The State of Mississippi has approximately 750,000 active Medicaid beneficiaries, roughly 25 percent of the state’s total population. According to data from the Kaiser Family Foundation, only seven states have a higher percentage of enrolled Medicaid beneficiaries.
The high percentage of beneficiaries in Mississippi comes at a time when government agencies are moving from a payer/claim adjudication model to one that relies on clinical data analytics. Any informaticist can tell you clinical data analytics is an essential element to coordinated accountable care, which the Centers for Medicare and Medicaid Services (CMS) is pushing across the country in an effort to reduce costs and improve care for beneficiaries.
The Mississippi Division of Medicaid (Mississippi DOM) has been tasked with generating a data analytics platform from a wide array of systems and services for its large Medicaid population. This kind of drive to analytics, from a Medicaid perspective, is uncharted territory for many state agencies.
One of the most successful projects is still ongoing in Colorado, where the state has committed to an accountable care initiative that relies on data analytics for actionable data. According to a report from the Kaiser Family Foundation, while this project has reduced costs in imaging and hospital admissions, it is still in the evolving stages on integrating clinical and claims data.
In Mississippi, the DOM recently completed building a clinical data repository, provider portal and Medicaid Master Patient Index (MPI). Creating a single-identifier for those beneficiaries represents the first major step in the Mississippi DOM’s plans for comprehensive clinical and claims-based data.
“With various systems and services at the DOM, it was important to build an MPI with a single Medicaid Beneficiary identity that could be used across multiple systems and services, internally to DOM and to harmonize with external systems/services, such as the Statewide health information exchange (HIE),” Rita Rutland Deputy Administrator of the Office of Information Technology Management (iTech) at the Mississippi DOM, said in an email to Healthcare Informatics.
Collaborating with Emeryville, Calif.-based MedeAnalytics, the MPI took approximately six months, said Rutland, and included several iterations. Not only did the development require technology and subject matter expertise (SME) as well. The SMEs were necessary to build an algorithm for matching, which required frequent reviews, builds, and revisions. The end-result was an MPI with a 95 percent confidence rate.
Rutland said the next step is to receive clinical data on DOM Medicaid Beneficiaries from providers, via the statewide HIE. This data will be inputted into the clinical data repository, where analytics can be performed.