Medicaid is neck deep in the opioid epidemic – covering 4 in 10 non-elderly adults with opioid addiction – and well aware of the critical need to explore technology solutions to address the crisis.
Solutions that incorporate 21st century innovations like Big Data analytics and Artificial Intelligence are showing incredible promise, and with the crisis accelerating, now is the time to start implementing them across the board.
HealthEC, which already assists a number of state agencies with Medicaid initiatives, has developed an opioid-abuse solution that we believe attacks the epidemic head-on by applying complex algorithms to aggregated data, analyzing the information, and presenting it within a suite of easy to read dashboards and reports for a 360-degree view across beneficiaries, prescribers, and fulfillment centers.
The solution, which seamlessly integrates with MMIS systems, combines powerful data analytics and care management tools to help:
- Triangulate data across provider, beneficiary, and pharmacy to identify prescribing and fulfillment patterns for all controlled substances
- Understand the combined cost of care (pharmacies, patients, providers and payers)
- Stratify patient risk into distinct categories: users, potential abusers, abusers and fraud
- Analyze data by geography, diagnosis, coverage type, drug class, specific drug, and more
- Identify barriers to treatment and expedite patient access to resources
- Coordinate care for high-risk beneficiaries
- Evaluate use and effectiveness of medication assisted treatment
Further, it empowers care coordinators with a number of features, including:
- Simplified clinical workflow
- Prioritized, summarized, and actionable work lists
- Real-time, automated notifications of prescription limit violations
- Increased patient engagement
- Assessment tools to identify and close care gaps
- Incorporated Social Determinants of Health (SDOH) data that can impact patient compliance and behavior
Some of our clients, who have been testing some of the solution’s data analytics for two years have reported that is has been an effective tool identifying and addressing a number of opioid-abuse scenarios, and we look forward to sharing their success stories.