Bill Davenhall
GIS: Bringing Medicaid
Strategy into Focus
NCSL
Annual Meeting
Washington, DC
December 2012
GIS is about Place Everything happens somewhere! ^
…and understanding WHERE things happens can save money.
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GIS Creates Data Layers . . . that links data about our geography
Street Addresses (specific places)
Land Features (lakes, rivers)
Facilities (buildings, bridges)
Administrative Boundaries (postal areas)
Space Attributes (travel patterns)
Population Attributes (density)
geography
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Where we live, work and play (our space)
Community Health (morbidity rates)
Environmental Exposures (air. Water, soil)
Livability (quality of life)
Threats and Risks (agents, vectors)
Time (history and future)
GIS Creates Data Layers … that links data about our unique relationship with place
place, person, time
It’s all about the view!
HH with “x”
Medicaid recipients
HH Count Total
Claims ($M) Claims$/Member
1 419,800 $3,460 $8,200
2 133,200 $890 $3,300
3 69,800 $410 $2,000
4 28,300 $210 $1,900
5 or more 13,400 $130 $1,700
37% of all Medicaid Households
have more than one recipient
receiving services
Source: Louisiana Medicaid Claims (rounded), FY2010/11
HH w X Medicaid
Recipients 0-0.5 mi. 0.5-1 mi. 1-2 mi. 2-4 mi. 4-8 mi. >=8 mi.
1 $12,500 $7,500 $7,700 $7,200 $7,200 $6,200
2 $5,100 $3,100 $3,200 $2,800 $3,000 $3,000
3 $1,900 $1,900 $1,900 $1,900 $2,000 $2,100
4 $1,800 $1,800 $1,800 $1,800 $2,000 $2,200
5 or more $1,700 $1,700 $1,600 $1,700 $1,800 $1,900
Source: Louisiana Medicaid Claims (rounded), FY2010/11
Close Proximity to Hospital
Increases Medicaid Costs Dramatically
The newest “clinical” health data: Street Address
123 Main Street Any Town, State, Zip
Unlocks Information
about Health and Social
Context Relevant to
Desirable Outcomes
Income
Service
Demand Neighborhood
Needs
Education
Lifestyle
Community
Partners Transportation
Walkability
Scores
Nutrition
Scores
Utilization
Rates Environmental
Exposures
Demographic
Change
Health and Social
Providers
Child Care
GIS
Health and well-being usually begin here…
8%
$46b
State Profile
• Nationally: 1:12 (8.1%) born at low or very low birth weight. Medicaid pays for 40% of these births.
• In Louisiana: 1:9 (11.3%, avg. = 7,264 per year; 2006-2010) were born at a “low birth weight” (LBW). Medicaid paid for 71% of LBW births in 2011.
• The March of Dimes reported that a LBW infant can cost $45k more, on average, to deliver than a healthy infant and is less likely to finish high school.
Targeted Community: New Orleans, LA
Census 2010 Blocks
New Orleans, LA
Population Density
>=100 persons/km2
(>99% of population)
Low Birth Weight Babies
Area Name New Orleans, 2006-2010 New Orleans, 2011
Births LBW LBW% Births LBW LBW%
Behrman 587 100 17.0% 102 16 15.7%
Holly Grove 361 82 22.7% 108 16 14.8%
Iberville 341 67 19.6% 55 3 5.5%
Plum Orchard 135 36 26.7% 39 4 10.3%
Read Blvd 174 38 21.8% 33 3 9.1%
Seventh Ward 277 48 17.3% 49 11 22.4%
Remainder 17,480 2,058 11.8% 4,065 463 11.4%
Total 19,355 2,429 12.5% 4,451 516 11.6%
Targets
Households
A low birth weight infant cost
Medicaid on average $45,000 more.
…we had 4,500 of those last year!
TODAY Louisiana knows where their low birth weight
babies were born last night, but TOMORROW they will
will PREDICT where they need to mobilize resources to create
better birth outcomes - using GIS
^
• Embed address verification and geocoding into workflows.
• Begin householding of utilization data.
• Use geographic modeling tools to predict utilization.
• Accelerate critical data acquisition and analytical cycles.
My Place History app – for iPod & iPad
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esri.com\geomedicine
Apple Store – Search: esri – pick orange button
To Learn More
http://www.esri.com/library/ebooks/geomedicine.pdf
How many will you choose to pick up?
Get Focused Fast!