改善国家医疗补助机构准入的分析框架

IF 1.1 4区 管理学 Q4 MANAGEMENT
Dwight Lewis, 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 Parton
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引用次数: 0

摘要

分析可以帮助确定战略,以提高人口保健服务的公平性和能力。然而,许多政府机构面临着繁重的工作量、有限的继续分析教育时间以及合同员工之间的员工流动等挑战。因此,简化分析工作流程有可能(1)提高劳动力成本效率和(2)确定改善参保人健康的策略。我们描述了一个分析框架设计,使几个经验方法自动化,并为增加阿拉巴马州医疗补助机构(AMA)登记者的医疗保健访问提供建议。所描述的框架,包括描述性和规范性的元素,已经成功地用于AMA分析部门进行的各种日常分析,并全面分析AMA注册的年轻人对持照牙医的可及性。具体而言,在牙科方面,该框架有助于确定(1)牙科手术是增加报销支付的理想人选;(2)AMA应该针对哪些地理位置进行干预,以改善AMA青年参保者获得医疗服务的实际途径。牙科保健框架提供的见解影响了50多万得不到服务的年轻人,并通过报销为持牌牙医带来了大约9000万美元的年收入。资助:D. Lewis, J. Parton, M. Hudnall, R. Tramp, X. T. Yang和S. Samsel在本研究执行期间获得阿拉巴马州医疗补助机构的工资支持。B. Cambron, T. Tyner, N. Biligowda和D. Rush在本研究执行期间受雇于阿拉巴马州医疗补助机构。其他作者没有声明收到与本研究相关的实体的资助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analytic Framework to Improve Access for a State Medicaid Agency
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. 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.
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