2019 State HIT Connect Summit

With states under tremendous pressure to modernize and develop more effective Medicaid IT systems that align with the Centers for Medicare and Medicaid (CMS) modularity mandate, agencies are looking to streamline infrastructure while reducing implementation cost, time, and risk. The Kansas Department of Health and Environment (KDHE) has adopted big data analytics to gain insight into ways to lower costs and improve outcomes for their Medicaid program. Analytics has provided the foundation for a growing number of government healthcare initiatives. These include population health management, value-based care, hospital re-admissions reductions, and clinical decision support. One the major challenges that states face is not a lack of data, but that they have too much of it. The challenge is how to discern what data is important and how to use it.

Historically, Medicaid agencies have generated enormous amounts of data and have faced technological challenges in aggregating, storing, analyzing, and visualizing this data due not only to its sheer volume, but also to privacy concerns. Over the past several years, KDHE, in partnership with its vendors, have brought numerous new data sources together and developed the capability to use and generate data in actionable and innovative ways. These include the use of near real-time analytics for program monitoring, which integrates healthcare data from multiple sources and in different formats into a comprehensive 360-degree Medicaid beneficiary view. Information can be viewed from the program, population demographics or individual level. 

The use of big data analytics has led to a successful realization of the Triple Aim, which translates to an immense savings in health care expenditures, improvements in care quality and greater beneficiary satisfaction and quality of life. Medicaid beneficiaries are typically high-cost, high-need populations and face an array of social, economic, and environmental factors that have a significant impact on their overall health. Given Medicaid’s complex populations and the implications for state budgets, KDHE is particularly interested in using data-driven innovations to enhance and bring efficiencies to the Medicaid program