Health Department Promotes Implementation and Use of Electronic Health Records in Underserved Areas To Improve Clinical Preventive Services in Primary Care
The health department in New York City uses subsidies, upfront and ongoing technical support, and quality of care feedback to promote implementation and use of electronic health records by primary care practices in medically underserved areas, leading to better care for patients in these practices.
Health Plan and Psychiatric Hospitals Reduce Readmissions by Reviewing Data and Developing Strategies to Improve Postdischarge Care
A partnership between a health plan and psychiatric hospitals focuses on sharing of quarterly data, case reviews, and deployment of specific strategies to improve postdischarge care, leading to significant reductions in readmissions, inpatient days, and costs.
Medicaid Plan Offers Diabetic Patients Access to Fitness Facilities and Coaching, Leading to Weight Loss and Improvements in Cholesterol and Blood Glucose
Medicaid managed care enrollees with type 2 diabetes receive free access to YMCA facilities and have regular meetings with nurses, dietitians, and personal trainers that focus on diet, exercise, and other aspects of disease self-management, leading to weight loss and improvements in body mass index, cholesterol, and blood glucose control.
Shelter-Based Medical Care and Case Management Enhance Access to Services for Homeless Women, Improve Outcomes, and Lower Costs
Volunteer physicians, supported by paid nurse case managers, provide homeless women with needed medical care in homeless shelters and connect the women to other needed medical and social services. The program has enhanced access to services, improved outcomes, and generated significant cost savings.
Statewide Medical Home Program for Low-Income Pregnant Women Enhances Access to Comprehensive Prenatal Care and Case Management, Improves Outcomes
A State-based, public–private partnership adapted its successful primary care medical home model to serve pregnant Medicaid beneficiaries, leading to enhanced access to comprehensive prenatal care (including intensive case management for high-risk pregnancies), better adherence to evidence-based care standards, and reductions in low–birth weight babies and rate of primary Cesarean sections.
Risk Management and Quality in Home- and Community-Based Services (HCBS): Individual Risk Planning and Prevention, System-wide Quality Improvement
This report explores the topic of effective individual risk management in community-based services among States engaged in risk planning for Medicaid home- and community-based services (HCBS) waiver participants.
Predictive Modeling: A Guide for State Medicaid Purchasers
This guide for care managers and State Medicaid agencies provides information on how to use predictive modeling tools to identify patients who are good candidates for care management.
Monitoring and Evaluating Medicaid Fee-for-Service Care Management Programs: A User's Guide
Monitoring and Evaluating Medicaid Fee-for-Service Care Management Programs: A User's Guide is designed to aid policymakers in understanding the policy issues, research evidence, and methodology related to evaluating the costs, quality, and impact of care management programs.
Designing and Implementing Medicaid Care Management Programs: A User’s Guide
The Medicaid Care Management Guide helps States design, implement, and evaluate care management programs for the chronically ill.
Participant Experience Survey: Elderly/Disabled (E/D) Version
This survey solicits feedback from elderly and disabled program participants about the services and supports they receive under the Medicaid Home and Community-Based Services waiver program.