Capability · Data Quality DQI/DQA & Compliance
The CMS Outcomes Based Assessment methodology now includes more than 500 critical and high-priority T-MSIS measures state Medicaid agencies must meet. CMS-0057-F's API deadlines land primarily on January 1, 2027. TEFCA has been operational since December 2023, with Qualified Health Information Networks now designated. Data quality is no longer an aspiration. It is a compliance frontier with named measurement standards.
Medicaid serves approximately 77 million people at $673 billion in FY2020, per GAO's foundational data-quality finding. The T-MSIS DQ measurement catalog is public and enumerated. Our work is the architecture that turns submission into passage of the OBA measurement.
Impacted payers must return prior-authorization decisions within 72 hours (expedited) and 7 calendar days (standard). Underneath the API standards sits an operational reality, provider directory freshness, prior-authorization workflow, and patient access data flows, that must be redesigned end to end.
TEFCA was published January 2022 and updated November 2023; the first QHINs were designated in December 2023 with data flowing within days. We advise operators evaluating QHIN participation on the operational architecture QHIN participation actually demands.
Barker and Barker holds public engagement with Wisconsin Department of Health Services. Wisconsin evaluates BadgerCare Plus on 19 HEDIS measures and Medicaid SSI on 14, publishing an annual HMO Report Card. Our Wisconsin base gives us direct working familiarity with state-level DQI/DQA operational reality, the layer beneath the report card.
Four-week read of the operator's data-quality architecture against the relevant standard. T-MSIS OBA, TEFCA participation criteria, or CMS-0057-F API compliance.
Prioritized rebuild plan, sized to civil-service or health-system bandwidth, with explicit measurement cadence and audit-readiness targets.
Continuous coaching for data governance, IT, and program leadership. Data-quality architecture is the layer that decays fastest without a working operating rhythm.
Quarterly measurement cadence and improvement-cycle review, because data quality is a running discipline, not a project.
Every engagement begins with a four-week diagnostic sized to your team's bandwidth.
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