Illinois Waiver Demonstration Project: Moving Beyond Clinical Integration to Analytics and Care Coordination
This week, the Fall 2012 Accountable Care and Health IT Strategies Summit welcomed Dr. Bala Hota, Chief Medical Information Officer at Cook County Health and Hospital System (CCHHS). Dr. Hota presented his work with “County Care” the new program approved under the federal government’s 1115 Medicaid Waiver which permits CCHHS to offer early enrollment to more than 115,000 individuals who will be eligible for Medicaid in 2014.
CCHHS recently secured the $100 million federal waiver to begin the effort of Medicaid expansion ahead of the 2014 expansion outlined in the 2010 Affordable Care Act. This waiver granted CCHHS the authority to enroll patients in Medicaid on a per member, per month basis – in exchange, CCHHS monitors quality of care, enrolls a large number of eligible Cook County adults, and provides quality & cost measurement using both claims and clinical data.
To enroll in and gain health care coverage within the Cook County Medicaid Network, eligible patients must live in Cook County, be 19-65 years of age, who have an income below 133% of federal poverty income level.
Though the scope of the waiver demonstration project continues CCHHS’s role as a safety net provider, the stipulations of the agreement ambitiously set benchmarks that welcome in the of era of care coordiantion and the electronic measurement of care quality. This is no small feat for CCHHS, which has the busiest ER in the city of Chicago.
Dr. Hota also reported on the current state of electronic health records (EHR) at CCHHS. 1800 Dell Wyse devices have thus far been installed, Physician Quality and Reporting System quality measures are currently in place, and both CCHHS hospitals have met Meaningful Use stage 1. Additional capabilities include realtime reporting when patients are being seen by physicians, with the eventual goal being partial automation for chart review or full automation using a standardized set of rules. The Waiver Registry is set up as an open source system with access to all legacy data, and the ability to modify EHR, as needed.
Since joining CCHHS in 2002, Dr. Hota has been heavily involved in the use of Information Technology in the measurement of disease and health care quality. He has worked on projects to conduct electronic surveillance for hospital-acquired infections, automate mandated communicable disease reporting to public health agencies, founded a key piece of the Illinois Health Information Exchange Infrastructure (The Illinois Public Health Node), and authored or co-authored over 38 peer-reviewed articles. He has served as the System Chief Medical Information Officer since 2011.