DataNet supported the mission of the DC Health Benefit Exchange Authority (HBX) to implement a health care exchange program in the District of Columbia in accordance with the Patient Protection and Affordable Care Act (PPACA), thereby ensuring access to quality and affordable health care to all DC residents.

Widely acclaimed as the Nation’s Best, DCHBX, with the help of several committed and competent DC based CBE’s like DataNet, built a uniquely optimized and customer focused health care exchange program that enabled individuals and small employers to find affordable and easier-to- understand health insurance and assist small employers in purchasing qualified health benefit plans for their employees. The exchange facilitated the purchase of qualified health plans and assist individuals and groups to access programs, premium assistance tax credits and cost-sharing reductions.

DataNet still continues to support the customer side of the DC Health Link program.

Related Content:
Securing a Healthier Future for the District of Columbia Medicaid Changes Under the Affordable Care Act DC HBX Establishment Act - DC Law 19-0094

States have been looking for innovative ways of improving the effectiveness of providing Medicaid services. DataNet understands the responsibility of the states to effectively utilize their taxpayer funds while still providing reliable healthcare to some of America's neediest citizens - one of the ways of doing this is improving the communication between government institutions, care providers, and the Medicaid recipients. DataNet also realizes the proper healthcare information exchange can help keep America running and that its improvement can come about with innovative information technology solutions.

As with its other healthcare IT work, DataNet strives to combine its 20+ years of IT experience with its network of healthcare expertise. DataNet builds trendsetting electronic infrastructures around which coordinated and customized healthcare informatics tools are built. All of this is done in such a way to alleviate the funds spent on administering and overseeing healthcare delivery and divert it back to those that need it the most - primary care providers, pharmacy networks, and clinician services. DataNet achieves this with the help of its partner network by implementations of:

  • EMR's that will reduce patient error rates
  • Electronic clinical decision support tools
  • E-prescription systems that not only fax information but actually securely transfer data
  • Security frameworks that authenticate users, authorize access to specific services, and ensure confidentiality and integrity of messages
  • Methods to reduce fraud, waste and abuse such as improper Medicaid payments
  • Policies for identity management, non-repudiation, patient data privacy and consent management

Overall, DataNet's team of subject matter experts, IT resources, and federal and state Medicaid experience will empower healthcare networks to improve or institute their healthcare information exchanges.

Like other organizations around the world, U.S. federal and state governments are trying to marry current technology with their massive amounts of Medicaid data to create up-to-date Medicaid Management Information Systems (MMIS). Governments face a problem in the Medicaid sector that has plagued several other government agencies: converting their legacy systems into state-of-the-art healthcare technology that benefits the state, providers, and Medicaid recipients. However, such legacy data conversions are not typical conversions; they require astute knowledge of the workings of the various subsystems of the MMIS and an ability to identify and correct for data errors from waste and abuse.

DataNet, with its long history in web-based application development and healthcare expertise, provides strong support to any state's MMIS fiscal agent. DataNet can help state or private clients with their Medicaid management in the following ways:

  • Providing resources to execute projects
  • Maintaining newly developed systems
  • Designing and developing components or applications to existing systems
  • Providing subject matter expertise in specific Medicaid issues

Overall, DataNet brings its high-touch, small business niche support to a large, complex system. With Medicaid experience at the state and federal levels, DataNet provides an edge that many businesses of similar size and scope do not have.

A new DataNet initiative involves a collaboration with healthcare experts to use IT to establish systems for fraud, waste, and abuse detection and control. In the U.S. healthcare system, particularly in areas such as Medicaid, claims or services are paid inappropriately, leading to a misuse of taxpayer funds.

In the area of fraud, waste, and abuse, DataNet builds on such experience as EPSDT tracking systems, Medicaid management information systems, and HIV/AIDS data management to create systems that focus on review, detection, audit, recovery, training and outreach. Such custom-developed systems or COTS solutions may include:

  • Database engineering support services in support of data mining and analytics
  • Risk assessment and report generation services
  • Quality Assurance/Testing
  • Security services
  • Health quality metrics
  • Web-based fraud, waste, and abuse detection systems

DataNet works in the interest of government and institution programs to provide innovative healthcare IT support in the elimination of fraud, waste, and abuse.