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Smarter Medicaid will be built with cloud, APIs

What: "Smart Medicaid: Leveraging cognitive technologies to improve health and program efficiencies," a report from Deloitte Insights.

Why: States' legacy Medicaid management information systems make it difficult for states to take advantage of new technology that could save money, increase staff efficiency and improve outcomes for Medicaid participants. 

Findings:  A truly “smart” Medicaid system would use open application programming interfaces and cloud platforms to take advantage of machine learning, geographic information systems and internet of things technology. APIs would allow states to easily share data with external systems, and cloud platforms would enable states to use inexpensive as-a-service solutions to meet smart-tech enabled goals, such as:

Remote patient monitoring, which can now include in-home sensors whose data can be analyzed by intelligent agents to detect patterns and respond to member needs.  

Improved options for non-emergency medical transportation through GPS-enabled ride sharing apps or platforms that can help reduce late and missed appointments and lower costs. Agencies would also be able to monitor the performance of transport vendors and detect instances of fraud, waste and abuse.

Target interventions by combining data from Medicaid programs with electronic health records and data from social services agencies to anticipate hospital admissions, emergency room use and substance dependence.

Improve customer service though the use of chatbots that can respond to questions about eligibility, benefits, enrollment and managed care organizations.

Ensure access to care using APIs, GIS and advanced analytics to data-mine thousands of claims to assess whether providers are accepting new Medicaid patients and which services are being rendered at what locations.

Verbatim: "Platforms that harness smart technologies have the potential to transform the way Medicaid agencies work. States that are first to upgrade their Medicaid platforms will likely be the first to implement “smart Medicaid” systems -- and reap the benefits.

Read the full report here.

About the Author

Susan Miller is executive editor at GCN.

Over a career spent in tech media, Miller has worked in editorial, print production and online, starting on the copy desk at IDG’s ComputerWorld, moving to print production for Federal Computer Week and later helping launch websites and email newsletter delivery for FCW. After a turn at Virginia’s Center for Innovative Technology, where she worked to promote technology-based economic development, she rejoined what was to become 1105 Media in 2004, eventually managing content and production for all the company's government-focused websites. Miller shifted back to editorial in 2012, when she began working with GCN.

Miller has a BA from West Chester University and an MA in English from the University of Delaware.

Connect with Susan at smiller@gcn.com or @sjaymiller.

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