Get Real-Time Visibility Into Medicaid Member Activity
Medicaid agencies run on claims and encounter data that lag weeks to months, with no real-time view of where members get care across MCOs and settings.
Data Lag Impacts Care and Costs
State Medicaid agencies own cost, oversight, and outcomes across a fragmented system, yet most work from claims and encounter data that lag weeks to months. With limited real-time visibility across Medicaid care settings, they act only after utilization and cost have risen, especially among high-need members. PointClickCare lets agencies sponsor a connected, real-time view across acute and post-acute care, moving them from retrospective reporting to timely action.
Fragmented Visibility Limits Program Impact
Lagging Data
Fee-for-service claims and delayed encounter data in Medicaid arrive weeks to months too late to act on.
Limited Oversight
Agencies depend on self-reported plan data with limited real-time verification.
Cross-MCO Fragmentation
Member activity is spread across plans, providers, and settings with no unified, real-time view.
Members With Complex Care Needs
Dual-eligible and high-need populations drive disproportionate utilization, but limited real-time data delays action.
PAC Management IQ
PAC Management IQ gives plans and providers serving Medicaid members real-time visibility into post-acute care, the setting agencies see least, where high-cost utilization concentrates. Teams act on readmission risk during the stay.
Additional Solutions for Medicaid Populations with Complex Needs
Emergency Department IQ
Emergency Department IQ supports statewide efforts to reduce avoidable utilization. It helps care teams see emergency department (ED) activity, understand patterns of use, and coordinate interventions for individuals who may need follow-up, behavioral health support, SUD support, or connection to more appropriate care settings.
Product Capabilities:
Real-time ED event visibility for admissions, discharges, and transitions that need timely follow-up.
High-utilizer and risk pattern identification to prioritize individuals who may benefit from coordination.
Care team coordination to support follow-up after acute events and reduce gaps during transitions of care.
Program insight into utilization trends tied to priority populations and statewide initiatives.
Care Response IQ
Care Response IQ supports state and public health agencies during emergencies by providing secure, real-time access to patient health information in field environments. It enables care teams to deliver informed care, coordinate response efforts, and maintain continuity for displaced or high-risk individuals during disasters and large-scale events.
Product Capabilities:
Track individuals across shelter environments with check-in and check-out visibility.
Support reunification by linking shelter, hospital, and ED activity to identify patient location.
Notify providers when individuals receive care in shelters or emergency settings.
Improve coordination of follow-up during and after disaster response.
Talk to an Expert
Connect with a PointClickCare expert for solutions that can help state programs act on high-risk populations in real time.
Explore Resources
Explore insights on Medicaid priorities, care coordination, and real-time data strategies for improving statewide outcomes.