HHS Medicaid Transformation Grants

On January 25, 2007, HHS released notification of awards to 27 states to fund new ways of improving Medicaid efficiency, economy, and quality of care through the development and enhancement of "innovative systems to get more value out of the money they [the states] spend providing care to their low-income elderly, chidren and disabled citizens."

Among the "permissable" uses of grant funds were:

• Reducing patient error rates through the implementation of technology (electronic health records, clinical decision support tools or e-prescribing programs).
• Improving rates of collection from estates of amounts owed under Medicaid.
• Reducing waste, fraud, and abuse under Medicaid, such as reducing improper payment rates. Increasing the utilization of generic drugs through education programs and other incentives.
• Improving access to primary and specialty physician care for the uninsured using integrated university-based hospital and clinic systems.
• Implementation of a medication risk management program as part of a drug use review program.

The primary source links are:

• Follow this link for the HHS press release of 25-January
• Follow this link for the details (some of the URLs are not accurate as of 1-26-07)
• Follow this link for the zip file for states A-I
• Follow this link for the zip file for states J-R
• Follow this link for the zip file for states S-Z
• Follow this link for a nice table and discussion from the Commonwealth Fund
  

The proposals are an interesting mix. Many emphasize health information exchange and some of these link such proposals with e-prescribing. The dominant health information exchange proposals include:

• Arizona - $11,749,500
• Connecticut - $5,000,000
• DC - $9,864,000
• Kentucky - $4,987,583 (primarily claims-based systems)
• Wisconsin - $3,043,272
• Total - $34,644,355
  

Others emphasize this topic to lesser degree - and some - like New Mexico and Tennessee - are restricted to e-prescribing.

Summary of grants from the CommonWealth Fund States in Action (March / April, 2007)

Focus of Grant	Number of Grants	State Grantees
Electronic medical records or health information systems and exchanges	13	AL, AZ, DC, HI, KY, MI, MN, MT, NM, TX, WV (2), WI
Pharmacy HIT tools	7	CT, FL, NM, ND, TN, UT, WV
Electronic verification of citizenship	4	AR, MA, MI, RI
Promoting good health and personal responsibility	2	WV (2)
Predictive modeling system	2	IL, KS
Program integrity (fraud reduction)	2	MD, NY
Medical information for children	1	NJ
Health provider credentialing	1	MI
Medicaid estate recovery	1	IN

A complete table listing can be found at the link above and is included below.

State Name	Project Name	Total Funded
Alabama	Together for Quality - Health Information Systems	$7,587,000
Arizona	Medicaid Health Information Exchange Utility Project	$11,749,500
Arkansas	Electronic Verification of Proof of Citizenship	$285,513
Connecticut	Health Information Exchange and e-Prescribing	$5,000,000
DC	Comprehensive Medicaid Integration (Patient Data Hub)	$9,864,000
Florida	GenRx Expansion	$1,737,861
Hawaii	Open Vista ASP Network	$3,188,535
Illinois	Predictive Modeling System	$4,849,200
Indiana	Medicaid Estate Recovery Centralization and Automation Project	$124,880
Kansas	Using Predictive Modeling Technology to Improve Preventive Healthcare in the Disabled Medicaid Population	$906,664
Kentucky	Health Information Partnership	$4,987,583
Maryland	Automated Fraud and Abuse Tracking	$576,228
Massachusetts	Secure Verification of Citizenship through Automation of Vital Records	$3,950,440
Michigan	One Source Credentialing	$5,208,759
Michigan	Expansion of Vital Records Automation and Integration Into Medicaid	$3,929,317
Minnesota	Communication and Accountability for Primary Care System (CAPS)	$2,843,340
Mississippi	As One - Together for Health	$1,688,000
Montana	Enhancing EHR - Clinical Decision Making	$1,481,152
New Jersey	Medical Information for Children	$1,516,900
New Mexico	e-Prescribing	$855,220
New Mexico	Electronic Health Record Project	$712,301
New York	Fingerprint Authentication at Point of Service	$5,500,000
North Dakota	Web-based Electronic Pharmacy Claim Submission Interface	$75,000
Rhode Island	IT Infrastructure Transformation	$725,253
Tennessee	Electronic Prescription Pilot Project	$674,204
Texas	Electronic Health Passport for Foster Care	$4,000,000
Utah	Developing a Pharmacotherapy Risk Management System with an Electronic Surveillance Tool	$2,881,662
West Virginia	Healthier Medicaid Members through Personal Responsibility	$1,937,110
West Virginia	Healthier Medicaid Members through a Stronger Medicaid Program	$1,731,680
West Virginia	Healthier Medicaid Members through Health Systems Improvement	$3,895,730
West Virginia	Healthier Medicaid Members through Applied Technology	$1,766,280
West Virginia	Healthier Medicaid Members through Enhanced Medication Mgmt	$4,287,110
Wisconsin	Health Information Exchange Initiative	$3,043,272
Total		$103,559,694