State of Michigan
Department of Community Health

Using a Bull Services Business Intelligence Solution to
Deliver Better Health Care

As the largest department in the State of Michigan , the Department of Community Health (DCH) is responsible fore managing delivery of health care services to more than 1.2 million clients and overseeing an annual budget of approximately $10 billion.   DCH administers many of the state’s most critical programs, including Medicaid, WIC, and child immunizations.

With a BI data warehouse as its backbone, DCH has integrated nine separate health-related agencies into a single environment.   Many of DCH’s clients are enrolled in multiple programs supported by the department.   However, prior to the BI data warehouse, it was virtually impossible for DCH to track and monitor services and costs associated with a single client through these separate health-related agencies included under the DCH umbrella.   Today, thanks to the BI solution, users across these agencies are able to track and monitor health care recipients and providers for access, quality, and cost.  

The DCH BI solution has been instrumental in improving the delivery of health care services, determining which programs are most effective, detecting fraud and abuse, reducing overall costs to taxpayers, and predicting Michigan ’s health care needs for years to come.  

The advanced health care analysis capabilities of the system enables geographic analysis, cost/benefit analyses of specific health care services, and patterns of services and expenditures by provider, specialty, county, age, and many other categories.   These help DCH make decisions about programs, providers, fees, and level of care in a more timely manner, based on a “total view” of services a recipient is receiving, and an overall pattern in a particular category (e.g., age, geography, etc.).

In addition, the enterprise BI data warehouse is used for monitoring the performance of DCH’s carve-out programs, like the Pharmacy Benefit Manager (PBM).   This ensures that there is an independent verification of the information the contractor is providing to the state.   With more and more responsibility for managing millions and millions of dollars of Medicaid/HHS expenditures being assumed by third parties, this capability is crucial for state and agencies to most efficiently manage these programs.

Here are just a few examples of how the information sharing in this integrated environment is helping DCH and the State of Michigan :

• Identification of coverage overlaps to reduce the number of instances where individuals are obtaining similar or duplicate services across multiple programs.   Reducing and eliminating these overlaps helps to deliver a higher quality of service for individuals and enhance opportunities for cost savings and/or additional federal funding.
• Eliminating inappropriate payments; for example, coordinating eligibility with lists of deceased residents is an important fraud issue.
• Enhancing the State’s capability to measure, analyze, and improve the effectiveness of major program initiatives, such as managed care, and the use of prescription drugs by Medicaid beneficiaries.
• Enhancing the monitoring the evaluation of the performance of managed care plans to encourage strong performers and improve under-performers.

These capabilities have provided Michigan with the following benefits:

• An estimated annual savings of between $75 million - $100 million through health care analysis (forecasting, identifying program overlap, assessing quality of service, track and substantiate savings in pharmacy costs, etc.)
• A 25% reduction in Medicaid administrative costs thanks to DCH’s ability to obtain rapid responses to queries, combine resources, and streamline operations.
• A doubling of DCH’s identification of fraudulent Medicaid activity thanks to the ability of the DSS to analyze and interpret provider and recipient patterns of claims, spending, etc.
• The launching of the Michigan Children’s Action Network (CAN), a Governor’s initiative that links health, human services, education, corrections, parole, and foster care data to improve the educational performance of at-risk children and schools.

The Michigan Department of Community Health has received awards from the National Association of State CIOs (NASCIO) and The Data Warehousing Institute (TDWI) for its use of the enterprise BI data warehouse.

Click on the links below for more information on State of Michigan BI solutions:

Michigan Department of Human Services benefits from the BI solution

Michigan State Courts benefit from the BI solution