Policy & Practice | Fall 2023

Consulting have continued to inte grate new data sources into the data warehouse to provide a broader view of a person’s whole health. Some examples of this include clinical data from the statewide Health Information Exchanges, housing status, public health data, case man agement data, and Department of Corrections (DOC) data. As a result, strategic alignment across government agencies and orga nizations is possible. For example, through this integrated data, HCPF is able to track behavioral health care utilization for members transitioning from the DOC into the community, understanding that if adequate health care is not accessed during this time it will lead to an increase in recidivism. The state now has aligned perfor mance goals around this population, including paying their managed care organizations (Regional Accountable Entities) for increasing behavioral health engagement for members releasing from state prisons. Expanding to become multipayer As part of Colorado’s overall behavioral health strategy (see Behavioral Health in Colorado: Putting People First, A Blueprint for Reform ), 1 Colorado’s Behavioral Health Administration (BHA) 2 is leveraging the existing Medicaid/ CHP+ eligibility, claims processing, and enterprise data warehouse and reporting infrastructure to support all the state’s behavioral health programs, including those administered outside of Medicaid/CHP+. The Behavioral Health Claims & Eligibility (BHC&E) Project will provide members and providers with a single point of entry to the state’s behavioral health services, which are currently admin istered by multiple state agencies. IBM will receive member, provider, and encounter data from the inter Change (MMIS) system for members accessing BHA services as a secondary payer in the system. IBM will process, integrate, and enhance the data for reporting, while maintaining secure user roles and access to the multipayer data. This will enable a more compre hensive view of the behavioral health system for the state and how it is

serving their residents. It also directly addresses one of their opportunities to increase accountability 3 by supporting their “systemic approach to collecting, reporting, and analyzing data and demographics [to] help identify ineq uities that need to be addressed.” Protecting citizens’ health and their data Security requirements and stan dards in the health care sector are, appropriately, controlled, but can be a limiting factor in leveraging tech nology in this space. An enterprise data warehouse that can maintain sensitive data across systems and agencies and only allow them to see data that they need is essential to fully utilizing and scaling an enter prise data warehouse. In Colorado, the BIDM is designed to tag sensitive data attributes and records based off regulations (for example, 42CFR Part 2, which limits the use of substance use disorder data) or by payer, as described above. Leveraging record tagging and security roles allows state agencies to leverage shared systems without compromising security. Takeaways The next generation of human services will be achieved with the right balance of modern tools and practices. Embedding the proper modern prac tices at the programmatic level will empower people with the knowledge and skills to effectively utilize the tools at their disposal. Modern tools characterized by advanced technology must be scalable, secure, and built on the proper foundation of high-quality data. Equipped with both, government agencies can deliver transformative services to their communities. Reference Notes 1. https://hcpf.colorado.gov/sites/hcpf/ files/Behavioral%20Health%20and%20 Integration%20Strategies%20PIAC%20 Subcommittee%20A%20Blueprint%20 for%20Reform%20Packet%20 October%202020.pdf 2. https://bha.colorado.gov 3. https://hcpf.colorado.gov/sites/hcpf/ files/Behavioral%20Health%20and%20 Integration%20Strategies%20PIAC%20 Subcommittee%20A%20Blueprint%20 for%20Reform%20Packet%20 October%202020.pdf

Medicaid program), Child Health Plan Plus, and other health care programs, has had a long history of prioritizing data and analytics to make informed, data-driven decisions as an agency and in their focus on whole-person care. As a partner in this mission, IBM Consulting implemented and administers the state Business Intelligence and Data Management (BIDM) system, which comprises an enterprise data warehouse with a robust integrated layer of data for analytics; business intelligence tools; a provider performance portal; and other performance measurement tools, including a certified Healthcare Effectiveness Data and Information Set (HEDIS) platform. What makes HCPF, and IBM’s relationship with HCPF, unique is that Colorado is a pioneer—an early adopter of new technology—and prioritizes robust internal analytic capabilities. The result is an exciting and impactful collaboration. Integrating programmatic insights with a data analytics portal With the implementation of the BIDM, HCPF and IBM Consulting launched the Health First Colorado Data Analytics Portal (CDAP) to support Medicaid’s primary reform health program, the Accountable Care Collaborative. Utilizing a Tableau interface, the CDAP allows providers and the state’s Regional Accountable Entities (RAEs), Colorado Medicaid’s managed care organizations, to access overall performance information, drill downs, client lists, and risk scores, refreshed monthly. Providers and RAEs benefit from the newfound access to information about their Medicaid members’ health care utilization. Operationalizing equity-driven health care and interagency alignment with an enterprise data warehouse In addition to standard Medicaid operations, the BIDM integrates social determinants of health data into the data warehouse. Colorado has been on the forefront of understanding that health care is only a small indicator of a person’s overall health. Therefore, after the initial implementation of their BIDM system, HCPF and IBM

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