Challenges and Opportunities

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Challenges and Opportunities In Working with
Medicaid
HRSA All-Grantees Meeting November 2007
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OCHIN Network
Founded in 2001 (501c 3) Mission To
improve the health of the medically underserved
through the best use of information and
information technology
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Background

• 20 Community Health Centers
• 150 clinics
• Washington, Oregon, California
• 200,000 Annual Patients
• 1,000,000 Annual Visits
• 3,500,000 Total Visits

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Background

• 35 Hispanic
• 2/3 at or below 100 FPL
• 50 uninsured in past year
• 45 on Medicaid in past year
• 20 rural

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Working with Medicaid

• Building HIT Infrastructure
• Financing Health IT

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Why

• 30 of Oregon Medicaid
• 25 of Oregon Uninsured
• 45 of Uninsured Children
• Safe, Neutral Partner for HIE

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Working with Medicaid

• Building HIT Infrastructure
• Health Information Exchange
• Data for Policy and Research
• Medicaid Transformation Grant

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OCHIN/Medicaid IT Infrastructure
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Health Information Exchange
Interfaces

• 11 lab orders/results
• 20 payor
• Medicare eligibility
• Dental eligibility
• Dental billing
• Document management

• Radiology transcription
• Pharmacy ADT
• EyePacs image processing
• Meditracks
• Surescripts Rx

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Data for Policy and Research

• National Library of Medicine IAIMS Grant
• Solutions

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Medicaid Transformation

• Health Record Bank
• Personal Health Record

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Working with Medicaid

• Financing Health IT

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Financing Health IT

• Role for Private and Public Granting Agencies
• Role for Medicaid

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Financing Health IT

• Oregon FQHC and RHC Rulebook
• Rule 410-147-0362 - Change in Scope of Services
• Section (5) (e) A change in applicable
  technologies
• (A) Maintaining Electronic Medical Records
  (EMR)
• (C) Updating practice management systems
• Authorized by statute (ORS 409) and
• Regulation (ORS 414.065)
• Implemented 7/1/2007

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Barriers

• Gaining and Maintaining State focus on Network
• Keeping Network focus on State
• Engaging Health Centers in discussions
• Getting the community to YES on HIE
• FUNDING
• Change of scope authorized, but not yet funded
  by legislature

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Lessons Learned

• Engage in multiple spaces
• Be persistent
• Look for degrees of separation
• Build relationships Foster cross-relationships

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Thanks!
QUESTIONS?
Howard Balshem [phone] balshemh_at_ochin.org