Analytic Framework to Improve Access for a State Medicaid Agency

Dwight Lewis Jr,Nickolas Freeman,Irem Sengul Orgut, Thera Tyner,Ryan Tramp, Niranjan Biligowda,Matthew Hudnall,Xin Thomas Yang,Thomas English,Marilyn Whitman, Steven Samsel,James Cochran, Barry Cambron, Danny Rush, Kumari Seetala,Jason Partonb

INFORMS JOURNAL ON APPLIED ANALYTICS(2023)

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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.
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