Recognizing the importance of technology in health care, the federal government provides a 90% match for development of Medicaid eligibility and claims payment systems, as well as the advancement of Health Information Technology (HIT) that supports the exchange of health information and adoption of electronic health records (EHR). Of note, HIT enhanced funding expires in 2021 unless it is extended.
New CMS guidance highlights specific ways the enhanced federal funding may be used:
- Prescription Drug Monitoring Programs (PDMP) – When linked to electronic medical records, PDMP information can aid providers in quickly accessing pharmacy data to aid clinical decision making.
- Advanced Analytics and Public Health Information – If specific criteria is met, 90% HIT funding can be used to link screening data from health risk assessment tools such as the Opioid Risk Tool into EHRs.
- Technologies for Coordinating and Increasing Access to Care – Access to substance use disorder treatment providers remains a challenge. Telemedicine and telepsychiatry can be integrated into care coordination technology.
- Enhanced Statewide Interoperability – The guidance reminds states that some portion of costs of systems outside the Medicaid enterprise may be eligible for enhanced match. An example would be connections to a birth registry that could support case management or treatment of a pregnant woman at risk of delivering a baby with Neonatal Abstinence Syndrome (NAS).
I was particularly interested in the last bullet because the guidance discusses how states might develop predictive models and deploy advanced analytical approaches by connecting Medicaid data with data from human services programs to support efforts to address the social determinants of health. As Medicaid increasingly moves toward value-based payments to support population health, addressing non-medical factors such adequate food, stable housing, and safe neighborhoods health is key to improving health outcomes and preventing the onset and debilitating effects of chronic disease while reigning in spending on medical care down the road.
But one aspect of enhanced federal funding is set to expire this year: the waiver of cost allocation rules for other benefit programs like SNAP and child care to take advantage of Medicaid eligibility and enrollment system technology. Unless CMS extends the cost-allocation waiver beyond December 2018 (as it has already done once), other benefits programs will have to pay a full proportional cost of technology development costs. So time is running out for states to reintegrate their non-health benefit programs into an integrated and modernized system that provides access to health coverage and other benefits that impact health. As my colleague, Kelly Whitener, and I wrote in our recent paper, integrating eligibility systems and multi-benefit applications are among key strategies for states to address the social determinants of health.
