The availability of Medicaid claims data through the New York Public HIEs has been long anticipated. Back in 2016, NYSDOH selected Healthix and three other New York State RHIOs (Bronx RHIO, Hixny, and HealtheConnections) to participate in the pilot to integrate Medicaid claims data into the HIE. Healthix was the only of the four to pursue a full integration model.
Healthix is excited to announce that we can now know which Medicaid patients the state has attributed to which DSRIP PPSs. This means Healthix can leverage Medicaid data to assist in triggering alerts and provide patient/member matching. Healthix can not expose actual claims data to Participants until the Department of Health provides final approval. When the DOH gives this approval, the clinical (but not financial) content of claims data will be fully available in the Healthix Portal and through secure exports (C-CDA, alerts).
Medicaid data may include clinical data from claims coming from providers not currently contributing data to the SHIN-NY as well as pharmacy claims data, which represents filled prescriptions. Having this data available will support New York State’s Performing Provider Systems (PPSs), by creating a more cost efficient and effective Medicaid program.