Leveraging Medicaid Claims to Map Complex Chronic Conditions for Emergency Preparedness.

Area of Science:

• Public Health
• Health Informatics
• Emergency Management

Background:

• Medicaid enrollees with complex chronic conditions (CCCs) and technology dependence are at high risk during disasters.
• States often lack systems to rapidly identify these vulnerable populations for disaster planning.

Purpose of the Study:

• To develop and implement a claims-based method for identifying Florida Medicaid enrollees with CCCs, including those requiring medical technology.
• To support emergency preparedness and response activities for vulnerable populations.

Main Methods:

• Utilized the Florida Medicaid Management Information System and a validated code framework to classify enrollees into 12 CCC categories.
• Analyzed data by age, geography, and technology dependence.
• Provided real-time reports to health plans before and after hurricanes (2022-2024).

Main Results:

• Identified 7.2% of 4.4 million enrollees with CCCs; 18.2% of these were technology-dependent.
• Geographic mapping revealed higher concentrations in disaster-prone rural and coastal areas.
• Health plans used the data for member outreach and service coordination during hurricane recovery.

Conclusions:

• Demonstrated the feasibility and utility of using claims data for disaster management.
• This approach can be adapted by other states to enhance emergency response and continuity of care for medically vulnerable Medicaid populations.