Providers face increasing administrative burdens related to paperwork, documentation, and data sharing agreements. Over the last few decades, reliance on technology and data sharing systems has come at a high-cost, both monetarily and on overall provider well-being. Unfortunately, this increase in documentation and technology has not been met with a stepwise increase in meaningful, comprehensive, or timely data related to beneficiary health outcomes. The question becomes, how can we accurately and meaningfully understand the quality of care that is being provided to beneficiaries, without adding to provider burden?
To answer this question, North Carolina (NC) Medicaid has partnered with the NC Health Information Exchange Authority (HIEA) to leverage the state-designated health information exchange, NC HealthConnex. The long-term vision for this work is to transition to digital quality measures (dQMs), relying on NC HealthConnex as a central, data aggregator that will ingest and transform data from various sources. Not only does this movement align with CMS’ goal of transitioning all quality measures used in reporting programs to dQMs, but dQMs inherently solve many of the challenges experienced under the current system. Through this transition, NC Medicaid aims to (1) reduce the administrative burden associated with sending and reporting data to multiple data sources, (2) provide near real-time quality measure data to providers, practices, health plans, and other permissioned entities to promote whole-person care, and (3) create an environment for information to be pulled in from various sources in a standardized and accurate format.
NC Medicaid is in a unique position to leverage NC HealthConnex, as connection to the system became mandatory for organizations who receive state funds for providing services (e.g., Medicaid) under the Statewide Health Information Exchange Act in January of 2023. To date, more than 60,000 providers are connected to NC HealthConnex, with over 6,000 health care facilities currently undergoing the onboarding process.
NC Medicaid is excited to share lessons learned in its journey to advance quality and population health via partnership with HIEA and the transition to digital quality measurement and efficient data exchange.