Healthcare Analytics for Indiana Hospitals and Clinics

Indiana operates approximately 115 acute care hospitals across a state where cardiovascular disease, high smoking rates, and obesity create an outsized chronic disease burden on every health system. Indiana University Health, the largest health system in the state at 16 hospitals, anchors the Indianapolis market alongside Community Health Network, Ascension St. Vincent, and Franciscan Health's 12-hospital network. Parkview Health dominates Northern Indiana from its Fort Wayne headquarters with more than eight hospitals. Rural Southern Indiana presents a different challenge: lower incomes, higher rates of opioid dependency, fewer hospital resources, and communities that have lost manufacturing jobs without gaining the economic diversification that has come to Indianapolis.

Indiana Medicaid operates through two main programs: Hoosier Healthwise for children and pregnant women, and the Healthy Indiana Plan 2.0 (HIP 2.0) for expansion adults — one of the most analytically unusual Medicaid programs in the US. HIP 2.0 requires member contributions to Personal Wellness and Responsibility (POWER) accounts as a condition of receiving enhanced benefits. Tracking member contribution compliance, lock-out periods for non-payment, and the interaction between POWER account status and benefit coverage creates analytics requirements that no commercial claims system was built to handle. MCOs administering HIP 2.0 — including Anthem BCBS Indiana, MDwise, and Managed Health Services — each handle these requirements differently, creating additional analytics fragmentation for providers.

Indiana Medicaid is administered by the Family and Social Services Administration (FSSA) through two primary managed care programs: Hoosier Healthwise for families and children, and HIP 2.0 for Medicaid expansion adults aged 19-64. HIP 2.0 operates under a CMS 1115 waiver with unique member cost-sharing requirements and benefit tier structures that create reporting obligations unlike any other state's Medicaid program. MCOs — Anthem BCBS Indiana, MDwise, and Managed Health Services — hold risk contracts and impose HEDIS quality reporting on contracted hospitals and physicians.

Indiana providers also participate in CMS value-based care initiatives, and IU Health's academic role creates research reporting obligations. The state's high opioid burden has generated specific waiver reporting requirements for substance use disorder treatment. MIPS quality reporting applies to Indiana physician practices, and CMS readmission reduction penalties have significant financial impact given Indiana's elevated rates of cardiovascular readmissions relative to national benchmarks.