24-Hour, Bilingual Nurse Line Provides Advice and Interpreter Services for Plan Members, Leading to Wiser Decisions and Cost Savings
Molina Healthcare, a Medicaid managed care organization, instituted a 24-hour bilingual advice line to address the health and language needs of its low-income, Spanish-speaking members; the program helped members make wiser choices, leading to fewer emergency department visits and significant cost savings.
Alliance Creates Community Health Workers’ Scope of Practice, Training Curriculum, Certificate Program, and Reimbursement Strategy, Expanding Their Integration Into the Health System to Reduce Health Disparities
A statewide consortium of community health workers, public agencies, and nonprofits aimed to reduce health disparities by developing a standardized scope of practice, creating a training and certificate program and a stable funding strategy to secure reimbursement from Medicaid. Their work resulted in greater integration for these workers in the health care work force.
Case Management and Home Assessments Reduce Asthma-Related Admissions, Emergency Visits, and Missed School Days in Diverse Urban Children
Case management combined with in-home environmental assessment and remediation of environmental triggers reduce asthma-related hospitalizations, emergency department visits, missed school days, and missed parent work days in diverse, low-income urban children with asthma.
Comprehensive, Culturally Sensitive Care and Self-Management Support Improves Health-Related Behaviors, Clinical Outcomes, and Emotional Health in Native Americans with Diabetes
The Full Circle Diabetes program provides comprehensive care and self-management support to Native Americans with diabetes, leading to improvements in health-related behaviors, clinical outcomes, and emotional health.
Formalized, Technology-Enabled Referral Relationships Between Medical Center and Community Clinics Enhance Access and Reduce Inappropriate Emergency Department Visits
A collaborative program leverages information technology to connect ED patients to a medical home and patients receiving care at FQHCs and county health clinics to specialists, leading to enhanced access to care, fewer ED visits, and significant cost savings.
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Discharge Risk Assessment
This risk assessment tool helps hospital discharge planners fully understand patient needs, thereby avoiding readmissions.
Payment Adjustments Tool For eHealth Programs
This interactive tool helps practitioners determine their payment adjustments and reimbursements for each of the Medicare incentive programs.
Improving Asthma Care for Children Toolkit: Best Practices in Medicaid Managed Care
This toolkit provides strategies to improve asthma care tested by a diverse group of health plans serving Medicaid consumers.
This Web site helps uninsured and underinsured consumers in California navigate the application process for discounted care from hospitals.
New York Regional Health Care Report Card
This online report allows health care consumers to compare the cost and quality of commercial health insurance plans by county in New York and New Jersey.