Off the Shelf TA

CP Impact on Health Utilization Outcomes

Despite all the data being shared by MassHealth, it is still a challenge for Community Partners (CPs) to both understand and present to ACOs how they are improving health outcomes for their assigned population. Hexplora brings its national experience working with health plans and MSSP ACOs to the Massachusetts health care reform initiative. Using EHR, ADT and MassHealth claims data, Hexplora’s analytics for both Behavioral Health and LTSS CPs provides population-based insights and enrollee-level actionable information. These insights are used by CPs to drive care coordination activities to improve population health outcomes.

The Health Utilization Outcomes suite of analytics easily visualizes several key health utilization measures: Inpatient Admissions, Emergency Department Visits, and Primary Care Provider (PCP) utilization. These outcomes are shown pre- and post-at the point of Participation Form Agreement or Care Plan Completion. In this way the CP can clearly answer a question: when enrollees engage with us, do we improve health outcomes? This allows the CP to show any stakeholder the clear and positive impact of CP enrollee engagement. This measure is one way of showing the health outcome value of a Community Partner program.

Hexplora can implement this analytic for a CP in a matter of weeks. Hexplora’s experience with multiple Massachusetts CPs and ACOs allows it to implement this functionality quickly and cost-efficiently.

ACOs and CPs would be able to customize the reporting based on what Utilization measures they like to see on the reports.




$25,000 - $75,000


Ongoing Availability


Solution blueprint in 2 weeks after data is shared, solution delivery in 4 weeks and customizations and support for 8 weeks


Either single or multiple participants (one ACO or CP per TA project OR multiple ACOs or CPs per TA Project)


Population Health Management