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Georgia DCH previews real-time Medicaid dashboards, data security and AI plans
Summary
Department of Community Health Commissioner Russell Carlson demonstrated a new DCH data platform intended to present near–real-time Medicaid enrollment, claims and quality dashboards, described security certifications and collaborations, and discussed using analytics for contract compliance and public-facing consumer tools.
Russell Carlson, commissioner of the Georgia Department of Community Health, and the agency’s chief information officer, Chad, demonstrated a new data platform and dashboarding capability the department intends to use for Medicaid oversight, procurement compliance and public-facing information. Carlson called it “our platform” and said it will “deliver all of our content” and provide a centralized presentation layer for stakeholders.
Carlson said the dashboards will show customizable, near–real-time metrics such as monthly Medicaid enrollment by age group and county, average claims per member per month, and quality measures including maternal-health encounters. He described the platform as intended to reduce lag in responses to legislative or stakeholder questions about enrollment, spending or program performance.
On data security and partnerships, Carlson said DCH has gone through a HITRUST assessment and is working toward high-trust certification; he said the department “scored 98.75 on the 19 domains, a 100% on 50dom” and that the secure environment allows DCH to bring partners such as Morehouse School of Medicine into the platform. He told members the secure platform will permit closer, internal monitoring of vendor and contract performance and reduce reliance on outside vendors to assemble compliance information.
During the demonstration, Carlson emphasized the platform’s procurement and contract-compliance applications: as new contracts and procurements come online, the department expects to use the dashboards to monitor vendor performance and apply penalties or incentives more consistently. “Before we could ask them to do a lot more, I think we all recognize the department's gotta be able to do a lot more to make sure we can enforce whatever we're asking of others,” Carlson said.
Committee members raised several operational questions. Representative Newton and others asked whether network adequacy metrics and geo-access calculations would deduplicate providers who operate at multiple offices; Carlson said the department has geo-access capability but deferred a detailed answer, and Chad said he did not have visibility on that item at the time. A legislator asked whether artificial intelligence would be used in the public interface to help consumers find services; Carlson said yes and described goals to route users to the appropriate resources and to produce content or requests on behalf of consumers where possible.
Members discussed how the tool could enable payors, providers and DCH to see performance metrics sooner and allow providers to respond proactively. Carlson said the department intends to evolve the platform’s capabilities and noted that additional procurements and system modernization efforts are underway that will feed into the enterprise capability.
