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Eight States Partner for Medicaid Transformation, Data Analytics

The National Governors Association is convening eight states to accelerate Medicaid transformation and share best practices around data analytics and health data exchange.

Medicaid transformation and data analytics

Source: Thinkstock

By Jennifer Bresnick

- The National Governors Association (NGA) has selected eight states from across the nation to participate in a health data exchange and data analytics collaborative intended to foster innovation in Medicaid.

Arkansas, Colorado, Delaware, Indiana, Iowa, Minnesota, Vermont, and Washington will share best practices for big data analytics and data governance with an eye towards reducing costs and improving value for residents.

The Harnessing the Power of Data to Achieve State Policy Goals: The Foundation for State Success in Improving Quality and Reducing Costs initiative will run for 16 months, providing technical assistance and convening experts in population health management, analytics development, and quality measurement to equip states with the tools they need to address the social determinants of health and generate more value from their Medicaid programs.

“This NGA data initiative will help us grow our ability to analyze how Medicaid dollars are spent, the health of the populations we serve and how well the health care system is doing in meeting the care needs of our clients,” said Delaware Governor John Carney.

“Harnessing data is an important way to measure and evaluate our progress as we shift from a health care system that is based on volume of care to one that this based on health outcomes of patients.”

READ MORE: How to Get Started with a Population Health Management Program

The Robert Wood Johnson Foundation (RWJF) will provide financial support for the collaborative.

“Our Medicaid team has launched several initiatives to improve the quality of care for our Medicaid clients, to address the social determinants of health and to encourage value-based payments,” added Delaware Department of Health and Social Services DHSS Secretary Dr. Kara Odom Walker.

“The NGA assistance will offer us support as we plan, implement and evaluate these special efforts. We need data to develop baselines, track progress and analyze the results.”

NGA and RWJF are also supporting two complementary activities along similar lines.

Alaska, Colorado, Illinois, and New Hampshire will also tackle Medicaid improvement by developing data-driven evaluations of key Medicaid initiatives, such as hospital value-based purchasing and substance abuse treatment.

READ MORE: Medicaid Savings Require Integrated Physical, Mental Healthcare

States will work to create evaluation frameworks that meet the needs of their specific programs, many of which operate under unique state Medicaid innovation waivers.

“The siloed nature of public agencies and public funding…can make it difficult for governors and their senior leaders to understand the extent to which public programs are achieving their goals,” explains an NGA paper on the importance of improving data analytics competencies within state governments.

“The challenge of administering public programs when each program has its own funding stream, rules and regulations is widely discussed in policy circles, but siloed data systems compound those challenges, making it nearly impossible for state leaders to know how many individuals and families receive services from one or more agencies and whether those services are making a difference in their lives.”

Architecting and implementing more comprehensive and detailed evaluation procedures can help state governors and other leaders to visualize the impact of policy decisions on patients and their families.

Meanwhile, Alaska will also join Hawaii, Kansas, Minnesota, and Rhode Island to work together for 14 months to enhance the delivery of services intended to improve the health and success of children and families, with a particular emphasis on socioeconomic issues that may impact child development and long term outcomes.

READ MORE: What Are the Social Determinants of Population Health?

RWJF and NGA have also worked with CMS and the National Association of Medicaid Directors to develop a state toolkit for Medicaid transformation, which is the result of a multi-state Medicaid Transformation Policy Academy session held over 18 months, starting in 2014.

Advanced data analytics should form the core of any Medicaid improvement effort, the guide states, especially as more states apply for Medicaid 1115 waivers under the Affordable Care Act to customize their public insurance offerings for residents.

“A successful transformation effort is data driven, and so repeated data analysis must underpin this project,” says the guide. “As a result, states will need to invest in information technology support to address this fundamental need for transformation proposals.”

“Using data, states will be able to create and defend a vision for transformation—for example, by identifying how the proposal will address gaps in health outcomes and by establishing potential savings generated from using a new approach to health care delivery and payment.”

Collaboration, comprehensive planning, and securing stakeholder support are also keys to success, NGA says, and data analytics should be used at the very beginning of the process to inform policy decisions and steer transformative projects.

“Because many transformation efforts focus on crossing silos and linking clinical care with the underlying social determinants of health, the core team should consider engaging with a cross-agency group of state officials to facilitate working across agencies, build trust among agencies that might historically have been independent and effectively make decisions to maintain momentum and execute the transformation vision,” advises the guide.

The three recently announced data-driven initiatives will help states develop these competencies by brainstorming with their counterparts across state lines and sharing the lessons learned from both successes and failures.

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