Performance Metrics Database and Analytics

The purpose of the Performance Metrics Database and Analytics (PMDA) is to improve states’ and Center for Medicaid and Children's Health Insurance Program Services (CMCS) abilities to effectively collect and store performance data, programmatic quality, and other reported information for oversight, monitoring and evaluation of 1115 demonstrations.

The 1115 demonstrations exhibit and evaluates policy approaches such as expanding eligibility to individuals who are not otherwise Medicaid or Children's Health Insurance Program (CHIP) eligible, providing services not typically covered by Medicaid, using innovative service delivery systems that improve care, increase efficiency, and reduce costs.  States who want to request a program under this authority must submit a written application to Centers for Medicare and Medicaid Services (CMS) for approval that details the goals and operational aspects of the program, and those applications are subject to public review and comment.

Programmatic quality for all 1115 demonstrations is that all demonstrations must remain budget neutral and are monitored throughout the lifespan of the demonstration.  As a result, the outcome of all demonstrations is categorized as performance data.

The system collects financial information regarding performance-based incentive programs from state representatives. The Content Management Application (CMA) within PMDA includes information to include name, email address, phone numbers and user credentials from state users, system administrators, and contractors for identification/authentication and communication purposes.

The types of financial information that are collected are publicly available financials associated with the cost of running a demonstration such as the cost associated with per member, per month.

PMDA user credentials are collected and maintained by the IDM system. IDM is external to PMDA and the PII within IDM is covered by a separate PIA. After initial log into the IDM system, a user inputs a user ID and password to gain access to PMDA. System administrators are granted access to PMDA upon approval of their Enterprise User Administration (EUA) which is a separate system which is covered by its own PIA) user Identification (ID). The EUA user ID is then used to create the CMS Enterprise Portal account to grant access to PMDA. 

The PMDA system regularly uses PII to retrieve system records including using the email, name, phone number and user credentials to access the PMDA system.

The PMDA was built with the capacity to support the CMCS. The purpose of PMDA is to improve states and CMS’ abilities to effectively collect and store performance data, programmatic quality, and other reported information. The system will also validate track performance-based incentives payments and have the capability to provide electronic reports that support CMCS oversight, monitoring, and evaluation of quality and performance metrics and other related incentive payments. PMDA also produces analytic files to support CHIP Services.

State users, which include employees and direct contractors working for the state government, will upload the demonstration documents (required from Section 1115 of the Social Security Act) to share with CMS administrative users to review. There is also a downloading capability that state users may utilize to edit and re-upload documents. These demonstration documents in the system will be maintained in the system permanently.

The CMA within PMDA will include information such as name, email address and phone numbers from state users, system administrators, and contractors for identification/authentication and communication purposes. It also collects financial information, such as publicly available financials associated with the cost of running a demonstration such as the cost associated with per member, per month as provided by state users in the demonstration files.

IDM is used to authenticate users - it collects, stores, and maintains user information such as name, email, phone number, and address. 

PMDA user credentials are collected and maintained by the IDM system. IDM is external to PMDA and the PII within IDM is covered by a separate PIA. After initial logging into the IDM system, a user inputs a user ID and password to gain access to PMDA. System administrators are granted access to PMDA upon approval of their EUA user ID. The EUA user ID is then used to create the IDM Portal account to grant access to PMDA.

• Name
• E-Mail Address
• Phone Numbers
• Mailing Address
• Other - User Credentials

• Employees
• Business Partners/Contacts (Federal, state, local agencies)

• Online

• Within the OPDIV
• State/Local/Tribal

• Private Sector

Users: Users require access to basic PII to perform business functions within the application.

Administrators: Administrators need access so they can perform maintenance and auditing.

Contractors: Contractors need access for role assignment and to perform audits. Only direct contractors (contractors using HHS credentials) have access to PII in PMDA.

Users Administrators: 

IDM is where the user credentials are processed. IDM roles are defined that govern the access to PII. When users request access to PMDA, they select one of the IDM roles. An administrator approves the user's request.

The IDM roles include, state user, CMS project officer, third party evaluation analyst and Administrator.