Did You Know?
- New York State spends $50+ Billion dollars a year on Medicaid.
- Around 50% of the U.S. population spends almost 97% of the allotted budget for healthcare.
- High-risk individuals (patients with multiple chronic illnesses) only make up around 20% of the population, yet consume around 80% of the state of New York’s Medicaid budget.
In a breakthrough new method of healthcare management, IBM and CMA have partnered together to build the infrastructure needed to detect high-risk patients sooner, so they can be helped sooner. Being launched for the first time ever in the State of New York, this software empowers patients and healthcare providers to build a culture centered on patient care.
Operating on IBM’s Cúram Social Program Managed Solution, The Health Home Initiative works with care coordinators, non-profits, and other organizations to create an advanced, highly-integrated system that delivers the best care possible to patients.
How the Health Home Initiative Detects High-Risk Patients
The ability to detect high-risk patients centers on data collection. The State of New York will use claims, encounters, pharmacy data, and post-inpatient discharge information to create a type of internal red-flag system.
Using this in-depth monitoring of collected data, The State of New York will track preventable health incidents – such as hospitalizations, emergency department use, detoxification, and so on. This system will be able to track chronic illness and detect poor disease management. As a result, the state will be able to recognize and categorize high-risk patients earlier by comparing current costs to past medical records.
Goals of the Health Home Initiative
- A speedier diagnosis process for patients, using proactive detection.
- More easily prevented malpractice suits that arise from misdiagnosis.
- Significantly reduced Medicaid costs for New York State.
- A reduced number of preventable health visits.
- Better managed high-risk patient cases.
State Health Commissioner Nirav R. Shah, M.D., M.P.H. said in a press release, “The new initiatives are critical elements in providing better care for patients at lower costs for taxpayers.”
IBM and CMA are developing a solution that has the potential to improve nearly every level of healthcare in the United States. For the first time in history, a healthcare management solution of this magnitude will be launched state-wide, and the results are expected to have a significant impact on Medicaid budgets and patient health in New York.
Download our whitepaper
Improved High-Risk Patient Management is the Key to Better Healthcare