Health and Human Services Solution

Transcription

1 Performance Management for Healthcare & Human Services Salient Health and Human Services Solution For Government Human Service Agencies

2 Contents Value Proposition... 3 Understanding the Big Picture... 4 Caseloads and Expenditures Understanding Drivers of Cost... 5 Focus on Safety Net... 7 Workload Management / Performance Evaluation Employment Foster Care Mental Health Government Human Service Agencies Value Demonstration 2

3 Value Proposition In these tight fiscal times, Salient s Health and Human Services Solution enables government agencies to leverage technology and information so that existing resources can be deployed as efficiently and effectively as possible to carry out mandated responsibilities. Salient s first-of akind, interactive visual data mining system provides the ability to maintain complete and continuous vigilance over agency expenditures and program activities. Salient s speed and ease of use gives administrators, supervisors, and line workers the ability to view and manipulate data available to them in ways never before possible. By providing complete visibility into cost drivers and patterns of utilization and productivity, the Health and Human Services Solution will help you align staff resources to meet demand, influence spending and service delivery, and improve performance. Salient brings coherency and visibility to data that are now stored in separate state agency silos so that staff have ready access to the comprehensive information they need to do their jobs effectively. The Solution currently deployed in New York State integrates data relative to the Medicaid, TANF, HEAP, SNAP, Safety Net, Welfare to Work, subsidized Day Care and Child Welfare programs. Salient s unique computing platform easily accommodates the integration of data from any other sources important to the customer; for example, financial and payroll systems can be integrated with the current Health and Human Services Solution to provide an even more comprehensive view of expenditures and revenue. The illustrations that follow in this document are intended to provide just a glimpse of the breadth and depth of this powerful and robust management tool. Please remember as you review our illustrations that: Navigation is all point and click and follows the user s train of thought - taking only seconds to change views The user is in complete control of the time periods he/or she wishes to view or compare Every view can be changed from a number to a graphic presentation with a click All views, number or graph, are interactive and allow the user to move from aggregate level data to recipient, vendor or worker detail in seconds Information can be exported to non-salient users right from the view you are in The powerful onboard analytical tools significantly reduce time from question to action Most importantly, these are just examples of how a user can interact with data made available in a Salient solution. The views, analytical tools and all functionality are applicable to any transactional data. Government Human Service Agencies Value Demonstration 3

4 Understanding the Big Picture In this view, we are comparing total social service and Medicaid expenditures in 2009 vs.2008 by major case type. With a click, we have switched to a graph view and are looking at the same expenditures over 4 years. You may want to focus on a specific program, select several programs or compare different periods. Point, click, answer in less than 3 seconds. Government Human Service Agencies Value Demonstration 4

5 Caseloads and Expenditures Understanding Drivers of Cost Here we are focused on cases with JD/PINS Foster Care payments over 24 months; comparing number of cases to the average payment per case. Explore further to determine what is driving the increase in cost per case. Still focused on the same cases, we are looking at the expenditures by pay category; for IV-E JD/PINS we have expanded our view to include pay types. We can insert the number of vendors or create a list of cases, vendors, or responsible workers. Government Human Service Agencies Value Demonstration 5

6 In the Salient Solution, we can create collections of people, places, and things on the fly. Still in social service payments, we have changed our view to the Child Care Subsidy Program and we are focused on informal day care providers. In this Scattergram, each dot represents a provider. We can see which providers are outliers in terms of payments per recipient and/or number of children cared for in any month during the period defined. We have applied highlighting to call attention to areas of concern. Government Human Service Agencies Value Demonstration 6

7 Focus on Safety Net We can see in this view of payments by pay category that there has been 6.7% increase in SN- FNP expenditures, but a 4.22% decrease in cases. To explore further we drill into SN-FNP. Now focused only on SN-FNP, we are viewing pay types. We can see a significant increase in congregate care facility costs. Notice the increase in cases receiving emergency shelter payments. Continue to investigate right down to payment line detail. Government Human Service Agencies Value Demonstration 7

8 In this view we are using both paid Medicaid claims and Welfare to Work information to determine if Safety Net recipients coded employable may be candidiates for an SSI referral. We employ the Storyboard Mode, which allows one user to record an analysis, and any other user to simply click their way through it. In the first step, we identify potential candidates for SSI. The user double clicks on a Recipient, and we see the classes of diagnoses contributing to the cost of their Medicaid Case. Government Human Service Agencies Value Demonstration 8

9 The user double clicks on a Primary Diagnosis Class to see the underlying diagnoses. Now the user can double click on a Diagnosis to see the actual claim-level detail to identify Providers who can assist with the SSI Application and Documentation. Government Human Service Agencies Value Demonstration 9

10 Once a recipient has been granted SSI, use the Solution to instantly calculate what the agency is due for the retroactive recovery of benefits paid out. Get all the way down to the invoice level detail to aid in recoveries. Government Human Service Agencies Value Demonstration 10

11 Workload Management / Performance Evaluation The Salient Health and Human Services Solution provides a robust management tool for staff at all levels. In this view, we see all applications processed by the agency in 2009 by days to disposition and type of disposition. We can easily change this view to show major case type, worker, unit, or many other dimensions. This view focuses on applications due and overdue by workers on an intake team. Worker NNH has applications for both Food Stamps and Medicaid. Government Human Service Agencies Value Demonstration 11

12 We drilled into worker NNH and see that 25 overdue applications are more than 91 days overdue. Next, we create a list of those 25 applications and send it to the worker directly from the Solution, as an Excel spreadsheet. This example focuses on application processing, but all examples can be applied to recertifications or any other type of transaction. Government Human Service Agencies Value Demonstration 12

13 In this view, we are comparing the performance of individual workers to that of the team. On the left side of the screen, we see that the Intake Team processed 994 applications; 60% were processed in 30 days or less. On the right side, we see the performance of individual workers. KMR, who processed 26% of the applications, processed almost 78% in 30 days or less. This view illustrates another way to compare the work of one to all others or a group of peers, over time. We can move from worker to worker or change the transaction type by clicking on the scroll arrow in the drill path. Government Human Service Agencies Value Demonstration 13

14 It is often important to track the impact of certain events on productivity. This is an example of how the impact of the state takeover of Medicaid administration might be monitored. This graph tracks Medicaid caseload size, number of Medicaid transactions completed, and the number of recertifications completed by agency staff. This view is saved to update automatically with the most recent complete month. Government Human Service Agencies Value Demonstration 14

15 Employment There are many ways to use the Solution to support Welfare to Work functions. In this example, we are comparing the participation rates for the agency to participation rates for each worker. In this month over month comparison, we can track performance related to keeping recipients engaged in key work activities. We can see the number of recipients engaged in work experience seems quite low. Government Human Service Agencies Value Demonstration 15

16 Foster Care Medicaid paid claims and managed care encounters are rich sources of information that can enhance assessment and service delivery and help shape program development for youth in Foster Care. In this view, we have created a cohort of youth in Foster Care over a 12-month period. We focus on inpatient claims by primary diagnosis class. We can see that almost 50% of the admissions were related to a mental disorder. Detailed information about providers or youth is only a few clicks away. Still focused on our Foster Care cohort, we are using a scattergram to study emergency department utilization. Each dot represents a child with an ED visit. Using our rubber banding capability, we select those youth with more than five visits in a year and create a detailed list. Government Human Service Agencies Value Demonstration 16

17 In the next two views, we are studying youth in Foster Care who have had four or more different psychotropic drugs in 12 months. We can see that 11 children had four or more Atypical Antipsychotic drugs. The Stacked by Volume Trend allows us see the prescriptions filled, one child at a time, to determine if there are patterns that warrant a closer look. Government Human Service Agencies Value Demonstration 17

18 Mental Health Medicaid paid claims and managed care encounters are also important sources of information for enhancing service delivery and planning for special needs populations. This view provides a summary of inpatient admissions for our OMH population. We are looking at this data by the state where care was provided and by age group. We can see a significant increase in hospitalizations between 2008 (last) and 2009 (this). Starting from this view, we can see drug costs and utilization for the OMH population. We are looking at all prescriptions filled for the OMH population in 2009 by therapeutic drug code. We can also change our cohort to other special needs populations, such as individuals receiving services from OPWDD or OASAS. Government Human Service Agencies Value Demonstration 18

19 Still focused on the OMH population, we have created a collection of recipients who were continuously enrolled in a MH Case Management program for at least 12 months. We use a stacked by volume trend to understand the frequency of inpatient admissions for this cohort. This document intends to introduce you to a small sample of the possibilities Salient offers to agencies regarding the use of complex data sources for oversight, performance management, and continuous improvement. We look forward to exploring with you the many data mining opportunities that await your agency with the implementation of Salient s Health and Human Services Solution! Government Human Service Agencies Value Demonstration 19

20 For more information, please visit our website at or contact: Linda Huffner, Vice President, Health and Human Services Government Human Service Agencies Value Demonstration 20