Each year, state Medicaid leaders from all over the country gather at the Medicaid Enterprise Systems Conference (MESC) to talk about the role of technology in meeting Medicaid and industry initiatives, like value-based care. Our client, Mississippi Division of Medicaid (DOM), spoke on their use of the consolidated clinical document architecture (C-CDA) standard to coordinate care and improve outcomes for their Medicaid beneficiaries. DOM is the first Medicaid agency in the nation to establish clinical data exchange with healthcare providers to directly benefit patients and physicians at the point of care. DOM has successfully exchanged data with University of Mississippi Medical Center (UMMC) which resulted in more than two million clinical summaries. They also recently partnered with Hattiesburg Clinic and shared more than 100,000 clinical summaries.
To achieve this level of connectivity, DOM faced many challenges such as differences in vendor implementation of industry standards and providers’ use of unexpected medical codes. We connected with Ian Morris, Project Manager for the State of Mississippi DOM, to get his take on the overall lessons learned from this project and what fellow government organizations need to keep in mind for similar undertakings. Here are three key takeaways:
- Rely on Vendors’ Expertise – DOM would not be able to achieve this level of success without qualified vendors who have the expertise to develop and support the technology infrastructure and needs of real-time data exchange for hundreds of thousands of beneficiaries.
- Be Realistic – These projects are time and labor intensive and can take years to achieve. Be patient and work around your trading partner’s various schedules and technologies.
- Collaborate – Every stakeholder has different end-goals but these projects are a joint effort. This means that the conversation needs to move away from “my data” and towards “our data” to better coordinate care.
Looking ahead, DOM plans to continue integration with Medicaid-focused health systems, Health Information Exchanges and state and federal agencies. In fact, just last month they went live with their third clinical data exchange connection – Singing River Health System.
To learn more on UMMC and DOM’s success, read our announcement here.
Get our take on industry trends
Introduction to social risk: What healthcare leaders need to understand
‘Social determinants of health’ has been a common phrase for decades now, but the term social risk is much less…
Read on...AI is your new crystal ball: How predictive analytics can reduce denials
The idea of having a crystal ball to better understand what claims will be denied is an awesome concept. But one we can’t rely on. Thankfully, we have predictive analytics to take the place of a crystal ball.
Read on...3 ways to reduce friction in payer-provider relationships
The dynamic between healthcare providers and payers has historically been quite strained. Though both parties are interested in improving the…
Read on...Position your organization for success under CMS-HCC V28
The transition from CMS-HCC V24 to V28 heralds a significant shift in risk adjustment methodologies and emphasizes improved accuracy and…
Read on...