Optum provides the unique ability to find deeper correlations and more patterns among patient populations. Their ability to merge clinical data from a diverse set of EHR systems and combine it with claims data and other sources into a single, validated, analytics-ready dataset gives AMGA a more complete view of participants’ data to then conduct its analytics. The Optum data integration process is designed to leverage interfaces like HL7s and 837s, which are native to your EHRs, and combine these data with standard formats for integrating adjudicated claims. Once the data is aggregated, Optum applies proprietary rules and algorithms to the 360-degree view of the populations.