States participating in Round 1 of the Centers for Medicare & Medicaid Services State Innovation Models Initiative relied heavily on data-sharing and health information technology to enhance care delivery. Problems arose, says a CMS report on the program’s second year.
The report summarizes the policies and strategies used by the six states in the program–Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont.
Maine’s goals, for example, included connecting behavioral-health providers to the state’s health information exchange and piloting patient access to medical records via the Blue Button project. Financial support went to behavioral-health organizations to improve their electronic health record technology.
In Minnesota the aim was to increase EHR and HIE use among providers in ACOs and the broader community and create an eHealth Roadmap to expand use of such tools by behavioral-health providers.
In Arkansas it was to use the state’s HIE to send emergency and admit-discharge-transfer information to Medicaid patient-centered medical home providers.
In Massachusetts it was to create a portal, Community Connect, for caregivers and beneficiaries to access home care records.
In Oregon it was to implementing an HIE system, CareAccord, for secure messaging.
And in Vermont, it was to look into telehealth solutions.
The report notes several challenges faced by each of the states. Massachusetts, Maine and Oregon, for instance, had trouble incorporating innovations into provider workflow.
“Oregon’s direct messaging technology has seen little uptake by providers, many of whom already have a preferred internal secure messaging system,” CMS wrote.
The accuracy and completeness of data has been an issue for states; in Arkansas, for example, a “lack of patient-specific behavioral health data” hindered provider efforts to treat patients.
CMS Principal Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., wrote that it’s “too early to attribute specific quantitative results” to the initiative. However, he believes the findings show that progress is being made by states, as shown in declines in ER visits and inpatient readmissions.
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