1. Uses of NH’s Claims Database: Comprehensive Health Care Information System (CHIS) Christine Shannon Office of Medicaid Business & Policy, NH DHHS July 31, 2009

2. NH CHIS Uses Medicaid program analysis, program and policy development and decision making; NHID efforts to increase information available on cost to consumers and purchasers; and Other groups focused on getting information to consumers, purchasers and communities.

3. Program Analysis, Policy Development and Decision Making Primary Care Depression Children in Out-of-Home Placement ED Use Chronic Respiratory Disease CV Diseases and Circulatory Disorders Q-CHIP

4. Cont. Prevalence/Utilization Mental Health Disorders in Children’s Health Insurance Programs Diabetes Health Plan Performance Summary Adult Preventive Payment Rate Benchmarking

5. Q-CHIP … once is not enough What is going on with adolescents? What is driving mental health utilization? Are findings consistent across geographic areas? How does clinical status affect utilization and cost?

6. “So What Factor” Plan a statewide effort to improve adolescent use of preventive care. Shape an Enhanced Care Coordination Program. Perform a Primary Care Study. Target efforts to decrease ED utilization by Medicaid beneficiaries. Decide whether to pursue risk-based managed care contract. Pilot Medical Home.

7. Cont. Incorporate age standardization, CRG and statistical significant testing into future studies. Report to legislative committee – and make public – Medicaid payment rates relative to commercial. Dispel some myths.

8. Primary Care Study 25% of NH Medicaid beneficiaries go to 2 types of provider groups (FQHCs and Dartmouth-Hitchcock Clinic). FQHCs see a higher proportion of adults; DHC sees more children. FQHCs had higher ED utilization. Evaluation of Medical Home Pilot.

9. Payment Rate Benchmarking

10. NHID Cost Information NH Acute Care Hospital Comparison: A Commercial Insurance Relative Cost Comparison www.nh.gov/insurance/consumers/documents/nh_ac_hosp_comp.pdf Analyzed 26 NH hospitals on inpatient and outpatient basis using NH CHIS and Hospital Discharge Data Set. Created relative cost index.

11. Cont.

12. NH Health Cost www.nhhealthcost.org/

14. NH Health Cost

15. Information to Consumers, Purchasers and Communities NH Hospital Scorecard www.nhpghscorecard.org Patient experience Patient safety Clinical quality Cost

17. Information to Consumers, Purchasers and Communities CDC Community Health Assessment Initiative: Health Care Claims Module Claims module will add information on disease prevalence and health care access for <65 insured (Medicaid and commercial). Town/zip level code user defined geographic areas to support community health assessment. 1 st efforts directed to cardiovascular, mental health and ED and primary care use.

18. Conclusion Be patient. Involve Medicaid program and clinical staff in report development/review. Budget/allocate funds for analysis. Publicize who is using data. NH is in good shape for health care reform.

19. Contact Information www.nhchis.org http://www.dhhs.state.nh.us/DHHS/OMBP/LIBRARY/Fina ncial+Report/rate_benchmarks.htm Cshannon@dhhs.state.nh.us 603-271-4964 Achalsma@dhhs.state.nh.us 603-271-4514