According to the ITN, AHCA seeks a solution that uses advanced analytics tools to aggregate and assess data to produce actionable insights via an interactive dashboard to guide future improvement and cost-effective strategies for Medicaid management.
“Since 2014, the agency has delivered medical services through the Statewide Medicaid Managed Care (SMMC) program,” the ITN states. “Most Medicaid-eligible recipients are required to enroll in an SMMC Managed Medical Assistance (MMA) plan to access healthcare services.”
By enrolling in an MMA plan, a patient-provider contract is established to deliver preventative care, disease management strategies and quality metrics reporting.
However, the agency seeks to improve enrollee health-care outcomes and reduce overall health-care costs in the Statewide Medicaid Managed Care program. As a result, the agency seeks vendors to:
- Ensure the accurate, complete and secure aggregation of Medicaid enrollment, claims, pharmacy and other related data
- Integrate additional relevant data sources, including social determinants of health and digital health program metrics
- Assess population health, medical and pharmacy expenses, network performance, non-clinical determinants, digital health programs, emerging risks, provider value and holistic benefit impacts
- Develop a user-friendly, customizable dashboard or similar solution accessible by key stakeholders
- Use a secure cloud-based platform to aggregate data and provide advanced cohort analysis to the agency
