- A Kentucky state initiative is using the state's secure HIE to provide coordinated care for Medicaid "super-utilizers" with the intention of diverting them from the ER. 16 hospitals are participating in the pilot program, using data analytics and geomapping, then leveraging the state's HIE to coordinate care.
- Kentucky analyzed its patient population data and found that in one year, 350,000 Medicaid recipients used ERs to the tune of $341 million. 4,400 recipients were classified as super-utilizers who visited the ER 10 or more times at a cost of $34 million.
- Kentucky officials said it’s still too early to provide measurable results, but maintain that coordinated care teams providing care outside of the ER will help divert patients and lower costs.
According to Dr. John Langefeld, chief medical officer for the Kentucky Department of Medicaid Services, the biggest challenge has been coordinating between providers who have historically worked in silos and had limited interaction. However, in the long run, the project has the potential to improve clinical decision making by amalgamating traditionally disparate data sets and ameliorating communications between health care stakeholders, GCN reports.