2022 Annual State HIT Connect Summit Creates Value for Medicaid Agencies and Public Health

The following is a guest article by Eliana Donner-Klein, Sr. Associate, Audacious Inquiry, a PointClickCare company.

In-person meetups trumped video conferencing at the 2022 State HIT Connect Summit held last week in Baltimore, Maryland. After three years of virtual events, attendees finally gathered in real life to break down siloes and celebrate new ways for healthcare data and health IT to create value for state agencies, Medicaid beneficiaries, community wellness, and public health. It was a packed event, and the turnout was impressive.

Opportunity bolstered by strategy and execution was a consistent theme across the general sessions. “Our industry is racing toward a moment where humanity will say no more, and will either have to slash and burn the healthcare budget, or create another way,” suggested Aneesh Chopra, Co-Founder and President, CareJourney. “I think about this as a mix of public and private partnerships. There’s a national debate that will continue to heat up.”

Micky Tripathi, ONC National Coordinator for Health Information Technology, also mentioned healthcare’s potential during his keynote address. Tripathi reiterated the importance of healthcare partnerships and information sharing among payers, providers, public health, and other parts of the ecosystem. “The pandemic stress-tested what we’ve created, not just from a technology perspective, but the policies as well,” he added.

Specific takeaways for Medicaid agencies and HIEs aligned with Chopra’s and Tripathi’s vision for cross-sector partnerships and information sharing. There are significant amounts of technology and data available, but gaps remain in collaboration across the industry to make that data actionable. For example, Paula Braun, Entrepreneur in Residence at the Centers for Disease Control and Prevention, recognized efforts by HIE to partner with public health departments to enrich data during the pandemic as one step to close relationship gaps.

Future opportunities should include leveraging HIE strong patient matching and data analytic capabilities to further improve Medicaid and public health data.

State by State: North Carolina and Florida Case Studies

Two state-focused Medicaid sessions highlighted how North Carolina and Florida are using data to create value and inform Medicaid managed care performance. In one session about why data and analytics need a multi-speed approach to support managed care optimization, Jay Ludlam, Assistant Secretary for Medicaid Administration and Operation in North Carolina, discussed how the state uses analytics and a data-driven mindset to hasten Medicaid transformation.

North Carolina implemented weekly scorecards to measure Medicaid Managed Care Organization (MCO) policy compliance and quality, including inbound deliverables, provider network coverage, testing, and customer service. In addition, Ludlam and his team analyze MCO claims denials to discern whether organizations have sufficient funding and ensure dollars are used appropriately. Backed by cultural and infrastructure support, Ludlam’s efforts improve the business, policymaking, communications, and insights of North Carolina MCOs.

Further south in Florida, a private partnership between the Florida Agency for Health Care Administration (AHCA), Florida’s Health Information Exchange (HIE) and Audacious Inquiry demonstrated the feasibility and impact of rapid-cycle data to reduce potentially preventable visits (PPV) across the state. Through Florida’s HIE, AHCA set up real time alerts for healthcare providers and MCOs whenever a patient was admitted, discharged, or transferred across over 300 hospitals and other health care facilities in Florida. The patient’s encounter diagnosis and disposition are also included in the data exchange.

This real-time data in aggregate gives AHCA, providers and MCOs a population health visualization of statewide healthcare usage. Here are four specific population health steps AHCA is now able to take based on this real-time encounter notification service.

  • Pinpoint outlier facilities where PPV are taking place, the reasons for PPV encounter, and exact timing of the encounters to monitor trends. Rank the order of Florida hospitals that have the highest rate of non-admission ER visits for Medicaid enrollees.
  • Identify specific geographies in need of improved health literacy and extended primary care and urgent care center office hours.
  • Monitor the impact of stakeholder engagements and determine rapid accountability of outlier facilities, MCOs, FQHCs, and primary care providers.
  • Hold strategic discussions with hospitals and MCOs to implement policy and practical interventions to better serve the Medicaid population by reducing PPVs.

While this use-case focuses on PPV as the health care outcome of interest, ACHA’s public-private partnership demonstrates the future trend of health policy to incorporate real-time data for rapid-cycle interventions, thereby enabling more strategic improvements in population health interventions.

Bringing Stakeholders Together to Advance Medicaid and HIEs

This specific health IT community—state Medicaid agencies and HIE—brings together two of the most critical stakeholders in the healthcare ecosystem and public health. The event highlights bright and talented minds that are addressing some of healthcare’s biggest issues and innovations. And when these experts come together in real life the opportunities are limitless.

About Eliana Donner-Klein

Eliana works at the intersection of business, health care policy, and politics for Audacious Inquiry, a PointClickCare company. She is an experienced patient advocate and writer for migraine and headache disorders.

   

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