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Components of a Winning Program: Health Plans’ Perspectives on EPA’s National Environmental Leadership Award January 18, 2017. Health Insurance Plan Strategies for Managing Asthma and Reducing Exposure to Environmental Asthma Triggers U.S. Environmental Protection Agency
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Components of a Winning Program: Health Plans’ Perspectives on EPA’s National Environmental Leadership AwardJanuary 18, 2017 Health Insurance Plan Strategies for Managing Asthma and Reducing Exposure to Environmental Asthma Triggers U.S. Environmental Protection Agency Cooperative Agreement #XA-83576401
Chris RegalSenior Health Research AssociateAmerica’s Health Insurance PlansMODERATOR Welcome and Introductions
Housekeeping • Please place all phone lines on mute. • Use the chat features to ask questions. Questions will be addressed periodically throughout the webinar as well as at the end. • Polling will be conducted during the webinar – please participate. • Slides will be made available and will be posted online at ahip.org/asthma.
Three-year Initiative with EPA October 1, 2014 – September 30, 2017 Identify and promote health plan best practices that align with the NIH EPR-3 asthma guidelines. Accelerate efforts to assess and disseminate health plan interventions that help prevent the onset of asthma episodes related to indoor environmental triggers. Compliment the EPA’s Indoor Environments Program priorities and goals of reducing environmental health risks by contaminants in indoor environments. Ahip.org/asthma
AHIP Asthma Video Series The Value of Success: Achieving Results and Recognition Establishing and Sustaining an Asthma Management Program Partnering and Collaboration: The Benefits for Health Plans and Partners
Which option best describes your organization? Polling Question #1
If you are not a health insurance plan, does your organization currently partner with health plans to deliver asthma management services? Polling Question #2
Where did you learn about the EPA Leadership in Environmental Asthma Management Award? Polling Question #3
Currently, does your organization plan to apply for this award? Polling Question #4
Tracey Mitchell, RRT, AE-C, Indoor Environments Division, U.S. Environmental Protection Agency mitchell.tracey@epa.gov 202-343-9446
The highest recognition a program and its leaders can receive for delivering excellent environmental asthma management as part of their comprehensive asthma care services. Awards in three categories: Health Plan, Healthcare Provider, Community in Action
The key to winning the Award is to demonstrate that your comprehensive asthma management program: • Embodies the System for Delivering High-Quality Asthma Care – including the key drivers of program effectiveness – as described in the Change Package; • Promotes the integration of NIH EPR-3 Guidelines throughout the continuum of care; • Includes a robust environmental component; and • Achieves positive health and financial outcomes.
Consider applying, if your work: • Addresses environmental triggers as part of a comprehensive asthma program. • Fosters high-performing collaborations and partnerships. • Improves the daily lives of those with asthma and their families.
Winners will receive: • A place in the Hall of Fame. • An engraved, crystal award. • Recognition in May during Asthma Awareness Month. • Recognition on national websites, including AsthmaCommunityNetwork.org. • Customized press kits, a descriptive snapshot of your program and support generating media attention. • An opportunity to serve as mentors to other programs.
Karen Meyerson, MSN, APRN, FNP-C, AE-C Director, Commercial Care Management Priority Health
Priority HealthIntroduction Mary Cooley, MS, RNVice President, Care Management and Operations Phone: 616.355.3232 Email: Mary.Cooley@priorityhealth.com Karen L. Meyerson, MSN, APRN, FNP-C, AE-C Director, Commercial Care Management Phone: 616.464.4816 Email: Karen.Meyerson@priorityhealth.com
About Priority Health________________________________________________________________________________________________________ Priority Health approaches health care differently. While most insurance companies focus on processing claims, we work closely with our customers to ensure they receive the right care, at the right time, in the right place. • We were created nearly 30 years ago by a group of physicians and hospitals who wanted to ensure that the community they served could afford access to quality care. • As a non-profit health plan we operate efficiently on behalf of our customers. We spend 90 cents of every dollar on our customers' medical care. There aren't many health plans that can say that. • We're leading the industry with our work to pull back the curtain on health care costs with one-of-a-kind tools to help our customers shop for health care. • 750,000 covered lives in the State of Michigan – Commercial, Medicare and Medicaid.
About Priority Health________________________________________________________________________________________________________ Our hard work is being recognized We have a long history of providing progressive products and smart programs that keep health care costs down and our community healthy. • Named among the nation's best by NCQA • First in the industry to reward physicians for quality care • Leading the industry in revealing health care costs • 9 out of 10 people would recommend Priority Health to family or friends We are improving the health and lives of our community • From the myriad of health and chronic disease management support our team provides to our customers - to the wealth of resources we provide our community - we strive to improve the health and lives of communities in which we live and work.
Award Winning Characteristics________________________________________________________________________________________________________ A Successful Collaboration • In 1999, Priority Health partnered with the Asthma Network of West Michigan – first-ever contract between a health plan and a grass roots asthma coalition in the nation • This partnership underscores the value of ANWM’s services and Priority Health’s commitment to its members • Provide home-based asthma case management to PH members with asthma • Reimbursement for services: • Home visits by RN, RT or LMSW (AE-Cs) • School visits • Care conferences • Reimbursement for home-based asthma case management can show ROI and value on investment
The Power of the National Leadership Award________________________________________________________________________________________________________ • Opportunity to promote innovation in chronic condition management (Asthma) • Risk stratification • Community partnership • Clinical and financial outcomes • Payment strategy • Recognition by National Leader (US-EPA) • Networking with communities across the nation • Mobilizing 1000 communities • Springboard for greater visibility in Asthma management best practices • Impetus for program development (COPD)
Karen E. Michael, R.N., M.S.N., M.B.A. Vice President, Corporate Medical ManagementThe AmeriHealth Caritas Family of Companies
Comprehensive Asthma Management Program Serving Medicaid Recipients and Their Families in Southeastern Pennsylvania • Karen E. Michael, R.N., M.S.N., M.B.A. Vice President, Corporate Medical ManagementThe AmeriHealth Caritas Family of CompaniesP: 215-937-8546 |M:215-498-7449kmichael@amerihealthcaritas.com
AmeriHealth Caritas’ Comprehensive Asthma Management Program AmeriHealth Caritas
AmeriHealth Caritas’ Comprehensive Asthma Management Program • No single initiative meets the needs of all members with asthma. AmeriHealth Caritas’ Comprehensive Asthma Management Program (CAMP) adopts a multi-pronged, population health-based approach to asthma care, adapting to the “local health ecosystem” and employing community engagement to address member needs. • Since receiving the National Environmental Leadership Award in Asthma Management, AmeriHealth Caritas has: • Seen member growth in CAMP’s constituent asthma initiatives (e.g., B.E.S.T. and Community Health Worker programs) and expansion into other AmeriHealth Caritas states. • Participated in the America's Health Insurance Plans (AHIP) National Asthma Leadership Roundtable and been included as a case study in AHIP’s Next Generation Asthma Care report.1 • Supported the asthma component of Medicaid proposal submissions nationwide, including a successful bid for Iowa Medicaid. 1. AHIP. Next Generation Asthma Care: Integrating Clinical and Environmental Strategies to Improve Asthma Outcomes. November 2016. AmeriHealth Caritas
Resources to Help Write Your Application: • Sample applications for each category (health plan). • Descriptions in the Hall of Fame and program profiles on AsthmaCommunityNetwork.org. • The Asthma Change Package, which presents a guide for achieving breakthrough improvements in community asthma care, including the key drivers of program effectiveness. • National Institutes of Health's (NIH's) Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma.
After participating in this webinar, does your organization plan to apply for this award recognition? Polling Question #5
2017 Activities Save the date • February 1st 11:59 p.m.: Application deadline for the National Environmental Leadership Award in Asthma Management Other AHIP Work • Next Generation Asthma Care: Integrating Clinical and Environmental Strategies to Improve Asthma Outcomes. Report from the AHIP National Asthma Leadership Roundtable For more information, contact Chris Regal cregal@ahip.org or 202.861.1441 ahip.org/asthma