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.
Hospital Successfully Links Recently Released, HIV-Positive Prisoners to Medical, Mental Health, and Social Services, Reducing Recidivism
A hospital links HIV-positive prisoners to medical care and other social services before and after release to enable successful reentry into the community, leading to enhanced access to these services and less recidivism.
In-Office Education via Hand-Held Electronic Device Enhances Patient Knowledge Without Burdening Primary Care Staff
A primary care clinic offers patients 3- to 5-minute educational video modules, leading to enhanced patient knowledge without placing incremental demands on physicians and staff.
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.
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.