Michigan Expansion of Vital Records Automation and Integration into Medicaid Abstract

In 2007, 27 states received Medicaid Transformation Grants under Section 6081 of the Deficit Reduction Act of 2005. The grants were rewarded to states that proposed innovative methods which in the end of the two years are designed to produce better health outcomes at lower cost.

The Center for Health Transformation is highlighting states that have received these Medicaid Transformation Grants, and will be following their progress for the next two years. In order for key decisionmakers and industry leaders from around the country to learn from others’ successes, it is our intention to provide this resource in order to showcase innovative practices from across the nation. In the future, this site will be interactive, allowing program directors to submit updates and comments regarding their program.

Complete grant application >>

The BRS database has been developed to contain birth data for Michigan births, to issue official certified copies of vital records, to enable official amendments to the recorded data and to generally serve as the official source of legal “prima facie” information on the facts of each birth. The database currently contains full or partial records on nearly 9 million Michigan live births. This large database has been constructed by uploading legacy data that had been captured over a nearly 50 year period and under 13 different data file formats and four distinctly different processing systems. This significant effort to standardize these data into a single and uniform database has been very successful but has important limits. These limits do affect the value of the data and the ability to rely on the database to make appropriate administrative decisions on Medicaid cases.

The major goals of this project are to address the following database issues:

• Birth record data prior to 1989 contains only limited “index” information on the birth. This can significantly reduce the likelihood of a case worker positively locating a birth record.
• Records have been identified that are missing within the database. This means an unsuccessful search of the file is not conclusive evidence that the birth facts supplied are incorrect.
• The birth records within the files are not all properly linked to corresponding death record data.
• The current birth data interface screens were designed prior to the significant upgrades to the BRS, and were not originally designed to be used by Medicaid staff. This upgrade will enhance the ability of a case worker to perform citizenship validation online and avoid unnecessary effort and expense by the recipient or applicant.

Funds are requested for a project ($3,929,317) that has four specific outcomes and objectives relative to database improvement.

1. Improve DHS Citizenship Validation Capability – Revising the DHS Medicaid eligibility intake worker interface to BRS to improve birth fact validation from approximately 70% to 90-95%.
2. Improve the reliability of Medicaid BRS search results – Identifying and resolving missing BRS birth data will raise DHS online case verification rates and ensure reliable search results.
3. Link Death Records to Birth Records – Provide Medicaid intake and quality improvement staff a source of death information to identify applications using false identity.
4. Upgrade Interface Screens – Increase the ability of Medicaid staff to properly locate and confirm birth facts in BRS.