Data Analytics Xiaoling Huang, Data Analytics Director for Medicaid - PowerPoint PPT Presentation

Data Analytics Xiaoling Huang, Data Analytics Director for Medicaid and CHIP August 2016

Medicaid Overview Medicaid is a jointly funded state-federal program that provides medical coverage to eligible needy persons. 4.1M Programs: Fee for Service 12% • Members Managed Care 88% • Budget STAR 83% • STAR+PLUS 15% • $67.9B STAR Health 1% • (fiscal year 2016-2017) 2

Our Four Key Goals Mission: To proactively support Medicaid/CHIP programs in making data-driven decisions in improving the health, safety and well-being of Texans Improve Health Outcome Strength Data Reinforce Contract Compliance Analytics Management Contain Costs 3

Our Mission Mission: To proactively support Medicaid/CHIP programs in making data-driven decisions in improving the health, safety and well-being of Texans Improve Health Outcome Strength Data Reinforce Contract Compliance Analytics Management Contain Costs 4

How We Do It Detect trends and identify anomalies • Utilization of services • Cost of services • Adequacy of provider networks • Monitor performance • Establish performance measurement methodologies • Evaluate program performance • Provide technical consultation to program areas • Enhance data analytics infrastructure and • capacities • Increase data analytics maturity and adopt business intelligence (BI) 5

Dashboards 6

Dashboards 7

Visits Ranked by Diagnosis 8

Track Seasonality 9

Frequency of Visits 10

Follow Correlations 11

The Steps taken • Clients Data Quality • Providers • Claims/encounters • Clinical • Standardizing • Descriptive • Case management • Linking • Statistical • Financial • Merging • Predictive • Compliance • Aggregating • Prescriptive • Performance • Assessment Interpretation Data 12

Questions 13