As part of a pioneering move to value-based care for its 5.3 million Medicaid beneficiaries, a U.S. state needed to ensure 25 unique healthcare provider networks could share, collate, and analyze patient information. Although the reforms were prompted by federal Delivery System Reform Incentive Payment (DSRIP) requirements, it was an opportunity to standardize and unify data that had previously been inconsistent and incomplete.
An adaptable new IT infrastructure was needed, customizable to each provider, enabling the tracking of patient information and prioritization of early intervention and preventative measures. The ultimate goal was to reduce costs while providing better patient care and increasing levels of health across the state.
This state’s response to DSRIP led to one of the largest and most comprehensive healthcare reform endeavors in the U.S. to date. The state now has a clear, state-wide IT strategy, while its 25 provider networks are designing and delivering local change targeted to the needs of patients. This includes the intel needed to enable local initiatives to adhere to state-level policy.
DSRIP was the impetus to coordinate value-based care and also to assess and enhance population health management. By consistently measuring, benchmarking, and reporting on cost, activity, and quality, this approach has real potential to define and improve care for all, not just the Medicaid population. It’s a blueprint that other healthcare providers can easily follow.
The move from payment-for-service provision to a value-based care system was the impetus for this state to standardize healthcare data and systems.
Working with state officials and local provider networks, as well as numerous IT platforms, KPMG created a technology blueprint that would shift focus to early intervention and preventative measures. This pioneering work would help transform healthcare across the state.
Key to success was creating a highly customizable blueprint for how IT infrastructure should look in future state. Over 100 tailored models that included business and system requirements were developed. Built in was flexibility to create adaptable platforms for electronic health records, health information exchanges, population health management, and patient portals.
Going beyond information sharing, providers throughout the state can standardize their data to directly improve care.
The real power of technology comes not from seeing it as a “quick fix” but from looking to the future and proactively rethinking its use as part of a shift in wider business practices. Meeting the new federal requirements around DSRIP was a priority, but customizing and streamlining systems had more far-reaching effects. In the future, health providers will share standardized data from many different sources to deliver improved care paths and far broader health benefits.
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