In just under a decade, Medicaid spending by the state of Missouri increased from 17 percent of the state’s general revenue in 2009 to 24 percent in 2018. Left unchecked, growth in spending is projected to reach 26 percent by 2023, outpacing growth in state revenue. Each percentage point increase represents roughly $100 million in general revenue, reducing the overall funding available for other state priorities like education, infrastructure and workforce development. State officials know they must contain costs in order to ensure long-term financial security of the Medicaid program, Mo HealthNet.
Officials in the MO HealthNet Division (MHD) have an underlying goal of shifting the focus of health care delivery away from volume of care and towards improved quality of care, or value-based care, in order to save the state money while also improving overall health outcomes in the long-term. MDH recently commissioned a Rapid Response Review, finalized earlier in 2019, to independently evaluate the entire Medicaid program, including health care outcomes, participant experiences, operational efficiencies and cost management, compare performance to other programs across the country and identify opportunities for improvement. MHD also created an office of Medicare Transformation to enact the recommended changes, and is currently procuring an Enterprise Data Warehouse (EDW) to replace the current outdated data management system. Building on momentum from these efforts, particularly from the data warehousing initiative, MHD is now looking to create tools and policies that will enable data informed decision-making across the department.
The EDW will initially hold the state’s Medicaid claims data, which is currently formatted to meet the requirements of a 40-year-old legacy system, and does not allow MHD staff to work with data in an easy or intuitive way. MHD is confident that by developing the appropriate dashboard tools and reporting systems, the available claims data can yield a wealth of information on Medicaid payments that can then be used to measure current program impact and create new performance metrics and program guidelines that advance value-based care. Importantly, leadership is determined that these tools should be accessible to staff across the department, not only those specializing in data analysis, ensuring a department-wide adoption of data-driven program evaluation and decision making.
This work will ultimately link back to a statewide strategy that streamlines how residents access any number of services including Medicaid, SNAP, employment and training programs, and identifies opportunities for cost savings and more efficient service delivery by leveraging economies of scale. To support this work, the state of Missouri will partner with FUSE Corps to host an executive-level fellow for one year who will help guide the development of dashboard tools that provide insight into the use of Medicaid through analysis of claims data.
PROJECT SUMMARY & POTENTIAL DELIVERABLES
The following provides a general overview of the proposed fellowship project. This project summary and the potential deliverables that follow will be collaboratively revisited by the host agency, the fellow, and FUSE staff during the first few months of the fellowship, after which a revised scope of work will be developed and agreed upon by the FUSE Fellow and the host agency.
Starting in April 2020, it is proposed the FUSE Fellow will begin his or her work with a listening tour to develop a baseline understanding of how claims data is collected and processed across Mo HealthNet, and how that data is currently incorporated into decision-making. The Fellow will interview MHD staff as well as stakeholders in other relevant departments including but not limited to Information Technology Services and other divisions within Department of Social Services to ensure coordination across the organization. Ultimately, the Fellow will guide the creation of a dashboard tool, allowing MHD staff to easily gain insight into patterns and implications of Medicaid claims.
In order to be successful in this role, the Fellow must show acumen in managing culture change, as they introduce plans that change how the department approaches decision making and program evaluation. The Fellow must be comfortable working with data and be able to clearly articulate a vision for how improved data usage can transform the operations of MO HealthNet in a way that brings along rather than alienates employees. Success will be demonstrated by the development of a sustainable and widely adopted tool to produce insights for MHD staff and leadership.
- Landscape analysis of Medicaid Claims Data and current MHD practices. Understand all aspects of Medicaid claims data as well as current capacity of MHD staff to utilize and analyze data. Research nationwide standards and benchmarks for claims and program evaluation. Identify opportunities for improved service delivery and cost management.
- Develop recommendations and create an implementation plan for new approaches to data use and analysis. Provide recommendations on implementation of dashboard tools and data analytics. Research new ways to use data more efficiently and effectively. Develop policy recommendations about how to use data to inform decisions about Medicaid claims and program design going forward including strategies for roll out and suggested employee trainings.
- Stakeholder Management – Partner with State IT staff to design a dashboard that integrates data from existing systems and databases, including preparing dashboard reporting requirements and building and testing activities. Partner with various DHS stakeholders to gain consensus on best way to meaningfully integrate and display data. Facilitate opportunities for learning and feedback to ensure widespread adoption of dashboard and related tools among city staff.
- Todd Richardson, MO Healthnet Division Director, Missouri Department of Social Services
- Jeriane Jaegers-Brenneke, Assistant Deputy Director, Missouri Department of Social Services
- Kirk Matthews, Chief Transformation Officer MO Healthnet Division, Missouri Department of Social Services
- Jessica Dresner, Deputy Director Chief Operating Officer MO Healthnet Division, Missouri Department of Social Services
- Jennifer Tidball, Deputy Department Director, Missouri Department of Social Services
- Anna Hui, Director, Department of Labor & Industrial Relations, State of Missouri
- Elizabeth McDermit, Management Analysis Specialist, Missouri Department of Labor & Industrial Relations
- Amber Addison, Application Portfolio Coordinator, Missouri Office of Administration
- JeffreyWann, Chief Information Officer, State of Missouri
- At least 15 years of professional experience in a relevant field, particularly with a strong background in population health and change management.
- Superior critical thinking and analytical skills.
- Ability to synthesize complex information into clear and concise recommendations.
- Ability to relate to a wide variety of diverse audiences with strong emotional intelligence and empathy.
- Excellent stakeholder engagement skills and the ability to use facilitative leadership techniques to coordinate stakeholder activities.
- Self-motivated, goal-oriented, entrepreneurial leader who can also be an independent worker.
- Persistent in obtaining information and creatively resourceful in identifying solutions to complex problems.
- Ability to create direction and movement within potentially ambiguous
- Exceptional written and verbal communication skills with an ease in public presentations.
- Understands the need for solutions to support all people in a community regardless of race, religion, gender, immigration status, or ethnicity.