Analytics works wonders in Colorado

Medicaid program benefits patients and derives millions in savings
By Anthony Brino
09:36 AM
Analytics works wonders in Colorado

Among state experiments in Medicaid policy, Colorado’s accountable care collaborative program is showing early successes in coordinating care and curtailing overutilization — and its analytics platform is supporting a good deal of the collaboration, despite a number of hurdles.

Now covering about half the state’s beneficiaries, Colorado’s Medicaid accountable care program saw a 15 percent reduction in hospital admissions and a 25 percent reduction in high-cost imaging in the 2013 fiscal year, contributing to $44 million in savings, the Department of Health Care Policy and Financing announced recently.

Most of that is going to providers as incentive bonuses and $6 million is returning to state coffers.

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“Next year at this time, we expect to be talking not only about savings, but also about all the ways the program provides value to our providers, clients and the community,” deputy Medicaid director Laurel Karabatsos said in a media release.

Under the program, primary care providers receive fee-for-service plus $4 per member per month for home-based care, and regional collaborative care organizations that help primary care practices coordinate patient care receive between $8 to $10 per member month, with about $1 from each withheld and then later paid out in quality-based performance incentives.

[See also: Analytics and the future of healthcare.]

Reporting that quality performance to Medicaid officials is a statewide data and analytics contractor, or SDAC, with the contract currently held by Treo Solutions. The SDAC also provides a management platform for primary care practices and regional collaborative organizations that lets them track patients at the individual and population levels.

The data and analytics service “greatly enhances the usefulness of Medicaid data for care management,” as Kaiser Family Foundation researcher Julia Paradise noted in a case study.

“State staff now consider the SDAC essential and say that, without it, it would be impossible to implement” the accountable care collaborative program, Paradise wrote.

The statewide data and analytics contractor emerged as a solution that could use Medicaid managed information system data, and will also be incorporated into a new MMIS Colorado is procuring.

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