Medicaid Interagency Services Agreement

CHSRA provides and assists Medicaid in: research, analyses, policy development, quality initiatives, project management, and medical & behavioral health consulting. Broadly this includes:

  • Modeling health care utilization and costs for use in rate setting and managing the various health care programs operated by DHS
  • Providing ongoing professional medical, pharmaceutical and project management consultation services
  • Serving as a liaison and providing access to University of Wisconsin resources, as needed
  • Other analytic support and requested research

Examples of recent evidence based Medicaid consultation, analysis and policy support research:

  • Ambulatory Sensitive Conditions
  • Anti-psychotic prescribing
  • C- Section & adverse outcome births (LBW)
  • Episode Treatment Groups
  • Evaluate single-specialty Health Homes
  • Excessive use of CAT, PET imaging
  • Gender bias in AIDS/HIV care
  • HEDIS measures
  • High Impact Procedures & Pharm. prescribing patterns
  • Hospital Readmits within 2-30 days by DX and DRG
  • Medicare - Medicaid price rationalization
  • Medicare “never events”
  • Multiple billings within 24 Hrs. for single ER visits
  • Multiple ER visits (e.g. Mental health, pain patients)
  • Prioritizing health services (e.g. Oregon state)

Project Duration: 7/1/2008 - present

Primary Personnel

Principal Investigator: Robert Stone Newsom
Contact Person: Robert Stone Newsom

Sponsoring Agency

DHS, Division of Medicaid Services, Formerly DHCAA – Division of Health Care Access and Accountability.

Links

Centers for Medicare and Medicaid Services (CMS)
DHS, Division of Medicaid Services

Presentations/Publications

Research & Publications, State of Wisconsin Bureau of Benefits Management, Division of Health Care Access & Accountability (DHCAA) Medicaid Division

  • Newsom, RS. “Wisconsin Medicaid AIDS/HIV Health Home SPA Two Years Post-Implementation: Effects of Beneficiaries Gender, Age, County, and Persistent FFS / HMO Membership on Costs, Utilization and Chronic Disease.” Center for Health Systems Research & Analysis, V1.0, UW-Madison, under contract with the Bureau of Benefits Management, DHCAA, State of Wisconsin, 4/1/16
  • Newsom RS, “Exploration of Evaluative Analyses & Methods: Claims-Based Options for the AIDS/HIV-Medicaid Health Home SPA, Exploring FFS Medicaid External Control Groups, Study II, 11/2014. Also the Urban Institute, Feb. 2015 and the National Academy for State Health Policy, Aug. 2015
  • Newsom, RS “Exploration of Evaluative Analyses & Methods: Claims-Based Options for the AIDS/HIV-Medicaid Health Home SPA, CDPS revision, Study 1, 7/25/14. Also the Urban Institute, Feb. 2015.
  • Newsom, RS "WI Medicaid Super-Utilizer Populations: Report I History, Methods, Data strategies". Research report, prepared for Director, WI Bureau of Benefits Management, DHCAA. Jan., 2014.
  • Newsom, Kilburn. "Finding Value & Cost savings by Reducing Payment Variation" A White Paper". Prepared for WI Bureau of Benefits Management, DHCAA Sept, 2013.

Selected white papers, original research & analyses: State of Wisconsin Medicaid Program (Proprietary to WI Division of Health Care Access & Accountability)

  • Newsom, “Healthcare Cost Variation Effect on Value Measurement” , DHCAA Management Team, 2013
  • Newsom, Kilburn “Identification and Amelioration of High Impact Procedure Codes” , DHCAA Management Team, 2013
  • Newsom, Kilburn “Multiple ER Visits (e.g. Mental health, pain patients)”, , DHCAA Management Team, 2010, 2012
  • Newsom, Collins “WI Anti-psychotic Drug Prescribing”, , DHCAA Management Team, 2012
  • Newsom, “ER use for Dental Related Services”, DHCAA Management Team, 2011
  • Newsom, “Trends in the Overall Performance of Wisconsin’s Family Care and Waiver Medicaid populations” DHCAA Management Team, 2011
  • Newsom, “Episode Treatment Groups” , DHCAA Management Team, 2010
  • Newsom, “HEDIS Measures”, DHCAA Management Team, 2010
  • Newsom, Kilburn “Ambulatory Sensitive Conditions”, DHCAA Management Team, 2010
  • Newsom, Kilburn “Multiple Billings within 24 Hours for Single ER visits” , DHCAA Management Team, 2010
  • Newsom, Kilburn “Reverse engineering, adaptation and simulation on past WI Medicaid data of the State of Oregon Health Services Commission: Prioritization of Health Services plan software application” WI DHHS, 2010
  • Newsom, Kilburn, Beutel “C- Section & Adverse Outcome Births (LBW)” , DHCAA Management Team, 2010
  • Newsom, “Medicare - Medicaid Price Rationalization”, , DHCAA Management Team, 2009
  • Newsom, “Uses of the Oregon Priority List ” , DHCAA Management Team, 2009
  • Newsom, “Medicare Never Events” , DHCAA Management Team, 2009
  • Newsom, Kilburn, Collins “High Impact Procedures & Pharmacy Prescribing Patterns” , DHCAA Management Team, 2009
  • Newsom, Kilburn “Excessive Use of CAT, PET imaging” , DHCAA Management Team, 2009
  • Newsom, Kilburn “Hospital Readmits within 2-30 days by DX and DRG” , DHCAA Management Team, 2009

Consultant Publications as Robert Stone Newsom, PhD