Tech Innovations Improve Care Coordination for Medicaid Patients
At the World Congress 10th Annual Medicaid Managed Care Summit, Yousuf J Ahmad, DrPH, cofounder, president, and CEO of AssureCare, and Paul Hiltz, MHA, former CEO of Community Mercy Health Partners, gave a presentation showing that care coordination for Medicaid members with chronic conditions can be optimized with innovative technology.
Dr Yosuf and Mr Hiltz shared data which showed that a mere 20 conditions account for more than half of all annual health care spending in the United States. According to the presentation, diabetes alone accounts for $101 billion and is growing at a rate 36 times faster than the cost of ischemic heart disease, the number one cause of death in the United States.
During the presentation, they discussed how social determinants of health impact development of chronic conditions among members. They defined social determinants of health as conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Social determinants of health can include things like stress, addiction, education, and poverty. They highlighted how these factors have impacted average weight over the last 40 years, increasing average weights of men and women by about 20 pounds.
They stressed that care coordination needs to be optimized in order to tackle both chronic conditions and social determinants of health in order to improve the overall health of member populations. They noted that coordination of data between agencies and providers, as well as integration of patient data, are essential.
A portion of their presentation focused on employing demographic information that is not traditionally covered under the traditional electronic health records in order to address social determinants of health that affect care delivery.
The presenters showed how use of a modular care coordination platform is helping California bridge gaps caused by databases that inadequately report patient data. Dr Yosuf highlighted the AssureCare database platform that integrates member and provider data, allowing payers to oversee the enrollment process, authorizations, and patient medical history data. According to the presentation, this platform also helps to identify patient demographics to determine and ameliorate social determinants of health. —David Costil
