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Free online service offers Medicaid providers access to patient information

Mede/Provider Access image

Free online service offers Medicaid providers access to patient information

Health-care providers across the state have a new digital tool to help them track their Medicaid patients’ medical histories and medications with the aim of delivering high-quality and cost-effective care ­— and it’s available to them free of charge.

The Mississippi Division of Medicaid (DOM) began offering Mede/Provider Access during the summer, a service created by outside vendor MedeAnalytics, to provide up-to-date patient information in an easy-to-access online application. The service differs from an electronic health record (EHR) because it’s a view-only access specifically designed for Medicaid providers, containing transformed claims-based clinical information for Mississippi Medicaid beneficiaries over a seven-year period, regardless of where the beneficiary has received treatment during that time.

Mede/Provider Access will help providers monitor their patients’ medical history, prescription medication filling habits and cut down on duplicative treatments.

“The advantage is that users can see another Medicaid provider’s treatment of that patient, which assists them in their treatment because they can see where their patient has been treated, see their diagnoses and what medications have been prescribed and filled by that patient,” said Cheryl Mize, lead clinical business analyst in the Office of Information Technology at DOM. “It’s another tool to assist them in their individual treatment of that patient.”

The service also allows Medicaid providers to view all claims submissions (both paid and denied) for the individual. The additional information is valuable as it helps to provide a more detailed picture of the individual patient’s medical history. Only viewing paid claims may not accurately reflect the patient’s actual history of clinical diagnoses, as clinical data are sometimes modified upon denial of the claim in order to achieve payment.

“It gives providers a lot of avenues to deliver better treatment, better outcomes and more accurate reimbursement,” Mize said.

The service went into effect June 30, 2014 and is not only limited to Mississippi providers; those in neighboring states also are encouraged to take advantage of the system, as Mississippi Medicaid beneficiaries may seek treatment in nearby cities such as Memphis, New Orleans or Baton Rouge.

“The Centers for Medicare and Medicaid Services (CMS) and the federal government has mandated that states begin to share information and participate with each other in providing the most cost-efficient and effective care for our patients and beneficiaries,” Mize explained. “Mississippi has a high percentage of Medicaid beneficiaries. That makes it even more important to us that we give our providers as much information as we can to assist them in treating their patients.”

Mede/Provider Access is funded through the Health Information Technology initiative, with the federal government covering 90 percent of the cost. So far, 226 individual users representing 30 providers/facilities have signed up to use the system.

Since launching Mede/Provider Access, Mize says the response has been extremely positive, including from a number of providers at the University of Mississippi Medical Center (UMMC).

“Parents and patients almost always claim they are adherent with their medications,” said Dr. Anne Yates, professor of pediatric allergy, asthma & immunology at UMMC. “When we can see what they actually filled at the pharmacy, it gives us an opportunity to discuss with them the importance of taking their meds as prescribed. It also keeps us from over prescribing. If we know they are not really taking the meds already prescribed, then we won’t put them on even more medications.

“Also, with (UMMC’s) EHR, I have access to all medications, diagnoses, and clinic visit dates and information from other providers in the UMMC system, but no access to data for visits outside of UMMC,” she added. “Mede/Provider Access helps to fill in those gaps, as many of our patients come from other parts of the state.”

Various state and federal regulations, as well as DOM policy, require additional protections on the use and disclosure of health information without authorization of the beneficiary. For beneficiaries who choose to participate in Mede/Provider Access, certain categories of health information have been identified as sensitive and will not be available through the service.

Unlike a typical electronic health record system, Mede/Provider Access is a view-only service, Mize explained. Providers cannot change or update a patient’s information, but the advantage is they can see another Medicaid provider’s treatment of that patient.

“Mede/Provider Access enables users to get a comprehensive sense of the patient’s care,” said Dr. John Showalter, assistant professor of medicine and chief medical information officer at UMMC. “Knowing which medications a patient has actually picked up from the pharmacy is very powerful information. The portal compliments an EHR nicely and allows for a more 360 degree view of the patient. It is easy to use and I would recommend it to other providers.”

For more information

If you are a current Medicaid provider and would like to learn more about Mede/Provider Access, contact Nancy Barton-Marini at 662-231-7715, nancy.bartonmarini@medeanalytics.com.

If you would like to become a Medicaid provider, contact Provider Enrollment toll-free at 800-884-3222.

For more information contact Erin Barham at 601-359-5773, erin.barham@medicaid.ms.gov, or Matt Westerfield at 601-359-6148, matt.westerfield@medicaid.ms.gov.