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Health Information Technology: Driving Improvements in MedicaidDon ImholzExecutive Vice President and Chief Information Officer

Provides health plans, programs and related services

Centene Corporation

• Coordinated care of government sponsored programs

• Medicaid, TANF, SSI, CHIP, foster care, special needs plans

• Contracts with 81,000 physicians, 950 hospitals and 255 Federally Qualified Health Centers (FQHCs)

• Seven health management companies

• Health plan services offered in 12 states with multiple product lines*

*In Arkansas, a Centene subsidiary acts as a Third Party Administrator (TPA). Kentucky and Louisiana health plans are currently in implementation.

1.6 million members

• Children

• Women who are pregnant

• Adults

• Foster care

• Long-term care programs

72% of our members are 18 years old or younger

Our Members

0-18 Years old

18+ Years old

0-18 Years old

18+ Years old

Historical Relationship Payers and Providers

Eligibles

Claims

Payments

Payers Providers

Managed Care Mission Now Way Beyond Claims

Managed Care Providers

Health IT is Vital to Improve Outcomes and Lower Costs

• Manual Task Automation– Routine – e.g. Keying in Information

– Non-Routine – e.g. Identification of Exceptions

• Speed of Information Movement– Electronic versus Paper

– Standards

• Quality of Information– Capture Electronically – e.g. Bar Codes

– Edit at Source

– Process Simplification

– Integrate and Compare Data

– Standards

“Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system.”

David Blumenthal, M.D., M.P.P

• One Medication Error per Day Per Hospital Patient

• Every 7th Admission Unnecessary• Every 5th Lab Test UnnecessarySource: National Quality Forum

Four Broad Areas of Health IT

Information Analysis Point of Care Technology

Reduced Admin EffortInformation Sharing

Centene has Invested in Health IT

Information Analysis Point of Care Technology

Reduced Admin EffortInformation Sharing

Centene Created EHR for Texas Foster Care

• Health Passport is a patient-centered, internet-based health record that allows healthcare providers to overcome the information barriers that exist within a transient population

• Using state-of-the-art technology, Health Passport improves care coordination, eliminates redundancy, and reduces provider errors by providing secure access to the member’s treatment history

• Including prescription drug utilization, immunization history, reported allergies, past doctor visits, behavioral health history, laboratory tests, vital signs and patient demographics

EHR Challenges

•Who Pays

•Who Manages

•Scalability

•Standards

•Privacy

•Measuring the Benefit

Inform ClinicalPractice

PersonalizeCare

ImprovePopulationHealth

InterconnectStakeholders

• Involve patients more in their care

PersonalizePatient Care

• Expand publichealth knowledge localized to specific communities

ImproveCommunityHealth

• Allow records to follow patients and reduce waste and errors

InterconnectProviders

• Increase knowledge of past care episodes and outcomes

ImproveClinicalOutcomes

ElectronicHealthRecord

EHR Benefits are Many Once Data Captured

12

Progress in Adoption is Accelerating

Percent

Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

Electronic ordering of

laboratory tests

Electronic access to your patients'

test results

Electronic prescribing of

medication

Percent reporting ROUTINE:

“Network Effect” Will Drive Accelerated Usage/Value

Source: 2008 Deloitte Survey of Health Care Consumers

Observations

•Funding Supports Strong Investments

•Standards

•Change Management

•Cost Drivers

•Technology Advancement Necessary but Not Sufficient

“That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.”

from The London Times in 1834

Commenting on ... the “stethoscope”

Conclusion: Quality of Care will Drive EHR Adoption