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New Opportunities for Disease Management and Care Coordination Programs in Medicaid

New Opportunities for Disease Management and Care Coordination Programs in Medicaid. June 6, 2006. Dexter W. Shurney, MD, MBA, MPH Senior Vice President, Chief Medical Officer. Healthways. Nationally recognized Care Enhancement company Founded in 1981 Publicly traded (NASDAQ: HWAY)

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New Opportunities for Disease Management and Care Coordination Programs in Medicaid

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  1. New Opportunities for Disease Management and Care Coordination Programs in Medicaid June 6, 2006 Dexter W. Shurney, MD, MBA, MPHSenior Vice President, Chief Medical Officer

  2. Healthways Nationally recognized Care Enhancement company • Founded in 1981 • Publicly traded (NASDAQ: HWAY) • First to be Accredited by NCQA, URAC and JCAHO • Supports the care of over 1,900,000 participants • 57 Health Plans representing a membership of over 50 million members • 300,000 eligible Federal Employee Program (FEP) members • 600+ Administrative Services Only (ASO) Employer Groups delivered through our Health Plans • Growing International presence • Third party review • Several Health Plan customers certified by the Disease Management Consortium (Al Lewis) • Programs reviewed and approved by Johns Hopkins • Multiple third-party published outcome studies

  3. Most Experience….. • Over 45 million member months of proven experience • Significant experience operating at scale • Implementation Excellence • Understanding of the Medicare Population • Understanding of the Medicaid Population

  4. Making a Difference….. ---Noteworthy Outcomes with Disparate Populations---

  5. Challenges • Transient / Mobile • Culture • Language • Privacy • Time of Day Availability

  6. Challenges • Self-esteem • Living in the Present • Socio-economic • Confounders

  7. Continuum of Reach… Having a “connection” is NOT the same as being “connected” Connecting Relevance TRUST Connection

  8. Credibility Matching…the “right person” with the member Trust… “The first and core principle in our value statement is “To trust and be trustworthy”

  9. Awareness Programs Motivation Self-efficacy Discrepancy Relevance… “Day-in-the-Life”

  10. PSMs Social Workers Other… Care Enhancement Leveraging Community Feet-on-the-Street

  11. REACH RELATIONSHIPS REVELANCE Summary… Meeting the Challenge

  12. QUESTIONS ?

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