Author: Jessica Hagins
Sam Thompson, executive director of the NC HIEA, and Jess Kuhn, Medicaid quality and population health systems analyst, recently presented at the Health Innovation Summit in Nashville, TN, along with Larry Mull, the deputy director of program evaluation at NC Medicaid.
The summit is hosted by the National Committee for Quality Assurance (NCQA), from whom the NC HIEA achieved a validated data stream designation through the NCQA Data Aggregator Validation (DAV) Program.
The presentation included key outcomes from working through the DAV program, as well as updates on the Advanced Planning Document submitted to the Centers for Medicare and Medicaid Services (CMS) earlier this year to leverage NC HealthConnex for three uses cases to support Medicaid’s quality, population health and care management efforts.
This was a sequel to the 2023 Summit presentation that provided an update on how the NC HIEA and NC Medicaid are leveraging NC HealthConnex in pursuit of digital quality measurement, the exchange of health-related social needs data and enhanced interoperability.
As Medicaid continues to promote value-based care, monitoring beneficiary health outcomes accurately and in a timely manner is paramount. At the summit, staff shared that NC Medicaid is launching a series of provider workgroups focused on primary source measure validation for key metrics that observe hypertension, diabetes and depression screening. The goal of this work is to review current systems and processes to collect these data and provide opportunities for improving the quality and completeness of data submitted to NC HealthConnex.
The group also discussed the importance of DAV certification, which allows payers such as NC Medicaid and health plans to look to NC HealthConnex as a single, trusted source of data. Health care providers who are participants of the NC HIEA also do not have to go through a time-consuming validation process for quality reporting measures every time a payer wants to use their data. This allows NC HealthConnex to function as a central data aggregator of clinical data that NC Medicaid needs to fully understand health outcomes in the North Carolina population.
The group also shared its success in the exchange of HRSN data with two large hospital systems in North Carolina, and its plans to expand this work next year. The Summit provided a great opportunity for the NC HIEA and NC Medicaid to share best practices and lessons learned from these activities, while also engaging with industry experts and leaders who are also navigating this space.
We are seeking NC HIEA participants to become early adopters of the dQM and HRSN use cases described above. Please visit our web page to read more information about these use cases, as well as FAQs regarding participation and incentives.