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Health Promotion in Kansans with Disabilities. Kansas Medicaid’s CMS Transformation Grant Kansas Health Policy Authority in collaboration with the University of Kansas Medical Center & Ingenix Presented by Theresa I. Shireman, Ph.D. University of Kansas Medical Center. Collaborative Effort.
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Health Promotion in Kansans with Disabilities Kansas Medicaid’s CMS Transformation Grant Kansas Health Policy Authority in collaboration with the University of Kansas Medical Center & Ingenix Presented by Theresa I. Shireman, Ph.D. University of Kansas Medical Center
Collaborative Effort • Kansas Health Policy Authority (KHPA) • Becky Ross • Sharon Johnson • Debbie Huske • University of Kansas Medical Center (KUMC) • James Backes, Pharm D • Allen Greiner, MD • Aimee James, PhD • Ingenix Impact Pro • Developer of solutions that are focused on improving health care through the use of information and technology • www.ingenix.com
Statement of Project Need • Persons with disabilities • Less likely to receive preventive health care services • High rates of chronic comorbidities • High rates of medication use • Compliance problems • Face variety of barriers to quality health care • Case managers • Support/coordinate vocational & social services • New responsibility for medical services coordination • Ultimate goal… improve beneficiary health!
Project Goals & Objectives • Increase use of age- and gender-appropriate preventive health care • Increase receipt of chronic disease monitoring services • Improve compliance with chronic medications
Project Description: Agencies • Case managers recruited from selected agencies: • Community Developmental Disability Organizations (CDDOs) • Independent Living Centers (ILCs) • Serve primarily physically disabled • Located throughout state of Kansas
Project Description: Impact Pro • Claims-based predictive modeling tool • Lists all paid claims incurred in most recent 12 month experience period including hospitalizations, doctor visits, medications, and other services • Uses ETG grouper logic to create condition specific episodes • Identifies gaps in care and opportunities for care interventions • Standard Impact Pro rules based upon clinical consensus • Ability to fully customize rules to identify members • Accessed via Web • Case Managers access the Impact Pro Reporting System on-line
Project Description: Training • Live training sessions • KUMC faculty • Medical & pharmacy home • Basic chronic disease management • Basic chronic medication management • Small group activities • Ingenix Impact Pro™ • Computer-assisted training
Project Description: Case Managers’ Support • Project website • Training materials • Useful links • Monthly e-newsletters • Developed by KUMC faculty & staff • Range of topics: chronic diseases, physical health, dental care, medications • Consultation with team MD & RPH • Email based: triaged by project manager
Project Evaluation: Case Manager Assessments • Surveys • Baseline & conclusion of intervention • Focus groups • Conclusion of intervention • Identify barriers & facilitators of implementation & program success • Team leaders & selected case managers
Project Evaluation • Changes in… • receipt of preventive care • receipt of chronic care monitoring • medication adherence • Pre- vs. post-intervention claims data • Within participating agencies • Across participating & non-participating agencies