Analytics help to improve Missouri’s Medicaid population care

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Three federally qualified health centers in rural Missouri, known as CHC Strategies, have put NextGen’s data analytics to use to target their most vulnerable populations.

So far, results have been encouraging, say executives of the health centers.

CHC provides care to some 107,000 patients—about 18 percent of all patients served by Missouri’s community health centers—in more than 53 of Missouri’s most rural counties. During the last 18 months, with the help of NextGen Population Health, CHC has been able to improve staffing and align workflows with best practices and plans to sign its first at-risk contract with a managed care company soon, CHC say.

According to Andy Grimm, CEO of Northeast Missouri Health Council, one of the health centers that forms CHC, the organization frequently uses NextGen’s geospatial capabilities to identify children with care gaps who live in geographically isolated areas. By cross-referencing rural schools and ZIP codes, they provide mobile medical and dental services to the hardest to reach and most in need.

The rural area in which these children live is a vast part of Missouri, and the families move around a lot, so it is hard to target them for services, Grimm says. NextGen has really helped with narrowing down where to find the children by school district so that CHC can send out a mobile clinic to their school.

The three centers that form CHC—Northeast Missouri Health Council, Community Health Center of Central Missouri and Jordan Valley Community Health Center—pooled their own resources to form CHC Strategies two years ago, setting as their first goal to gain an aggregate view of their data with one central access point, Grimm says.

It took about six months to gain approval, but CHC was able to persuade all three Medicaid providers in Missouri—United, Wellcare and Centene—to participate with NextGen for the project, Grimm says.

The biggest challenge payers face is their members’ lack of engagement, Grimm says. This often leads to care gaps, and non-compliant patients make unnecessary ER visits. Payers aren’t the best situated to engage patients; it’s better done with care coordinators at the clinic level. Because of this, the Medicaid payers saw the value in bringing NextGen’s analytics into the picture to help CHC reach the patient population in need.

“When we say we own our own data at the CHC level, we mean just that,” Grimm says. “Many of the analytic tools available in the industry claim health providers will own their own data when, in fact the vendor owns it and you’re beholden to their software. The beauty of NextGen Population Health is that it's infinitely scalable, and we retain clinical and local control.”

By pooling resources including staff, hardware and data, CHC achieved its dream and serves as a hub that enables its member community health centers to assume upside and downside risk with the Medicaid payers, Grimm says. Each center has its own NextGen Population Health instance that runs on its own database. CHC has enhanced database access to aggregate the data from all three of its health centers, to create a more holistic picture of the larger rural population’s health, costs and outcomes.

CHC likes how the NextGen data is available on the EMR. The care gaps and risk scoring show on the header of the patient chart, so it is seen by everyone that is part of the patient visit, not just by data analysts working behind the scenes, Grimm says. This enables CHC to identify and close care gaps when the patient is in the room.

“When ZIP code is a better predictor of health than genetic code, it’s imperative for providers to keep a close eye on their rural populations,” says Betty Rabinowitz, NextGen’s chief medical officer. “And as value-based payments become more prevalent, understanding the interactions among cost and quality is also important. CHC Strategies has mastered both with the help of the NextGen Population Health platform.”

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