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Data and Care Coordination - Case for Chapter 8 Bobbie Kite 531 You are the assistant clinical manager in a regional health plan in Houston, Texas. Your Chief Clinical Director (CCD) asked you to investigate how your health plan providers compare to other providers in the state in relation to costs. The Chief Executive Officer (CEO) is the eventual audience of this information so that they can decide where care coordination efforts should be focused during the next fiscal year. The CCD was a bit excited that the CEO didn't give a specific direction and said they heard rumors of publicly available datasets of surveys that will help to showcase key provider ratings on various specific areas. They asked that you prepare some numbers to reflect how the general practitioners and select specialists of your choice) compare to others in the state and provide specific information on clinical outcomes that relate to communication with providers. In addition, they requested you make some recommendations based on your findings and anticipate challenges the organization will encounter for each one as they embark on new care coordination efforts. Where to Start? What do you know about care coordination and what other organizations are doing? A first step that might be helpful would be to learn more about the topic, to define this, and to focus your search What three datasets on healthdata.gov are relevant to solving the challenge in this case study? How can you best present your findings and recommendations in an executive report? Hints: Demographics might include things like profitonprofit, clinical information might include specific patient populations, and administrative data is anything related to cost and/or business characteristics How will you define a question to ask and answer for your case study organization? What is that question going to be? The idea here is to use publicly available datasets to gain insight from the population that will in turn give evidence to specific opportunities for your organization. You will want to look for one dataset related to clinical measures, one dataset related to administrative data, and one dataset related to quality By navigating multiple datasets, it will illustrate how different environments affect the gathered data. It will be necessary to do a bit of research based on your case study to adequately complete this step. The purpose of this case study is to gain experience concerning how to think of data environments from differing perspectives and how to ask and answer questions from publicly available datasets that can translate into actionable items for a specific organization What are the steps you will use in each case study? This will depend on your case organization, the types of datasets you select, what question you decide to ask and answer, and your level of familiarity with presenting findings in executive reports. Discussion Questions 1. How do you determine what to compare between health plans? 2. What resources do you have available to handle the lack of direction you were provided? 3. Where would you find examples of "some numbers to help focus your search? How do you make an executive summary out of so much information? 532