A new Governing Institute case study has been published, “New York Uses Data to Transform Healthcare Delivery,” which describes how CMA’s industrial-strength data warehouse provides the enriched data insights needed to improve Medicaid patient care.

Data Transforms Healthcare DeliveryThere are six million eligible Medicaid recipients in the state of New York — the second most of any state. The program is costing the state $18.2 billion in FY 2017, or 19 percent of its $96 billion operating fund. That expense is expected to increase by another $1 billion in FY 2018. These numbers mean that if New York can make Medicaid more efficient by even a fraction of a percent, it will positively impact other programs the state supports — not to mention its bottom line.

Most states — including New York — have transitioned to a managed care model to gain more control over Medicaid-related expenses and provide better care to this often-underserved population. But this can be a difficult undertaking without a strong foundation of coordination among the variety of providers serving Medicaid recipients, and a holistic view of their care.

In 2014, New York began to implement Medicaid’s Delivery System Reform Incentive Payment (DSRIP) program, a federally funded initiative that promotes community-level collaborations and focuses on system reforms. The goal of the program is to reduce avoidable hospital visits by 25 percent over 5 years.

To meet this goal, the state not only needed data, but also the ability to glean valuable patient insights from that data to help pinpoint risks and inform care decisions.

“DSRIP provides the runway and the funding for providers to come together, begin to work and act differently, and better coordinate and collaborate patient care — all with the intention to drive better outcomes,” says Ken Romanski, executive vice president of CMA, the IT solutions and services company New York contracted with to design and operate a data warehouse to achieve its DSRIP goals.

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