Competency Area #3: Access, apply, and exchange data across all entities involved in MassHealth member wellness and care
The key elements that comprise Competency Area #3 are outlined below. These can be used as touchpoints in determining whether your TA project helps advance your ACO or CP in this competency.
Access and apply data in support of care design, quality improvement, risk stratification, and overall organizational decision making: ACOs and CPs access and apply MassHealth member data within their organizations in order to ensure that models of care, quality improvement activities, risk stratification models, evaluation approaches, and organizational decision making overall are grounded in a data-driven understanding of the health and social needs, complex care needs, and overall characteristics and preferences of the unique population(s) of MassHealth members they serve.
Exchange data with all entities involved in the care of MassHealth members: ACOs and CPs exchange MassHealth member data, as appropriate, across all entities involved in member wellness and care, including hospitals, specialist providers, oral health providers, state agencies, social service agencies, and community-based organizations, as well as the entities that comprise the ACO or CP, in order to ensure comprehensive, coordinated care and services for every MassHealth member enrolled in their ACO or CP.
ACO/CP Integration: ACOs and CPs exchange and apply MassHealth member data across ACO-CP partnerships in order to ensure that MassHealth members with complex behavioral health, long-term services and supports, and health-related social needs benefit from comprehensive and seamless systems of care.