FEI SUCCESS STORIES
Medicare-Medicaid Data Integration (MMDI) Technical Assistance
State Medicaid agencies have the option to request Medicare data from CMS for integration with Medicaid data in order to improve care coordination and address program integrity for individuals enrolled in both Medicare and Medicaid (dual eligible beneficiaries). States face a number of challenges to bringing Medicare data into their technical environments and integrating it with their Medicaid data. From identifying an appropriate integration environment and the tools necessary to process and load the various types of data, to having the expertise and available resources on hand to perform the tasks, to becoming familiar with the new data sets and understanding their potential value to the state, each state represents a unique set of circumstances that must be navigated to achieve the common goal of effective Medicare-Medicaid data integration.
Through competitive procurement, the Centers for Medicare and Medicaid Services (CMS) selected FEI to assist states with their efforts to integrate data from multiple state and CMS databases, and make effective use of that data for the improvement of care coordination and program integrity for the dual eligible population. Through highly focused meetings with states and a range of technical and clinical subject matter experts, FEI assessed the technical assistance needs and developed a robust framework of tools that are designed to facilitate state acquisition, familiarization, integration, and utilization of the Medicare data. FEI’s flexible approach captures best-practices at a macro level, but also allows for sensitivity to state-specific needs.
States deemed FEI’s support as “invaluable” and “integral” to their successes with data integration. FEI has helped states gain efficiencies to support effective Medicare-Medicaid data integration by:
- Developing common guidelines and tools, such as mappings and database staging models, which assist states with the integration of multiple datasets.
- Creating taxonomies to assist states with developing a consistent interpretation of data fields across different data sources.
- Assisting states with developing solutions to address gaps associated with missing or inconsistent data.
- Assisting states with programming and complex algorithms, such as final action processing and master data management solutions, that are required to read and use the data for integration.
- Assisting states to develop collaborative processes that facilitate data-driven decision making for program improvement.
- Assisting states with understanding how the integrated data can be utilized to help meet their program improvement goals. States have been “extremely impressed” by this analytic guidance, which is provided in the form of use cases that incorporate an analytic approach, metrics, bench marking resources, algorithms, and a technical supplement describing the methodology for implementing the use case in a state environment.
- Providing individualized, hands-on knowledge transfer for all assistance initiatives, ensuring that states are able to implement, maintain, customize, and expand on a solid data integration foundation.
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