Missouri Hospital Association improving information sharing to bolster health care

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The Missouri Hospital Association announced its data company, the Hospital Industry Data Institute, had selected Collective Medical to provide “add-ons” to its platform. HIDI provides timely access to data and information services for participating hospitals, which supports their strategic planning, advocacy and health policy initiatives.

For example, Capital Region Medical Center uses HIDI to look at hospitalizations within the region, said Lindsay Huhman, the Jefferson City hospital’s director of marketing.

“We look at what specialization we need. We look at what specialization might be leaving our service area,” Huhman said. “We use it for a lot of planning purposes. It’s a pretty neat tool they put together.”

It’s a tool that helps people get the right care at the right place at the right time, she said.

SSM Health — a Catholic nonprofit and the St. Louis-based owner of St. Mary’s Hospital in Jefferson City — uses HIDI on a limited basis because it has its own in-house analytics group, said Jessica Royston, SSM Health regional marketing and communications manager. However, the health care provider will review the add-ons to see if they are something it may use in the future, she said.

Changes that came about from the American Recovery and Reinvestment Act and health care reform have encouraged hospitals and physicians to use more information technology to improve care, according to hidionline.com/hidi.

Decades of hospital data program experience and analytic capacity, combined with Collective Medical’s “outcomes-based” tools help health care teams gather near real-time data about patients.

The Collective Medical upgrades being installed this summer will also allow HIDI participants the ability to identify, track and coordinate care for patients, including COVID-19 patients, according to an MHA news release.

“The system will allow notifications to be pushed directly into existing workflows, in near real time and at the point of care,” according to the news release. “This clinically relevant information will help care teams determine which of their patients may require additional resources, such as intensive care or isolation.”

The program will allow hospitals to share information about patients immediately with caregivers, MHA spokesman Dave Dillon said.

“One of the biggest challenges to quality for the health care system,” Dillon said, “is that providers throughout the continuum of a patient’s health care are not always connected (or) they are not connected all the time.”

Primary caregivers may not know that a patient is being admitted to a hospital during an emergency. That may challenge the caregiver’s ability to manage the patient’s health after release from the hospital.

For example, Dillon said, a person who is receiving treatment for heart disease from a primary care physician may have an emergency procedure, then be released from the hospital. The primary physician needs information about what the patient underwent, but the patient also needs to see the physician for follow-up services, Dillon said.

The add-ons can help coordinate the moving parts, he said.

The idea of the add-ons was initially considered to allow hospitals to use the information for the state’s Medicaid program — MO HealthNet. “We’re going to see significant value across the Medicaid population,” Dillon said.

The state is helping fund the add-on through part of the provider tax that hospitals pay, he said.

Missouri hospitals pay in about 5.95 percent of net patient hospital revenue (what hospitals are paid for patient care services), just under the federally allowable maximum of 6 percent. These “provider taxes,” called Federal Reimbursement Allowance, are used to attract federal matching funds.

Matches vary from state to state, depending on how well-off the state is. Mississippi, for example, has a match rate of 77 percent, which means that for every $23 the state contributes, the federal government matches it with $77. In Missouri, the rate is 65/35.

Provider taxes help pay the state’s share of Medicaid. In fiscal year 2018, MO HealthNet cost $10.3 billion. Of that, $2.2 billion came from the state’s general revenue fund, $5.5 billion from federal funds and $2.6 billion from other funds (primarily the provider taxes).

Medicaid serves a lot of people with chronic health conditions, Dillon said. Many, but not all, have primary care physicians.

And many are using emergency rooms for care when they don’t have a health crisis, he said. “If you specifically have people with chronic conditions — that’s mostly best-managed through primary care,” Dillon said. “If the primary care provider can see in real time, within minutes of admission or discharge, they can see what their responsibility will be around that patient.”

Sharing information also helps support a push in Medicaid programs to improve quality of care.

“Hospitals are investing in this system to improve the value of our state’s health care system, with an emphasis on the Medicaid program,” MHA President and CEO Herb B. Kuhn said in the news release. “Under the leadership of Gov. Mike Parson and MO HealthNet Director Todd Richardson, the state is embarking on a major reform effort within the Medicaid program. The HIDI-Collective partnership will create critical infrastructure to help accelerate this reform — bringing value and cost reduction in the near and long-term for Medicaid and, as the program expands, for all stakeholders.”

The state program is moving from a “paid-for-service” program, to one based on outcomes.

As it is, the program can cost hospitals millions of dollars. For example, if a person goes to a hospital for an emergency service and is discharged then returns again before 30 days are up, Medicaid does not pay for the second visit. Getting primary care physicians involved immediately can prevent returns, Dillon said.

The communication helps improve the “health bubble” around patients, he said.

The changes are challenging, Dillon said. Some systems still depend on providers sending faxes to and from each other.

“That is pretty much buggy-whip technology,” he continued. “You discharge a patient with a prescription, and they don’t fill the prescription. They don’t follow up with their physician. They boomerang.”

This technology helps overcome the boomerang, he said.

Another thing HIDI is good at is determining which patients are at highest risk for readmission or repeated use of the system.

“We can build the system around the idea of the risk analysis,” Dillon said. “A very-low-risk individual will get the same treatment, but (for a high-risk person) we can say to a hospital, ‘This is somebody who has had a history of non-compliance with their medical plan.’ So a proactive outreach to their physician may be worth it.”