Category: Clinical Data Infrastructure

Mississippi Division of Medicaid to Become First Medicaid Agency to Exchange Clinical Data

In March, MedeAnalytics announced that the Mississippi Division of Medicaid (DOM) had become the nation’s first Medicaid agency to send and receive clinical data in real-time. The agency worked with MedeAnalytics and Epic to share Medicaid data with the state’s largest provider of care to Medicaid patients, the University of Mississippi Medical Center (UMMC).

Following the announcement, Rita Rutland, deputy administrator for the division’s Office of Information Technology Management, and several others associated with the project spoke to HealthLeaders and StateScoop on the topic. If you missed it, here is a glimpse of what they said:

“After years of working with our technology partners to build a foundation consisting of an EMPI and clinical data repository, we can now instantly share patient summaries with external stakeholders, such as UMMC. This real-time access to beneficiary data will improve insight into beneficiary health trends, empower better care decisions and much more,” said Rita Rutland in a conversation with HealthLeaders.

In an interview with StateScoop, Dr. John Showalter, chief health information officer for UMMC, said, “Now we’re able to reach into the Medicaid clinical data repository when we schedule a patient or they show up at the ER, so it’s pre-cued for our physicians and already brought into their workflows. In a single click, our physicians can see all the medications they’re on that they’re filling prescriptions for, all the visits they’ve had, what kind of doctors they’ve seen, what tests they’ve had.”

David Dzielak, the Medicaid division’s executive director, also spoke with StateScoop, “We’re not content anymore with just having the providers see our beneficiaries and treating them for the conditions that they have. We really want providers to adopt the idea that they have the condition, but how do we prevent them from progressing and how do we move them back to a more healthy condition or health status?”

For additional insights from Mississippi DOM and UMMC, visit our “In the News” page.

HIMSS16: Revenue Cycle Improvement, Performance Management & Clinical Data Infrastructure, Oh My!

This week, 43,000 healthcare industry experts, from CEOs to clinicians and IT professionals, will descend into Las Vegas for the HIMSS Conference & Exhibition, the largest event in the health information technology field in the U.S.

From meeting and networking with health IT expects to keynotes from Sylvia Mathews Burwell, Secretary of Health & Human Services, and Peyton Manning, Quarterback for the Denver Broncos, MedeAnalytics is looking forward to the action packed and educational event.

We are also excited for the 300 educational sessions that will be presented during the week, including three from MedeAnalytics’ own customers: Baptist Health System, Jersey City Medical Center and the Mississippi Division of Medicaid (Mississippi DOM). These clients will address their successes with revenue cycle improvement, enterprise performance management and the implementation of clinical data infrastructure.

Mark your calendars for these sessions:

Mississippi Division of Medicaid will share challenges and success stories from the implementation of clinical data infrastructure components such as a MPI, clinical data repository (CDR) and Provider Portal. Chris Smith, Clinical Data Interoperability Program Manager for the DOM, will share ongoing and future planned Medicaid strategic clinical data integrations with external stakeholders (State HIE) and provider clinical systems (Electronic Health Records, Laboratory Information Systems, etc.).

  • Date and Time: March 1, 2016 from 2:30 – 3:30 p.m. PT
  • Location: Sands Expo Convention Center, Lando 4205

Jersey City Medical Center, a Barnabas Health facility, will discuss how the health system combined data, analytics and enterprise performance management to create a closed-loop solution that improved care metric performance and accountability. During this session, Joseph Scott, President and CEO of JCMC, will outline how they emerged from the verge of bankruptcy to a multi-million dollar positive revenue while improving patient care. They have since been awarded the prestigious Vision of Performance Excellence Award (VoPE), which is the state level of the Malcolm Baldrige Award. 

  • Date and Time: March 3, 2016 from 8:30 – 9:30 a.m. PT
  • Location: Sands Expo Convention Center, Marcello 4404

Baptist Health System, one of the largest healthcare systems in Alabama, will discuss how they improved their revenue cycle with new processes and analytics technology to address several major changes impacting their organization, including an EHR system conversion and the state’s decision to opt out of Medicaid expansion. Rosh Plugge, Director, Revenue Systems and Controls, and Pete Welch, Senior Analyst of Revenue Systems, at Baptist Health System will address these circumstances and how they improved the revenue cycle while maintaining positive patient satisfaction.

  • Date and Time: March 4, 2016 from 10:30 – 11:30 a.m. PT
  • Location: Sands Expo Convention Center, Delfino 4004

MedeAnalytics hopes to see you there! Can’t make the sessions? Download the presentations on their respective links. In addition, join the HIMSS16 conversation with MedeAnalytics on Twitter by following #HIMSS16, #RethinkRCM, #PutData2Work and #HITWorks. 

Six Steps to Success with Population Health

Shared accountability agreements create significant financial incentives for providers who capitalize on them. Doing so requires population health management initiatives that systematically improve clinical outcomes while reducing costs.

Collecting and analyzing data play a crucial role in population health management. With big-picture insight into patient populations and utilization trends, you can focus your care managers on the right patient interventions and seamlessly transition to accountable care—without disrupting clinical workflows.

Here are six actionable steps you can follow to create an effective population health management program.

  1. Aggregate your data. The first step toward achieving success in an accountable care environment is capitalizing on a solution that will aggregate all of your clinical and claims data so you can identify areas of opportunity. The data helps you understand how you’ve performed historically so you can focus on the areas where you are ready to take on risk rather than entering into contracts blindly.
  2. Analyze your data. Static reports and raw data by itself do little to enable clinical and cost improvements. Advanced, self-service data analytics give you the capabilities you need to easily design and measure population health initiatives.
  3. Communicate with patients. Once you’ve identified disease management opportunities and intervention initiatives, you can proactively communicate to those at-risk patient populations. Involving patients in their own care goes a long way toward improving patient engagement.
  4. Engage clinicians. To drive clinical improvement, it’s important to get physician buy-in and align physicians around the organization’s population health strategies and metrics. The key is to show physicians the facts, utilizing evidence-based practices.
  5. Measure success. Monitor your organization’s performance on your P4P and HEDIS quality measures in near real-time. This ensures that you will be able to focus on areas of improvement throughout the year prior to reporting your results.
  6. Start at home. Integrated delivery networks have practiced the concepts behind population health management long before the advent of accountable care. Follow their lead and start your population health initiatives with your self-insured populations.

To get started, learn more about MedeAnalytics Population Health or email us

We’re presenting at MESC 2015 to share our success with the Mississippi Division of Medicaid

Tomorrow at MESC Conference 2015, we will be presenting the success of Mississippi DOM’s Medicaid Clinical Provider Portal with the Mississippi Division of Medicaid. If you’re attending come see us at 9:30 a.m. ET in Room 319.

The session will cover how the Mississippi Division of Medicaid (DOM) deployed Provider Access, a clinical portal that gives Medicaid physicians real-time access to a single source of clinical data from multiple health systems on DOM beneficiaries. Medicaid providers now have insight into a patient’s longitudinal health record for all DOM beneficiaries with the ability to export Medicaid clinical data from the portal directly into their EMRs (a Meaningful Use Stage 2 requirement). This clinical portal leverages DOM’s EMPI—a critical component as DOM moves toward MITA 3.0—that manages over 2.3 million potential beneficiaries’ identities.

Chris Smith, clinical data interoperability program manager at Mississippi DOM, will discuss this innovative project including, the core elements of the clinical portal fostering population health and interoperability, the challenges surmounted in the face of this new program along with funding, adoption rates, capabilities and results—a year after implementation.

For the complete conference agenda and additional details on MESC Conference 2015, visit here

Award-Winning Baptist Health System Converts to Epic with MedeAnalytics

The Challenge

In a climate of growing requirements for population health management and changing reimbursement models, Baptist Health System recently converted to Epic in an effort to manage clinical outcomes, improve revenue cycle productivity, and ultimately ensure financial viability. Although system conversions come with challenges of their own, MedeAnalytics Business Office gave the organization quality, credible data analysis that enabled them to convert to Epic with confidence.

The Solution

Before implementing MedeAnalytics in 2005, Janice Ridling, Vice President of Revenue Management at Baptist Health System, noticed a lack of quality, credible data analysis. “It was difficult to get the information we needed,” she said. “What we did get were canned reports that weren’t timely. Plus, we were always reporting on the past. We had no predictive analysis and no ability to slice and dice the data.”

With MedeAnalytics, Baptist Health System gained access to real-time insight into the revenue lifecycle, identifying bottlenecks, delays, black-hole accounts and more. The data analytics solution enables the health system to proactively trend AR data, perform comparative benchmarking and drill down into detailed patient accounts and transaction detail.

Baptist Health System came to trust this data over the years and that trust was strengthened during their conversion to Epic. Analyzing the complex data stored within Epic can be time consuming, often requiring assistance from IT. Epic performs at its best when complemented by self-service data analytics solutions, like those from MedeAnalytics. Having easy access to these data insights proved vital to the organization in their attempts to identify and plug revenue gaps.

Results

With MedeAnalytics, Baptist Health System was able to:

  • Reduce AR days from 47.1 to 40.1
  • Track and trend self-pay and POS collections
  • Confidently convert to Epic while maintaining self-service analytics

Baptist Health System’s revenue cycle achievements have also been recognized by HFMA. For the fourth time, the health system won the HFMA Map Award for High Performance in Revenue Cycle this year. Winners of this national award demonstrate inventive, patient-centered revenue cycle practices that deliver sustainable financial performance. Baptist Health System attributes much of their revenue improvements to MedeAnalytics, thanks to the reduction of KPIs and the enhanced management of receivables, which were vital components for the organization’s award recognition.

According to Janice Ridling of Baptist Health System, “MedeAnalytics was a primary factor in our success with our Epic conversion, and we continue to find new and innovative ways to analyze our data.” 

Read the full Baptist Health System case study and additional results here.

Data Analytics to Improve Medicaid Care and Costs

As the healthcare industry shifts to value-based care and fine-tunes their efforts to lower unnecessary costs, Medicaid state agencies have looked to major players in the healthcare data analytics space. This leap is of course not easy for many of these state entities but the Mississippi Division of Medicaid (Mississippi DOM) offers a shining example of how to successfully leverage data analytics to improve care while reducing costs. Several other state Medicaid agencies have already tapped on Mississippi DOM for insights and best practices for adopting a similar initiative. I predict that we’ll see many other states making the leap into big data in 2015 to align their payments with quality and value.

Mississippi Division of Medicaid Taps Data Analytics

Before 2013, Mississippi DOM was struggling to manage its 2.1 million potential Medicaid patients’ records and identities. To bring more cohesion to a fragmented patient identification system and improve patient safety, Mississippi DOM brought on a data analytics expert to help deploy a clinical Master Patient Index (MPI) in 2013. By leveraging powerful analytics and advanced algorithms, the Mississippi DOM staff successfully matched 91% of all 2.1 million Medicaid beneficiaries’ data throughout the state.

Leveraging analytics, Medicaid providers were able to create a single-identifier for each of Mississippi’s 800,000 active Medicaid beneficiaries. This process allowed administrators to easily manage patient records and ensured that providers were viewing the right longitudinal record during a clinical visit. During the initial implementation, over 8 years’ worth of data (plus lifetime events, such as amputations) were sorted, matched and created into single identities within Medicaid’s records. This process – which consisted of several iterations – took just under a year to develop, refine and implement.

As Mississippi DOM began to implement its population health management program and MPI, it experienced some challenges that shaped the initial implementation of the program.

The first challenge was developing a system that would be able to handle the immense amount of data that would be analyzed at any given time. Mississippi DOM needed to build a modern infrastructure on top of their legacy systems in order to manage 2.1 million identities, which could include between 600,000 and 800,000 active identities in any given month. This is a challenge that the industry will continue to face and overcome as the vast amount of data created on a daily basis continues to increase.  

A second obstacle was around leadership obtaining buy-in from the various stakeholder groups across the state. Other providers were required to agree to work with Mississippi DOM to create this globally harmonized MPI system, by integrating and synchronizing local and regional MPI systems. This proved to be a major challenge, and unifying the existing MPIs with the robust MPI that Mississippi DOM has developed has yet to be completed. The reality is that each provider has an MPI that is at a different stage of its lifecycle and these systems will need to work together to build the robust state-wide MPI Mississippi DOM leadership envisions.  

After overcoming external and internal challenges, Mississippi DOM achieved a 91 percent confidence rate in automated matching due to the complex algorithm developed by the technology provider.

Looking Ahead

Mississippi DOM is now looking towards the next phase of the project: harmonizing the Medicaid clinical MPI with external stakeholders to support clinical data exchange. Updates will be announced in the coming year.