“Don’t bite off more than you can chew.”
“Don’t boil the ocean.”
“Less is more.”
Pick your cliché about avoiding the risk of trying to do too much and accomplishing little. The fact is, all clichés have some truth to them — and “starting small” can lead to big results.
Health and Human Services (HHS) agencies should apply this approach when drawing on the power of analytics to improve the lives of those they serve. HHS professionals can use analytics to focus on smaller and critical segments of the population to achieve real changes — quickly — in outcomes and quality of life.
For example, this kind of segmented use of analytics has the potential to improve the lives of thousands of foster children in Michigan. While Michigan certainly relies on data integration and sophisticated analytics for broad swaths of its health and human services needs, the state also has mastered the art of a laser-like approach to improve outcomes among selected populations.
To address improvements in foster care, Michigan has combined the powerful data and analytics capabilities of an enterprise data warehouse with a comprehensive statewide web portal and care management tool, called CareConnect360 (CC360), that is becoming increasingly central to the state’s goal of developing a deep, broad and sharp view of the people Michigan serves and the care needs they have.
A first-of-its kind initiative in Michigan — and one of the first such solutions in the country — CC360 was initially rolled out by the Michigan Department of Health and Human Services (MDHHS) and its technology partner, Optum, to the state’s physical and behavioral health plans that serve Medicaid beneficiaries, as a way to close gaps in the care continuum. For the first time, it enabled physician-health plans to see a beneficiary’s behavioral health information and vice versa, which helps professionals develop integrated care plans.
Since then, MDHHS has granted CC360 access to authorized home office and field foster-care professionals to obtain physical and behavioral health information about the children they serve — a total of 14,000 foster children in all, more than 95% of whom are covered by Medicaid.
With this access, caseworkers can understand, analyze and monitor medical care received by foster children, as well as get insight into their medical histories, including:
- Whether and how they are being treated for chronic medical conditions
- The number of and reasons for emergency department visits (repeated visits could indicate signs of abuse or untreated medical conditions)
- The number and types of filled medications that health professionals have prescribed for both physical and behavioral issues
- Whether children have received dental treatment
- Whether children have made well-child visits and are under the care of a physician
Staffers can also use the CC360 tool to identify gaps in care and to inform new foster parents of a child’s medical background when the child is placed.
The state’s goal is to provide coordinated care to children in foster care by addressing their behavioral, developmental and physical health needs in a comprehensive, cost-effective way.
Such support of foster care children epitomizes the state’s desire to focus on “people, not programs,” and break down silos that may prevent such an approach. States often are organized so that silos exist between those programs defined as “health only” and those defined as “human services.” Yet, in the case of foster care children particularly, their health care needs and problems are often compounded by their circumstances that transcend traditional “health care programs.”
Numerous challenges face children in foster care, including emotional, behavioral and educational difficulties, abuse issues, placement instability, and juvenile justice involvement. National studies have shown that nearly 90% of children entering the foster care system have physical health problems, and more than half have two or more chronic conditions. Almost a quarter have three or more chronic conditions, such as asthma, anemia, malnutrition, and some manifestation of abuse.
In addition, many foster children with behavioral issues are prescribed psychotropic drugs — stimulants, antipsychotics, antidepressants and others — that also have an impact on their physical well-being.
With CC360, Michigan’s foster care professionals now have a window into the totality of care and treatment of the children for whom they’re responsible, which will enable them to make better and faster decisions, and improve overall well-being outcomes for this relatively small, yet vulnerable population.
What could possibly be a nobler goal — and a more effective and efficient use of resources?
Trying to analyze too much data may outstrip an agency’s ability to uncover meaningful insights. Yes, there are important answers buried in there somewhere, but there’s just too much digging to do. Trying to overreach also wears down your team — morale will suffer if the results don’t match up to the enormous effort required to comb through millions of records and data points.
Other states may want to adopt Michigan’s approach by carefully focusing on their critical issues and cost areas, then segmenting — even micro-segmenting — their efforts to make rapid, tangible improvements. Looking at smaller groups allows states to dig deeper into the data, really understand the issues, and develop solutions.
For the sake of the people they serve and the professionals who serve them, HHS agencies would be better off to shrink “big data” into “small data” and make it “great data.” To do that, it’s better to “go deep rather than broad.”
Or to quote another cliché: “Better to eat the elephant one bite at a time.”
For more information on how we can help your state, visit optum.com/stategov.
About the Author:
Director, Health and Human Services Programs, Optum
Scott has 40 years of experience in health and human services programs and systems having served as the Deputy Administrator for the Food Stamp Program at the Food and Nutrition Service (FNS) at the US Department of Agriculture, and then as Administrator of FNS. He was the Policy Coordinator to the Deputy Secretary of the U.S. Department of Health and Human Services and served as a Professional Staff Member with the United States Senate Committee on the Budget. He has been providing IT consultative services to state and local governments in health and human services programs. He holds a Bachelor’s degree in economics and political science and a Master’s degree in public administration.