Case Study
Empowering a Community Care Organization Through Data Integration and Analytics
Databridge Solutions helped a community care organization streamline its data management by integrating multiple data sources, automating workflows, and developing predictive analytics to improve care plan completion and reduce emergency visits. These enhancements strengthened stakeholder communication, increased operational efficiency, and ensured long-term success by demonstrating value and meeting performance metrics.
Our client, a community care organization specializing in care management for Medicaid members with complex social health needs, faced significant data management challenges. Tasked with improving health outcomes, enrolling members into care management, completing care plans on time, and reducing unnecessary emergency department (ED) visits and hospitalizations, the organization struggled to coordinate and utilize data effectively. Despite access to several software programs and databases, disorganized information hindered program efficiency and made it difficult to demonstrate value to stakeholders.

Challenges
Program Improvement
- Disjointed data from multiple sources created barriers to tracking performance and identifying opportunities
for improvement. - Meeting metrics such as care plan completion rates and reducing ED visits required a clear understanding of their performance compared to peer organizations.
Program Defense and Justification
- Insurers and government entities used incomplete or inaccurate data to question their performance.
- The organization needed robust analytics to refute these claims and emphasize their competitive strengths, such as specific strategies for reducing ED visits and hospitalizations.
Solutions
Databridge Solutions implemented a comprehensive data management and analytics approach tailored to the
client’s needs.
Data Integration and Cleanup
Databridge combined data from internal systems, ACO reports, state-provided claims, and common care management software (eHana). This process ensured the data was cleaned, validated, and ready for analysis.
Automated Processes
Manual data workflows were automated, enabling staff to focus on care delivery rather than administrative tasks.
Dashboard Development
Interactive Tableau dashboards were developed to consolidate data in an accessible format. Databridge collaborated with staff to ensure the dashboards addressed their specific needs and provided actionable insights, offering training for effective use.
Predictive Analytics
AI powered predictive models helped the organization anticipate resource needs and optimize staffing, improving overall performance.
Ongoing Support
Regular collaboration with staff included dashboard reviews, troubleshooting, and refining data solutions, ensuring continuous alignment with organizational goals.
Results
Improved Data Utilization
Consolidated data sources provided clarity on performance metrics and outcomes, enabling informed decision-making.
Enhanced Program Performance
Predictive analytics improved resource allocation, reducing ED visits and hospitalizations. Care plan completion rates and member engagement also increased.
Stronger Stakeholder Communication
Reliable data allowed the organization to counter insurer and government claims effectively and highlight their competitive advantages.
Operational Efficiency
Automated workflows reduced administrative burden, freeing staff to focus on direct care.
Business Success
Meeting performance metrics led to retained contracts, bonus payments, and more constructive stakeholder conversations.
Conclusion
Databridge Solutions empowered the client to transform their data challenges into actionable insights, enabling them to improve program performance, demonstrate their value, and strengthen their competitive position. By integrating and visualizing data, automating workflows, and providing ongoing support, the organization achieved better outcomes for Medicaid members and ensured its long-term success in the care management landscape.