Medicare data helps ID high-risk populations in natural disasters

During natural disasters such as hurricanes, Medicare claims data is highly effective for identifying those individuals who are dependent on life-maintaining medical and assistive equipment and are at risk from prolonged power outages.

That’s the contention of Karen DeSalvo, MD, former National Coordinator for Health IT, who made the case for leveraging such beneficiary data in testimony on Wednesday before the Senate Special Committee on Aging, which held a hearing on disaster planning for older Americans in the wake of Hurricanes Harvey and Irma.

DeSalvo, who served as Health Commissioner for the City of New Orleans during Hurricane Isaac in August 2012, told the committee that she subsequently saw firsthand the benefits of Medicare data in June 2013 when the city and the Department of Health and Human Services piloted a first-in-the-nation emergency preparedness drill to—among other activities—respond to widespread power outages.

“We worked with HHS to leverage Medicare data and new technologies like geo-mapping to be able to create a map in our community of where seniors who were electricity-dependent lived,” she said. “We learned the Medicare data worked. It was accurate.”

DeSalvo added that of the more than 600 people that the claims data identified in the New Orleans area as using a home oxygen concentrator or ventilator, only 15 were on an existing medical special needs registry.

That successful pilot system—called emPOWER—has since been scaled by HHS and is available to first responders and public health officials around the country, not only in disaster response but also in preparing for events, according to DeSalvo.

The emPOWER initiative provides a publicly available and interactive map that integrates monthly de-identified Medicare data at the U.S. state, territory, county and ZIP code level, with real-time NOAA severe weather tracking services to identify the number of at-risk individuals who may be affected by natural disasters.

“It’s an example of how we can use technology and local experiences married, with federal resources to really do better in preparedness and response,” she observed. “In fact, HHS recently used this tool in Irma and Harvey.”

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Besides electricity-dependent individuals, DeSalvo said emPOWER’s medical claims data can also be used to “give us a sense of people’s health on a population level,” identifying those who are on dialysis or have ambulatory challenges and are wheelchair bound.

“In New Orleans when I was Health Commissioner—and we still use it regularly—it’s a way, for example, if there’s a boiled water advisory to target individuals who might be on special feedings or dialysis and we want to forewarn them,” she added. “So, it’s not just for electricity.”

However, DeSalvo warned that tools like emPOWER are only as good as the data that go into them. As a result, she called for expanding the tool to include not only Medicare data but data from Medicaid and private payers.

In addition, DeSalvo said that “Congress needs to support action on the ground” to test the use of emPOWER in communities across the country. “It’s one thing to have information in a box, but we have to also be able to act upon it on the front lines, and that requires training exercises, perhaps with local public health and the Public Health Service Commission Corps,” she concluded. “There have to be humans on the other end that can take that information and make use of it by making phone calls and going to people’s doors.”