In December 2013, the State released the draft “Washington State Health Care Innovation Plan” for public comment. According to the draft plan, the State has made progress over the last several years to build up their health IT and health information exchange.
The rate of EHR adoption among Medicaid providers has increased significantly and EHR adoption by the entire system is above average compared to the nation as a whole. However, the state has a rapidly changing and diverse HIE environment ranging from providers with high functioning EHR capabilities and their own clinical data repositories to providers still using paper.
The state’s healthcare market generally is competitive, particularly among delivery systems and public and private payers. Larger healthcare organizations have moved to position themselves for longer term success in an environment where more constrained resources and greater expectations exist. The state is looking to maximize their revenues in light of anticipated reduction of fee-for-service and cost-based payment streams.
However, as providers strive to meet the second stage of Meaningful Use requirements, broader HIE capacity to support interoperability is becoming increasingly important. HIEs in the state are supporting care coordination, care management, public health monitoring and surveillance, and consumer activation.
Today, the state’s Health Care Authority and OneHealthPort manage the statewide HIE but are exploring enhancements to the HIE. The two organizations are seriously considering acquiring a new HIE platform. The platform would add a clinical data repository, care management tools, a less resource-reliant EHR, and a patient portal to the current HIE.
The two organizations are also considering deploying a clinical data repository because within three years every Medicaid encounter will result in a continuity of care document being sent to the HCA clinical data repository.
Washington State is one of a few states with an integrated social service client data base. This means that the state can use claims and encounter data to identify costs, risks, and outcomes for individuals receiving services across state-funded social and health programs. The database already provides internal and external decisions and links to other source of information.
The state’s advanced analytic capabilities are being deployed using both Medicaid and Medicare claims data to monitor, track, and analyze health service use, medical expenditures, morbidity/mortality outcomes, and social service impact outcomes.
The data is used to support cost-benefit and cost offset analyses, program evaluations, operational program decisions, geographical analyses, and in-depth research. The state would like to add real-time clinical information that would incorporate the financial and clinical side of care.
The state is building an all-payer claims database to improve and expand upon the Washington Health Alliance’s existing multi-payer claims database that will be able to collect and analyze medical claims data and report on the quality and cost of healthcare in the state. With the addition of cost information, the database will become a resource containing comprehensive healthcare claims data from multiple sources including Medicare.
The Washington State Health Care Innovation Plan will form the basis for a multiple year State Innovation Models testing grant. It also charts the course for change in the state to link clinical and community factors to support health. It is thought that by linking clinical and communities, there is the potential to generate more than $730 million in return on investment.
Go to www.hca.wa.gov/shcip/Documents/shcip_InnovationPlan_121913.pdf to read the “Washington State Health Care Innovation Plan” December 2013.