WHERE THE WORLD
CONNECTS FOR HEALTH
SpectraMedix assists health systems and ambulatory care providers transition to "fee for value" and "risk-based models". Our enterprise-wide clinical and business intelligence solutions are powered by core competencies in:
• Advanced data integration, warehousing and visualization
• Measures calculation and regulatory reporting for hospital and ambulatory programs and custom initiatives
• Predictive modeling and at-risk patient surveillance for performance initiatives from patient to population level, and for financial risk profiling and modeling.
East Windsor, NJ – January 15, 2018 – Leaders from Staten Island Performing Provider System (SI PPS) and its partner SpectraMedix were selected to present at the 2018 National HIMSS Conference about their success utilizing community needs assessment, data and technology to improve the delivery of care to Medicaid patients and the uninsured as part of New York State’s Delivery System Reform Incentive Payment (DSRIP) program. Their session, “Transforming Medicaid Delivery on Staten Island: A Case Study” will highlight, in particular, the strides SI PPS is making in managing opioid addiction.
The presenters for the session are Joseph Conte, PhD, Executive Director of SI PPS and Raj Lakhanpal, MD, Chief Executive Officer of SpectraMedix.
“Our organization works with hospitals and community-based providers to develop quality programs," said Dr. Conte. “We mine multiple data sources and use data visualization to identify the people we need to reach. Most recently these are people struggling with obesity and opioid addiction. By pinpointing the neighborhood, the age, sex and cultural background of individuals, SI PPS can deliver targeted education.”
The case study will illustrate how SI PPS, one of the 25 PPSs in New York, is achieving its DSRIP project goals, and what DSRIP and Medicaid Transformation programs in other states can learn from them. It will demonstrate the population health management strategies, along with the data-driven applications provided by its partner SpectraMedix, used by SI PPS to monitor outcomes, fill gaps in care, improve care for high-risk populations and provide resources where there are regional health disparities.
Areas of focus will include:
SI PPS has seen significant improvement in 30-day ER Utilization Rate in Health Home At-Risk Intervention, Disease Management in High-Risk Populations and Integration of Primary Care and Behavioral Health Services. SI PPS has also been successful reducing Potentially Preventable Emergency Room Visits and Potentially Preventable Readmissions.
DSRIP and other Medicaid Delivery Transformation Section 1115 Waiver programs are designed to expand Medicaid eligibility and clinical services for low-income residents. In New York, up to $6.42 billion is allocated to the state’s PPSs, with payments tied to performance improvement in system transformation, clinical management and population health.
“We are honored to be speaking at 2018 HIMSS on our work with SI PPS,” said Dr. Lakhanpal. “By using analytics and predictive modeling tools for risk stratification, disease-specific and project-specific registries, and the analysis of medical and behavioral health service utilization, our partnership has helped SI PPS gain intelligence into changes in population health resulting from their clinical integration, care coordination and data sharing efforts.”
“Transforming Medicaid Delivery on Staten Island: A Case Study,” The session (ID: 39) is taking place March 6th at 11:30AM at the Las Vegas Venetian Convention Center at Delfino 4004.
SpectraMedix partners with hospitals, health systems, provider organizations, health information exchanges and payers to improve care delivery and support their transition to value-based payment models. Our industry leading SpectraMedix 360™ Platform, powered by the eMeasures360™ quality management and eureQa360™ population health intelligence solutions, provides advanced data integration, quality measurement and population health analytics capabilities to implement initiatives including the Merit-Based Incentive Payment System (MIPS), Medicaid reform programs, Clinically Integrated Networks, ACOs, financial risk modeling, bundled payments and electronic clinical quality measures.
About Staten Island Performing Provider System
Staten Island Performing Provider System (SI PPS) is a 501(c)(3) formed by Richmond University Medical Center and Staten Island University Hospital to implement the Delivery System Reform Incentive Payment (DSRIP) Program on Staten Island. DSRIP is a program of the New York State Department of Health and the Centers for Medicare and Medicaid Services to improve the quality of care for Medicaid patients and the uninsured, with the primary goal of reducing avoidable hospital use by 25% over 5 years. Up to $6.42 billion dollars are allocated to the New York State DSRIP programs with payment based upon performance in system transformation, clinical management and population health. Over 60 healthcare agencies and community-based organizations are partnering with SI PPS to undertake the DSRIP program on Staten Island. The mission of SI PPS is to improve access to high quality, culturally sensitive care, transforming and improving the health and wellness of the community.
East Windsor, NJ — February 22, 2018 — NJHA Healthcare Business Solutions, and affiliate of the New Jersey Hospital Association has selected SpectraMedix as its Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP) solution partner for its members. SpectraMedix was selected due to its on-going success in delivering Medicare reporting solutions for hospitals and large providers.
“Implementing MACRA is a key component in our members’ transition to value-based care,” said Tim Keough, MPA, RHIA, FAHIMA, Vice President, Health Information Services, NJHA-HBS. “We chose SpectraMedix based on their experience combining clinical and billing data across health systems to power quality improvement initiatives, the capabilities of their platform, and the expertise of their MIPS team.”
SpectraMedix’s cloud-based systems are able to aggregate and normalize data from a wide array of sources, and provide custom dashboards, queries and interfaces in formats that work best for each client. Key benefits of eMeasures360™ include:
In addition to NJHA- HBS’s recent partnership, the SpectraMedix MACRA Solution is endorsed by HANYS Solutions, a subsidiary of the Healthcare Association of New York State and HealthCurve Analytics, a subsidiary of the Missouri Hospital Association. The company’s population health platform is also used by 20 percent of New York State’s Performing Provider Systems (PPSs) in implementing the DSRIP Medicaid Transformation program across their regions.
Raj Lakhanpal, MD, Chief Executive Officer of SpectraMedix said, “We are proud to have been selected by NJHA to support New Jersey hospitals in their transition to MACRA. Our comprehensive experience in transforming data into actionable intelligence is key to providers’ ability to implement value-based payment programs.” Dr. Lakhanpal also noted, “As commercial payers introduce their own value-based payment policies, it is more important than ever that providers understand where they are on the reporting and payment spectrum.”
February 28 2018, 1:16pm EST
As contracts increasingly incentivize providers to take on risk for patient care, they’ll need to use more advanced population health management strategies and use data gathered from sources that come from outside the organization’s walls.
That’s the approach being used by the Staten Island Performing Provider System (SIPPS), which is participating in a Medicaid waiver program that aims to expand eligibility to the federal program and offer more clinical services to low-income residents.
SIPPS is relying on a data aggregation platform from SpectraMedix, which enables near real-time collection of data from electronic health records and a variety of other sources, such as health centers and emergency medical service systems.
SIPPS is one of 25 performing provider systems in New York State participating in the federal Delivery System Reform Incentive Payment (DSRIP) program. That initiative and other Medicaid Delivery Transformation Section 1115 Waiver programs seek to expand Medicaid eligibility and clinical services for low-income residents in participating states. In New York, as much as $6.4 billion is allocated to the state’s DSRIP Performing Provider Systems, with payments based on achieving performance improvement results in system transformation, clinical management and population health.Joseph Conte
Medicaid pays 50 percent of the overall cost for the program, with the state paying the rest. New York has taken an ambitious approach to the program, asking participating healthcare organizations to achieve 25 percent reductions in admissions and readmissions, while reducing emergency department visits as well as meeting other goals, says Joseph Conte, executive director of SIPPS.
“We’re managing care for 180,000 lives, and we’re very much driven by outcomes,” Conte says. “We ingest and socialize all the data that we bring in. We’re a data sponge—for example, we bring in data from the New York Police Department for the number of people who have overdosed, and from school nurses on asthma patients.”
The SpectraMedix platform brings in the various types of data at midnight each day, and “this allows us to do hot-spotting and geo-mapping, and it allows us to create relationships with organizations serving those in need,” Conte says. He compares the provider’s role to that of a control tower at an airport, enlisting the help of community organizations to address factors such as helping those patients who are driving excessive utilization, who are coming to the emergency department instead of physician offices, or who need behavioral health support.Raj Lakhanpal
“The platform helps identify patients who have gaps in care or have gaps in hitting measures, and then we can get those gaps filled,” says Raj Lakhanpal, CEO of SpectraMedix. “The application’s ability to take in information and make it available to providers quickly also offers benefits, he adds. “Now, we are collecting information from clinical data, and that makes it very impactful.”
Clinicians can access information through dashboards or in any way that’s helpful to them, Lakhanpal says. “Some providers say, ‘Give me a PDF file with a chase list or showing gaps in care.’ Or some say, ‘Give me an Excel spreadsheet.’ We provide information in the form they want to consume.”
“There’s a global movement to value-based care, and it requires a different way of taking in information that we have in the fee-for-service world,” Conte adds. “Honestly, people have a hunger for this type of information. But it needs to be presented to them in a way that is user friendly and simple, and so that it matches what their role is.”Lakhanpal and Conte will present a session at the HIMSS18 Conference and Exposition on SIPPS’ experience, entitled, “Transforming Medicaid Delivery on Staten Island: A Case Study,” at 11:30 a.m. Tuesday, March 6, in Delfino 4004 in the Venetian Convention Center.