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Medicaid to launch huge data project

By Christine Jordan Sexton
11/13/2009 © Health News Florida 

In a big step forward in the use of electronic health records, Florida is preparing to make the health histories of more than 1 million Medicaid patients accessible to 80,000 doctors, clinics and hospitals in the state on a secured-access system, one of the planners said Thursday.

Christine Nye, director of the State Center for Health Information and Policy Analysis, outlined the program at a Miami conference on Medicaid but said the formal announcement should come next week. The center is part of the Agency for Health Care Administration.

The system won’t include those enrolled in Medicaid HMOs, said AHCA Press Secretary Tiffany Vause, because they don’t have the claims data from the managed care plans. “We are moving that way,” she said.

The information will be that derived from claim forms, including office visits, hospitalizations, diagnoses, prescriptions, immunizations and lab results. Except in an emergency, it will be available only if the Medicaid patient agrees, Nye said, and the state will track every authorization that is granted. 

“We will be able to audit every point of access that a provider has to a patient,’’ Nye said.

The system, which AHCA hopes will be available early next year, will initially be free to doctors, hospitals and clinics. They will have access to the portal through their web browsers, Nye said.

The EHR will be available only in the traditional “fee-for-service” delivery system, in which health-care providers submit claims directly to the state for payment, and not for patients enrolled in Medicaid HMOs, Vause said

Current Medicaid enrollment in Florida is 2.6 million, and of those about 1 million are in HMOs.

While Nye conceded that data derived from claims are not the “be-all, end-all,” she said, they “provide a lot of information that is valuable.” They can help caregivers diagnose ongoing medical problems and identify gaps or duplication in patient care.

AHCA plans to keep expanding the website so that it becomes a “one-stop shop” for those who treat Medicaid patients, Nye said.

This health information technology (IT) initiative comes on the heels of another, launched late last month by former AHCA Secretary Holly Benson. It offers Medicaid patients an online medical profile they can fill in with their health information. Eventually AHCA will add the claims information too. 

The health profile is being branded as the My Florida Health eBook and the My Florida eBaby Book. 

AHCA has a contract with Availity for both health IT initiatives. Availity was launched in 2001 by Blue Cross and Blue Shield and Humana. Its website claims that Availity has the most advanced health information network in the country and that it processes 600 million transactions annually.

Upward of 150 people attended the conference, How Medicaid Stakeholders Can Adapt, Survive and Thrive. It was underwritten in party by the Health Foundation of South Florida, which also provides funds for Health News Florida. The conference was tailored to South Florida health care providers.

The six-hour meeting focused on an array of issues, from the future of Medicaid Reform to the emerging Medical Home model; however, the use of IT in health care was a recurring theme.

William O’Leary, an executive director at Microsoft Corp., told the audience that in the next 90 days the federal government will release guidelines on how it will release the $20 billion for health IT contained in the American Recovery and Reinvestment Act of 2009.

The $20-billion stimulus is “pretty significant,” O’Leary said, considering total health IT spending in the country, from all sectors, public and private, was less than $40 billion before.

O’Leary said $17 billion of the stimulus will be targeted for electronic health records to be used by hospitals and physicians across the country. In many ways, he said, the IT funding will do more to improve the health system than the bills pending before Congress.

But to get the stimulus, Florida will have to put up 10 percent in matching funds, which could prove difficult to get in a year when the state is facing at least a $2.6 billion deficit. 

--Christine Jordan Sexton is co-founder of