Idaho's pilot program aims for reduced costs, improved quality
Idaho's pilot program aims for reduced costs, improved quality
"We are excited about the opportunities identified in the stimulus package related to HIT," says Leslie Clement, Idaho's Medicaid administrator. "HIT provides the opportunity to transform our current high-cost health care environment into a more efficient and effective system."
Ms. Clement says she is hopeful that the funding will enable health care providers throughout the state to obtain the necessary HIT to improve health care coordination and reduce duplication.
Idaho has begun a statewide pilot of its Health Data Exchange, and Medicaid participates in this endeavor. "We hope the Data Exchange can assist us in our efforts to promote person-centered medical homes," says Ms. Clement.
The Idaho Health Data Exchange is a product of Idaho's Health Planning Quality Commission, which was initiated in 2006. Members include representatives from private health plans, Medicaid, community clinics, hospitals, physicians, and an employer health coalition. A web-based hosted application and a secure exchange of health information is provided. Provider participation is voluntary, and patients may opt out of participation.
The pilot began this year, starting with three hospitals. "Interface work is almost complete. The plan is to add 100 physicians in this first year," says Ms. Clement.
Subsequent phases over five years will add 30 hospitals, 10 independent data sources and 1,500 physicians. The program has an "EMR-lite" product that is particularly attractive for small practices that are unable to afford an EMR purchase on their own.
Medicaid staff are working with commercial health plans to identify performance measures to evaluate how the Data Exchange reduces costs and improves quality. "One meeting has taken place that resulted in brainstorming ideas that would measure pharmacy and medical utilization," says Ms. Clement. Some potential measures include controlled substance usage, reduction of multiple prescribers, reduction in multiple pharmacies, overall reduction in pharmacy costs, lab testing utilization, imaging utilization, ED costs per visit, inpatient admits from the ED, and general hospital admits per 1,000.
"We're in the very early stages of identifying performance measures," says Ms. Clement. "There will likely be many changes as we sort through our ability to develop standard measures that can be tracked in both public and private health plans."
Ms. Clement says that, ultimately, she expects to see a decrease in costs due to reduced duplication and improved coordination. "Our participating providers should benefit from having improved access to health information that will better inform their decisions about what tests to order and what drugs to prescribe," she says.
One potential obstacle, however, is that competing large medical providers are inclined to proceed with acquisition of information technology tailored to their own needs rather than accommodating to a statewide system. "It is a huge challenge to get everyone on the same page," says Ms. Clement.
Ms. Clement acknowledges that there are significant differences between public health plans and private health plans. However, she says if some common system requirements are not developed, higher administrative costs incurred by health care providers will continue, and these are ultimately passed onto consumers and health plans.
"As one of the major payers in the state, it's important for Medicaid to participate," she says. "Some of these efforts are best led by Medicaid, but must include other key payers in order to develop a single statewide system."
Contact Ms. Clement at (208) 364-1804 or [email protected].
"We are excited about the opportunities identified in the stimulus package related to HIT," says Leslie Clement, Idaho's Medicaid administrator. "HIT provides the opportunity to transform our current high-cost health care environment into a more efficient and effective system."Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.