Analytic Framework to Improve Access for a State Medicaid Agency

Abstract

Analytics can help identify strategies to improve the equity and capacity of health services for populations. However, many government agencies experience challenges with heavy workloads, limited time for continued analytic education, and employee turnover among contracted staff. Therefore, streamlining analytical workflows has the potential to (1) improve labor cost-efficiencies and (2) identify strategies to improve health among enrollees. We describe an analytic framework design that automates several empirical methods and provides recommendations for increasing healthcare access for Alabama Medicaid Agency (AMA) enrollees. The described framework, which includes descriptive and prescriptive elements, has been successfully used to inform various day-to-day analyses conducted by AMA’s Analytics Department and comprehensively analyze AMA-enrolled youths’ accessibility to licensed dentists. Specifically, in the dental context, the framework assisted in identifying (1) dental procedures that were ideal candidates for increased reimbursement payments and (2) geographical locations that AMA should target for interventions to improve physical access to care for AMA’s youth enrollees. The insights offered by the framework for dental care impact more than 0.5 million underserved youth and roughly $90 million of annual revenue for licensed dentists through reimbursements. History: This paper was refereed. Funding: D. Lewis, J. Parton, M. Hudnall, R. Tramp, X. T. Yang, and S. Samsel received salary support from the Alabama Medicaid Agency during the execution of this study. B. Cambron, T. Tyner, N. Biligowda, and D. Rush were employed at the Alabama Medicaid Agency during the execution of this study. The other authors do not declare the receipt of funding associated with entities affiliated with this study.