MEDICAID
Medicaid plans face special challenges in managing patients. Many factors contribute to these special challenges:
- The economic circumstances of the patients
- The limited number of clinics and hospitals that will receive Medicaid patients
- The lack of data integration across clinicians, programs and the health plan
Medicaid plans are facing the challenge of explosive growth and new program requirements being
mandated by new Federal legislation. These factors contribute to distinctive challenges in
managing cost and individual patient health. EmmData has developed a system that captures
the major sources of eligibility, claims and pharmacy data. The data is analyzed, modeled
and formatted to be made available to the health plan for decision support. The system also makes
data available to clinicians and medical management programs. This integrated data approach
allows all plan programs to share and better understand patient status and conditions for better
outcomes and better resource use.