Data sharing could help states better align Medicaid and public health efforts, report finds
State Medicaid and public health agencies could do more to improve community health outcomes by sharing data, coordinating resources and establishing formal partnerships that can withstand changes in leadership and policy, according to a new report from Pew Charitable Trusts.
The report, published Oct. 28, looks at how states are using collaboration between Medicaid and public health agencies to address issues including maternal and child health, chronic disease, behavioral health, and healthcare workforce shortages. The research found that while these partnerships are already producing positive results, many remain limited to individual programs or short-term initiatives rather than becoming part of agencies’ long-term operations.
Both types of agencies often serve similar populations and have access to different types of information that, when combined, can give states a more complete picture of residents’ health needs, according to David Hyun, a senior officer with Pew’s State Health Solutions team.
“They have a lot of the same health goals at the state level, they just come at it from different angles, and they bring in different interventions and strengths, so to speak, in addressing those problems,” Hyun said in an interview.
Medicaid agencies typically maintain enrollment, provider and claims information, while public health departments collect data on disease prevalence, immunizations, births and deaths. The report found that combining those records can help states identify gaps in healthcare access, target interventions and evaluate whether programs are working.
In Idaho, for example, Medicaid diabetes screening data was combined with public health estimates of diabetes prevalence to identify where disease rates were high but screening rates were low.
North Carolina allows designated public health employees to access state Medicaid data through formal agreements. The state’s Healthy Opportunities pilots also use Medicaid funding to address factors affecting health, including food insecurity, transportation and interpersonal violence. The report found the state was able to partially reduce program costs through fewer emergency department visits.
Despite progress, states still face several challenges to sustained collaboration, including incompatible data systems which limit interoperability and insufficient funding for technology upgrades. States need IT systems that allow Medicaid claims, enrollment records, immunization databases, vital records and other health information to be securely accessed and analyzed across agencies.
But simply connecting historically-siloed systems doesn’t guarantee that agencies will be able to use the data effectively, Rachel Zetts, another senior officer on Pew’s State Health Solutions team, told StateScoop.
Zetts said that while technology improvements are needed, this type of long-term collaboration requires significant policy changes and sustained investment from state officials.
“More of a need to build the broader infrastructure around data sharing efforts and collaboration,” she explained. “Building those in a way that are adaptable for different types of use cases and also making sure that foundational expectation for collaboration is in place, so that as leadership or staff changes over time, that kind of work can continue beyond those initial stages.”
Hyun added that states also need to understand how their partners operate and what information they can contribute in order to define metrics for a successful partnership.
“On the Medicaid side, any health outcomes that can be translated into cost is very important, but typically, public health doesn’t do that,” he said. “Public health agencies aggregate [data] at the community level, but on the Medicaid side, they’re more interested in how health outcomes for individual members impacts overall health cost savings.”
The report’s findings come as states face additional pressure to update Medicaid systems and administrative processes ahead of new federal requirements under H.R. 1. States are preparing for more frequent eligibility reviews and work-reporting requirements, changes that may force agencies to coordinate data across systems to better manage these additional demands.
Minnesota, for example, has been developing data-sharing agreements with other state departments to support automated Medicaid eligibility determinations. Similarly, California is looking to maximize data sharing to reduce paperwork and caseworker intervention as it implements the law.
Zetts said that Medicaid and public health agencies can also look at how changes in healthcare access can improve resource deployment to the populations that are the most in need.
“Looking for those short term signals can help them better tailor their efforts to drive those long term health outcomes,” she said.
Hyun emphasized that while the research did not specifically examine H.R.1 or its fiscal impact on state agencies, partnerships can help agencies make more efficient use of limited resources by combining expertise and funding around shared priorities. He said Pew aims to help states move beyond isolated collaborations and establish a framework for sustained partnerships by working directly with states to put the report’s recommendations into practice.
“It’s really about creating a sustainable framework that is less likely to be impacted or swayed by the changing leadership and funding environments,” he said. “To create a structure that can be more durable during times of change.”
