State of California formally accepts Bull Services’ Medicaid Solution

Successful implementation of largest Medicaid data warehouse in the nation will help California manage $38 billion program and more than 6.6 million beneficiaries

The State of California has formally accepted the Bull Services Next Generation (NextGen) Management Information System/Decision Support System (MIS/DSS) Business Intelligence solution to help manage its $38 billion Medicaid program, known as Medi-Cal.

The solution, which went “live” in the spring, is designed to more efficiently manage the Medi-Cal program, save money for California taxpayers, and improve health care services for millions of Californians.

It is the largest Medicaid data warehouse in the nation, containing more than three billion Medi-Cal eligibility, claims, and provider records in a relational database.

Bull Services has implemented similar solutions in Michigan, Illinois, New York, Minnesota, and Utah, which have helped these states realize more than $2.5 billion in combined financial benefits—many times their initial investments—and achieve breakthrough results in health care quality and outcomes.

With the successful implementation of the California solution, Bull Services’ BI solutions now help manage Medicaid programs that cover one of four Medicaid recipients in the United States (15 million of 59 million) and account for more than one of three Medicaid dollars expended nationwide ($115 billion of approximately $325 billion). Bull Services’ BI solutions have been recognized by the National Governors Association (NGA), the National Association of State CIOs (NASCIO), and The Data Warehousing Institute (TDWI).

Supports More Beneficiaries than Any Other Medicaid Program in Nation

As the primary funding source for health care services provided to low-income adults and children, elderly, and disabled persons, Medi-Cal is responsible for providing the care and improving the overall health of approximately one out of every five Californians. With more than 6.6 million beneficiaries, no other Medicaid system in the nation covers as many people as Medi-Cal does.

According to the California Department of Health Care Services (DHCS), the new Bull Services solution will help California continue among the nation’s leaders in:

• Managing medical assistance programs
• Delivering high quality health care in the most cost-effective settings
• Emphasizing prevention and early intervention
• Improving health care outcomes
• Uncovering and reducing fraud and abuse
• Improving day-to-day program management and monitoring
• Modeling future strategic initiatives

The California solution will usher in a broad level of analytical capabilities for DHCS, enabling the department to conduct sophisticated trend analyses and predictive modeling — all designed to reduce cost and improve health services. Within DHCS, there are more than a dozen divisions that will benefit from the MIS/DSS, including Audits & Investigations, Systems of Care, Managed Care, and Pharmacy. The system will provide executives, program managers, analysts, and staff with rich capabilities in managing DHCS business.

It will be a key tool to manage and monitor the future of California’s Medi-Cal program by providing a user-friendly, state-of-the-art design to support future enhancements that can help DHCS successfully meet program and policy goals.

Numerous Data Sources Linked for Advanced Analytics

The NextGen MIS/DSS contains Medi-Cal data from many sources (e.g., fee-for-service claims paid by the Fiscal Intermediary; manage care encounters submitted by health plans) that provide services to Medi-Cal beneficiaries and other departments within the Health and Human Services Agency that administer specific Medicaid-funded programs (for example, the Departments of Mental Health, Public Health, Social Services, and Developmental Services).

Because the NextGen MIS/DSS is so data rich, it can be used for a variety of analytical purposes, including providing information for ongoing and ad-hoc reports to state and federal control agencies, such as the Legislative Analyst’s Office (LAO) and the federal Centers for Medicare and Medicaid Services (CMS).

The system has 10 years of California Medi-Cal data that is more than four terabytes. It will refresh on a monthly cycle, replacing the oldest month with the most currently available month, while maintaining a full 10 years’ worth of Medi-Cal data, making it the largest repository of integrated data in the health and human services environment.

The NextGen MIS/DSS solution is part of a four-year, $44 million contract that calls for Bull Services — the nation’s leading Business Intelligence solution provider in the public sector Health and Human Services space – to provide the hardware, software, services, and consulting expertise for the Medi-Cal system.