Research, Data Analytics, & Measurement of Program Outcomes (Analytical Support) 2017-2018

This contract is designed to support program evaluation research and improving the effectiveness, economy, and the quality of services delivered to Medicaid and Kentucky Children's Health Insurance Program (KCHIP) beneficiaries. It also establishes the baseline member characteristics and an evaluation tool for Kentucky Medicaid's forthcoming 1115 waiver. The over-all research objectives identified as the focus for the scope of work are those articulated in the "Triple Aim": 1) Better healthcare for individual Medicaid/KCHIP beneficiaries, 2) Improved healthcare for the population (Medicaid/KCHIP), 3) Financial accountability and value-based decision making for healthcare resources. The Kentucky Department of Medicaid Services (DMS) is embarking on a major demonstration, using an 1115 waiver issued by the Center for Medicaid and Medicare Services (CMS) to address the health care needs of 'able bodied adults' enrolled in Medicaid. There is an urgent need to research and characterize the impacted population, including their age, gender, household status, education, work status, income, recent medical claims, residential location, and associated managed care organization. After the program is launched in calendar year 2018, there will be an ongoing need to monitor system usage, and adapt the program as DMS learns how well the system is working. IPOP will provide technical and analytical expertise on the identification, migration, and integration of multiple disparate data sets into a data warehouse environment. IPOP will provide independent data verification and validation of data sources where applicable. Through datamining and analytics, custom dashboards will be designed and implemented to visualize data which will provide guidance on quality control for DMS and provide dissemination of results for individualized research study projects. IPOP will perform program analysis and guidance on implementation of new DMS measures surrounding the following areas of study: specific business cases, cost/benefit analysis, cost effectiveness, utilization patterns, and complex impact analysis. IPOP will perform gap analysis and benchmarking of Kentucky across other state Medicaid programs regarding healthcare costs, utilization, and DMS trends, study feasibility assessments for independent data requests, and guidance on clinical protocol and quality assurance decision support projects. IPOP will provide subject matter expertise for the Information Technology Governance process development and management; as well as, epidemiological and statistical measurements expertise for health status indicators. IPOP will design epidemiological and program utilization studies, design data collection methods, collect data, analyze and interpret data, and dissemination of results. In addition, DMS is the recipient of a project grant entitled Improving Maternal and Infant Health Outcomes in Medicaid and KCHIP. IPOP provides data mining and analytics, program analyses, implementation support, independent data verification and validation, gap analysis and benchmarking, and written reports and presentations as they relate to the developmental measures for the Maternal and Infant Health Initiative (MIHI) grant. UKIPOP shall conduct research in the following areas: 1) Design and implement integration of multiple data sources in complex data warehousing environment, 2) Conduct quality assurance audits through data verification and validation of data sources, 3) Program analysis on identified research study use cases identified- Emergency Room super utilization initiative, psychotropic medication utilization, usage of medical homes, and complex care and high needs populations in Medicaid/KCHIP 4) Program analysis for DMS services using cost/benefit analysis, cost effectiveness, utilization patterns, and complex impact analysis. 5) Outline DMS quality program objectives and implementation strategy for the year, 6) Perform gap analysis and benchmarking of Kentucky across national and regional Medicaid programs regarding healthcare costs, utilization, and DMS trends, 7) Design comparative effectiveness analysis and reporting process for DMS, 8) Develop evaluation tool for KY Medicaid 1115 waiver, 9) Data mining and analytics, program analyses, implementation support, independent data verification and validation, gap analysis and benchmarking, and written reports and presentations as they relate to the developmental measures for the Maternal and Infant Health Initiative (MIHI) grant.