Data Integration Issues Cost Health, Human Services Agencies $342B

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The top challenge facing health and human services agencies is data integration, which is wreaking havoc on information systems, costing billions of dollars and reducing care quality.

That’s the finding of a new survey of 155 IT executives and program managers working with healthcare and other social service agencies—85 percentof whom say their agency faces challenges when it comes to the eligibility and verification of beneficiaries.

On average, these agencies take more than three work weeksto confirm benefit eligibility. However, even with that lengthy process, they estimate 11 percentof the people who receive government healthcare benefits are not actually eligible to receive them. As a result, those surveyed by MeriTalk—a public-private partnership focused on improving the outcomes of government IT—believe nearly $342 billion is wasted annually due to eligibility and verification issues.

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When it comes to the eligibility and verification of healthcare beneficiaries, agencies indicated that their biggest hurdle is data integration, with 44 percent sayingthey are unable to leverage all available data due to system and/or integration challenges. And, 43 percent of those surveyedbelieve their current processes hinder their agency’s ability to satisfy beneficiary needs.

Almost half of respondents (47 percent) say a focus on data integration could eliminate significant financial loss, as well as improve customer service through faster and more accurate results. They argue that a renewed focus on data integration can improve the customer experience (64 percent), accelerate eligibility requirements (63 percent), and reduce costs by accurately identifying recipients (55 percent).

Towards that end, those surveyed recommend:

*Auditing current systems and processes: Evaluating eligibility and verification processes to identify inefficiencies and design a path forward.

*Prioritizing data integration: Improved data integration will enhance productivity, improve the customer experience, accelerate eligibility determination, and reduce improper payments.

*Improving collaboration: For technology improvements to take hold, case workers and IT departments must come together to define needs, devise solutions, and justify investments.

The full results of the survey can be found here (registration required).

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