In the weeks before the 12th annual Stewards of Change symposium, many of us are anticipating a somewhat anxious conversation about health and human services systems reform. Supporters of the measures within the Affordable Care Act that promote better sharing and use of data are mindful that Congress has recently taken a first step towards repealing it. And it remains uncertain whether the new administration will continue to provide the regulatory guidance and leadership that have pushed agencies to integrate their administrative data as part of the bi-partisan agenda for more evidence-based policy over the past decade.
The good news is that, while important federal decisions remain in limbo, state and local leaders have not waited to put the integrated data systems (IDS) they’ve already developed to practical use. The Annie E. Casey Foundation just released a series of case studies documenting several examples of how integrated data systems are improving care coordination, program evaluation, policymaking, and the design of new initiatives:
- In Washington, health care providers are using a predictive modeling tool known as PRISM to improve service delivery and allocate resources more efficiently among a high-risk caseload eligible for both Medicare and Medicaid. Drawing on information from multiple data sets stored and linked in the state’s IDS, PRISM identifies a subset of high-risk clients who are most likely to benefit from intensive, coordinated care management. Early results from a demonstration program show a savings of $21 million in Medicare expenditures among eligible individuals relative to a comparison group.
- Researchers in Wisconsin used an IDS developed by the Institute for Research on Poverty to demonstrate that the state’s policy of pursuing child support orders against parents whose children were removed from the home by child welfare services not only failed to reduce total costs, but actually lengthened the time children spent in foster care. Based on these findings, the Department of Children and Families is currently revising its policy on referring parents to child support enforcement when their child is in out-of-home care. Under the revised policy, a referral will be sent to the local child support agency only if the child has been in out-of-home care for at least six months and the parent is not making progress toward reunification.
- Cuyahoga County in Ohio used an IDS built by Case Western Reserve University to develop the country’s first county-level pay-for-success initiative, Partnering for Family Success. The program provides a mix of housing assistance and housing resources, behavioral health services, an innovative trauma support intervention and intensive case management to homeless mothers who have children in the child welfare system. If the intervention succeeds in reducing the number of days children in the program group spend in care by 25 percent, it could save the county $4.3 million in child welfare costs over five years.
These are applications of shared data that get better results for kid and families. And they are results that are available now to leaders to want to follow the increasingly well-marked path towards integrating their own health and human services data. To acknowledge and encourage more of this good work, the Annie E. Casey Foundation compiled some key resources, research and other real-world examples of integrated data systems in action, and created a video introducing the concept.
As we gather in Baltimore to try and peer into the fog ahead of us and to chart a course through it, let’s also take advantage of the opportunity to mark the distance we have traveled – and to add to this list of places where better data is already helping public leaders create better communities.
Chris Kingsley is a senior consultant to the Annie E Casey Foundation.