The Benefits of Data Exchange Between Registries and MCOs

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Presentation transcript:

The Benefits of Data Exchange Between Registries and MCOs Presented By: Letty Cherry and Abigail Ryan VaxTrack Immunization Registry Riverside & San Bernardino County Departments of Public Health

Overview VaxTrack Background and Facts Why Partner? Establishing a Successful Partnership Ensuring Data Quality Benefits of Data Exchange for MCOs

Overview - Continued Benefits of Data Exchange for Medical Care Providers Benefits of Data Exchange for Registries Conclusions

VaxTrack Background Region covers > 27,000 square miles Consists of rural, remote, suburban and urban areas Population > 3.3 million people

VaxTrack Background History 1994 - San Bernardino County 1996 - First private providers enrolled 1999 – First MCO (IEHP) 2000 – Riverside County added 2001 – Second MCO (Molina) 2002 – View Only

VaxTrack Facts More than 738,000 children in the registry 55.4% have immunizations 38.5% of children under 2 years have IZ history

Why Partner? Children were going outside of the health plan to get shots Parents can change providers and/or health plans every 30 days.

Establishing a Successful Partnership – The Beginning Memorandum of Understanding (MOU) with both Riverside and San Bernardino Counties detailing services – including collaboration on IZ registry. IEHP’s Medical Director former Health Officer Childhood immunizations a priority

Establishing a Successful Partnership, continued Both sides agreed on data exchange using billing data. Designed file format Negotiated minimum data set for record Accepted additional data (e.g., plan ID #) Electronic files sent weekly Received historical and current data MCO disclosed to parents

Establishing a Successful Partnership, continued Ongoing QA of data sent Regular error reports automatically generated Timely feedback to the MCO

Establishing a Successful Partnership, continued IEHP pays incentives for each IZ given correctly Encourages proper recording and reporting of IZ

Establishing a Successful Partnership, continued Second MCO began sending billing data in 2001 Results of data exchange with MCOs: > 113,380 children’s records added from 1999-2002. > 856,000 IZ Immunization Data Exchange with IEHP 1996 – 146 immunizations (submitted in 1999) 1997 – 11,564 immunizations (late 1999) 1998 – 66,498 immunizations (late 1999) 1999 – 110,578 immunizations (late 1999) 2000 – 145,508 immunizations 2001 – 246,128 immunizations (Riverside County added) 2002 – 276,190 immunizations

Benefits of Data Exchange for Managed Care Organizations  in quantity and timeliness of IZ Reminder/Recall notices sent to members Better data for HEDIS Decreased medical record reviews

IEHP HEDIS Data 2001

IEHP HEDIS Data 2002

Benefits of Data Exchange for Providers Improved immunization rate for clients Instant verification of vaccine history Potential cost savings Reduced registry data entry burden since data extracted from billing forms

Benefits of Data Exchange for Registries Facilitates registry growth  provider participation May encourage other MCO participation.

Sources of VaxTrack Data

The Benefits of Data Exchange -Conclusions IEHP’s IZ rate rose from 75th to 90th percentile (12/99 to 12/02) Molina’s UTD rate for 2002-2003 went from 49% to 72%  Provider participation by 116% # Children with IZ  94%

Contact Information Letty Cherry, MHA – Riverside County lcherry@co.riverside.ca.us 909-354-1400 Abigail Ryan, MPH – San Bernardino County aryan@dph.sbcounty.gov 909-383-3070