How a Health System Implemented a Population Health Platform for Medicaid Program


emids delivered project management, change management and training services to help UHS care managers meet new state requirements.

Overview

United Health Services (UHS) is an upstate New York integrated health system comprised of four hospitals, a senior residence, physician practices and a home health organization.

In 2016, the organization now had to comply with the New York State Medicaid Health Home (MHH) program. This included automating the care management workflows to support the health home processes. New York’s health home requirements included data integration with a regional health information exchange (HIE).  Noncompliance would jeopardize UHS’ Medicaid reimbursement. We facilitated a vendor evaluation and selection process which identified Netsmart as the vendor of choice. We also worked closely with Netsmart and UHS to complete the pre-implementation planning work in a rapid timeframe, in preparation for the aggressive implementation schedule.

Solution

The implementation of Netsmart’s care coordination application began in June 2017, giving UHS less than four months to have the system ready for care managers in time for the state’s Medicaid deadline. Due to the tight timelines and the critical nature of the project, UHS care management and IT leaders knew strong change management support would be needed. We had proven experience successfully leading care management toolset implementations with change management support for large healthcare organizations, making us an excellent fit for this high-stakes project.

We applied proven processes to coordinate between the UHS care management team, the vendor and the regional HIE. This provided integrated project management, communication, risk management, quality assurance and data validation, training, and support throughout the four-month implementation.

Results

We supported the growth of UHS’ MHH program, ensuring the state’s requirements and deadline were met.

“The team at emids did a wonderful job of understanding and accounting for our organizational culture, creating smooth change management and transition plans for our staff,” said Annie DePugh, director of population health at UHS. “We were thrilled to maintain an on-time delivery schedule and avoid issues that could have been a roadblock with our care managers.”

Healthcare providers must continuously stay on track with changes in federal reimbursement programs, which often call for new IT requirements and workflow modifications. Complexities often come up when transitioning to new workflows and toolsets. We were a key partner in helping UHS evolve rapidly to meet an important new set of Medicaid Health Home requirements, ensuring consistent program operations and the best possible care for its chronic Medicaid population.

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