2018 State HIT Connect Summit

Following its strategic plan, the West Virginia Bureau for Medical Services (BMS), a division of the West Virginia Department of Health and Human Resources (WVDHHR), is in the midst of re-aligning its healthcare infrastructure to address the three-part strategic goal of better health, better care, and lower costs. An efficient and effective healthcare system must be built on three inter-related goals:

● Better health: West Virginians can reach improved health and productivity through a renewed focus on addressing the root causes of poor health including lack of preventive care, physical inactivity, and poor nutrition.

● Better care: West Virginians should always get the right care, in the right place, at the right time. Yet, there is widespread agreement that the health care system as currently structured results in both missed opportunities for care and the provision of unnecessary, and sometimes harmful, health care services.

● Lower costs: West Virginia can lower the total cost of health care per person throughout the system –including Medicaid, CHIP, Public Employees Insurance Agency (PEIA), and private insurance – by improving the efficiency of care and reducing waste and duplication.

With the growing availability of health data, West Virginia’s healthcare delivery is moving beyond individual care to population health management. Using technology and analytics, population health management shifts care from immediate treatment to predictive and preventive care. To this end, the Bureau is working toward implementing a Universal Data Vision consisting of comprehensive data structures into which data from many sources can be easily imported. A variety of modules (per CMS2392-F §433.111(h)) will be used to mine the data structures to perform analytics and generate reports, and BMS is in the midst of implementing its first module – a Quality Rating System (QRS) per CMS 2390-F§438.334. A Universal Data Vision facilitates the shift to predictive and preventive care.