California chooses Innovaccer's AI to improve Medicaid outcomes for vulnerable populations
California is looking to better understand its Medicaid population, and it’s selected health IT company Innovaccer to analyze claims data on over two million of the state’s enrollees. Insights will be used to help providers working with Medi-Cal—the state’s safety net insurance program—to improve outcomes, the company said in a statement.
A total of sixteen Medicaid managed care plans will have their data analyzed by artificial intelligence as part of the program. Metrics tracked will go beyond care quality, looking at efficiency.
The goal is to help providers with “care coordination for vulnerable populations” and “support efforts to secure payments tied to performance metrics,” which typically means the ability of providers to contain costs.
"California’s Medi-Cal transformation is one of the most ambitious in the nation, and we are proud to play a role in making it a success," Abhinav Shashank, cofounder and CEO of Innovaccer said in a statement. "By equipping safety net providers with actionable intelligence powered by Innovaccer Gravity, we can help them close care gaps, improve outcomes, and ensure that millions of Californians receive the right care at the right time."
Once data is analyzed, the California Equity and Practice Transformation (EPT) Health Program, an initiative launched by the California Department of Health Care Services (DHCS), will use it to support primary‑care practices, with an emphasis on improving health equity. Reports generated from DHCS are not only used to send compliance reports to the Centers for Medicare & Medicaid Services about how well Medicare in California is performing, but it also, in turn, shapes the way care is delivered within the state.
The data will also help California's PopHealth Learning Center—an agency working to support independent practices and community health initiatives improve the health of patient populations that tend to struggle with chronic illnesses.
"The Learning Center unites purchasers, health plans and primary care practices. We translate policy into practice, align incentives with capabilities, and ensure no one is left behind in the state’s ambitious transformation," Jennifer Sayles, MD, Chief Executive at the Learning Center said.
"By leveraging Gravity by Innovaccer, primary care practices across California will gain unprecedented visibility into performance through a single, aggregated score across all participating plans—calculated for multiple quality performance measures—helping them meet EPT program requirements, earn payments and improve the lives of millions of Medi-Cal patients,” she added.
Through data-driven insights, Innovaccer is able to “ensure practices have the intelligence they need to understand patient and population health conditions, identify opportunities for improvement, get credit for care delivered, and ensure value-based payment is implemented with a more complete picture of practice performance,” the company said in a statement.
The partnership begins immediately.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.