Preparing to Support Medicaid Managed Care
This year is sure to bring great change to the business models for North Carolina’s health care providers as the State plans to launch Medicaid Managed Care in the latter half of the year. For many providers this will mean reevaluating their approaches to population health and care management of their patients.
As practices look to become NC Medicaid Advanced Medical Homes (AMHs) and qualify for enhanced Medicaid reimbursements, they will need to determine how to most efficiently access and leverage data on their patients’ care administered outside of their practice, within their daily workflows. The North Carolina Department of Health and Human Services (NC DHHS) has released a data strategy policy paper on this topic wherein NC HealthConnex is noted as a data partner who can meet this need for its participating providers, and at no cost.
The NC HIEA has partnered with NC DHHS throughout the planning process to ensure its HIE services can provide timely access to the individual-level patient data across care sites that hopeful AMHs will need, while minimizing the administrative and cost implications of the new data and quality requirements. NC HealthConnex already provides access to this data from more than 4,500 facilities statewide (with more than 3,500 more in the onboarding process) via the NC HealthConnex Clinical Portal or directly within a participating provider’s EHR.
What’s more, NC*Notify, the event notification service powered by NC HealthConnex, provides a pushed daily report of the information that Tier 3 and Tier 4 AMHs will need to maintain their status and highest-level reimbursements on their specified patient panel. This information includes hospital Admission, Discharge, and Transfer (ADT) data.
In addition to working directly with our participants, the NC HIEA stands ready to partner with NC Medicaid’s Prepaid Health Plans (PHPs) as soon as they are announced to efficiently assist our participants in their data needs under Medicaid Managed Care. We look forward to helping providers leverage statewide HIE to improve patient care and reduce cost to the system at large, while meeting their new requirements under the managed care model.
NC*Notify Enrollment is Open
As a reminder, enrollment is open for NC*Notify, an event notification service that alerts providers of their patients’ health events outside of their organization or EHR in a timely manner to support successful transitions of care and improve care management.
Insight into a patient’s interactions with other health care providers and health systems, like that provided by NC*Notify, can help providers improve continuity of care, reduce avoidable hospital readmissions and achieve their financial goals under value-based care contracts. As a full participant of NC HealthConnex, a provider may fill out an enrollment form and identify the patients they would like monitored, and NC HealthConnex will deliver actionable information on those patients as frequently as once a day. It’s that simple.
This year, the NC HIEA will focus on building out NC*Notify functionality and capacity, including additional data formats, delivery methods and health data from the HIE itself and other state systems. In 2020, look for the addition of clinical intelligence that will drive more actionable, real-time notifications to improve care management and population health initiatives.
The NC HIEA encourages full participants of NC HealthConnex to consider the benefits of NC*Notify and enroll today. Please note that there is no cost to enroll or use the base NC*Notify service. For more information on how NC*Notify can help with patient care needs, visit the links below.
Still have questions? Reach out to the NC HIEA provider relations team at (919) 754-6912 or via email at hiea@nc.gov.
Update on HIE Platform Upgrade
The NC HIEA is working, with technical assistance from our partners at SAS Institute, to migrate NC HealthConnex to the InterSystems HealthShare HIE platform. As a result, work on connecting new participant systems to the HIE is currently paused. The NC HIEA anticipates resuming work on new connections in April and will be in touch with each participant regarding new connection schedules, applicable training or other user needs.
Participants should note that the migration and resulting pause on new connections will have no impact on their compliance with reporting obligations under the HIE Act. Participants who are still in the queue to connect on their deadline will automatically receive an extension to June 1, 2020.
The NC HIEA is also upgrading the integrated Direct Secure Messaging (DSM) service. Users of the integrated DSM service will be pleased to learn that reports on message delivery and receipt will be available on demand via a new self-service reporting feature. If your organization leverages NC HealthConnex DSM through its EHR, the NC HIEA will be in touch to provide training on this new capability. For more information on DSM, click here.
Stay tuned for informational webinars on the new NC HealthConnex platform in March and April.
NC HIEA Calendar of Events
- How to Connect Call – February 25, 2019 at 12 p.m. – Interested providers are invited to join a monthly "How to Connect" call to learn about who we are, the state mandate, steps to connect, and the HIE’s value-added features.
- NC HIEA Advisory Board Meeting – January 31, 2019, 2-5 p.m. at SAS Institute, Building C (820 SAS Campus Dr, Cary, NC 27513). As always, this meeting is open to the public.
Questions? Contact the NC HIEA at hiea@nc.gov or call (919) 754-6912.
User Experience Survey
Thank you to the NC HealthConnex participants who responded to the recent user experience survey. We value the feedback and continued support of NC HealthConnex and will be sharing results of the survey in the next monthly update.
In Other News
- The American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), and five other national hospital associations release a six-point plan for public and private stakeholders to advance healthcare interoperability and health data exchange. EHRintelligence.com
- US DHHS releases 2018 Health IT report to Congress
- Predictive analytics allows clinicians, financial experts, and administrative staff to receive alerts about potential events before they happen, and therefore make more informed choices about how to proceed with a decision. Read about 10 high-value use cases for predictive analytics. Healthitanalytics.com
- ONC publishes SAFR guide to help emergency care providers improve health data exchange. Ehrintelligence.com
- A regionally-established pediatric asthma care management program, which includes leveraging a student health record platform, is extending its reach. Healthcare-informatics.com