2024 SAG Award Winners

Inland Empire Health Plan

View Photo(s) of Award Presentation

Project Goal

Inland Empire Health Plan is constantly searching for better, more efficient ways monitor and report on provider network adequacy. As state regulators become more proficient in GIS, reporting requirements become more complex. It's important to remain innovative in addressing the evolving requirements.
The goal for this project was to design a process that accurately assesses the IEHP provider network in relation to enrolled members. Membership needed to be represented in a way that the process would run quickly and efficiently. It was also vital to incorporate the current convention of using Representative Population Points (DHCS dataset)into the new process so that time / distance could be calculated for potential members.
Learn more about us

Business Problem Solved

Inland Empire Health Plan was able to develop a process that aggregated membership to hexagons that had been "segmented" by by zip code. A centroid was created for each segment so that it could share the attributes of the segment (Grid ID, Zip Code, County, Member Count) via a spatial join. The Representative Population Points were then appended to the centroids to create the analysis layer (Origins) used in the OD Cost Matrix. A python script was created in order to iterate through the provider feature class, by type, and load as the Destinations in the OD Cost Matrix. The results were written to a feature table so that the could be analyze within SQL.
Overall, efficiency was dramatically increased and reporting requirements were satisfied while maintaining a good representation of member location.

Technology Implemented

Esri ArcGIS Enterprise, ArcGIS Pro, Network Analyst, Business Analyst

Development Team Biography

Eric Dick works as an informaticist III with the Quality Systems Department, Health Care Analytics. His focus is on spatial and network analysis with an emphasis on provider network adequacy.

Darren Moser works as an informaticist with the Quality Systems Department, Health Care Analytics. His focus is on porvider auto assignment and quality reporting (HEDIS).