Experience Health ND Medicaid Health Management Program

1. Experience HealthND Medicaid Health Management Program

2. Experience HealthND Medicaid Health Management Program • Partnership between North Dakota Department of Human Services, Medical Services Division & USCM began in 2007 • Community-based care management program for Medicaid recipients with chronic health conditions including: • Asthma • Chronic Obstructive Pulmonary Disease (COPD) • Congestive Heart Failure • Diabetes

3. Experience HealthND Medicaid Health Management Program • On October 1, 2011 NorthDakotaMedicaid made the Health Management Program available through multiple providers • Experience Health ND is now a Health Team Provider providing program services to enrolled members as well as new eligible recipients

4. Experience HealthND Medicaid Health Management Program Program Design: • Participation is voluntary and recipients may opt-out at any time • Collaborative services working closely with providers and community organizations to maximize adherence to providers treatment plan • Evidence-Based National Practice Guidelines • Information to educate/empower recipients • Clinical decision making for encouraging adherence

5. Experience HealthNDMedicaid Health Management Program Program Goals • Increase adherence to doctor’s treatment plans, improve self care practices and augment patient-centered care • Improved the quality and timeliness of care • Enhance member’s decision-making, understanding of conditions and use of available health services • Reduce utilization and cost of resources including unnecessary ER visits and hospitalization • Improve health outcomes

6. Experience HealthNDMedicaid Health Management Program Program Service Delivery • Registered Nurse Care Managers working with members & • their families • Telephone Health Information Line 24 Hours/Day • Tele-health home monitoring for high risk in remote areas • Physician/Provider Collaboration & Adjunct Support • Community Resource Coordinator builds partnerships

7. Experience HealthNDMedicaid Health Management Program Registered Nurse Care Manager Support • Enrollment and comprehensive assessment • Care planning in collaboration with providers, recipients and families • Education on importance of medical home, regular office visits • & adherence to provider’s treatment plan • Coordination of care for health care needs • Assistance to access & utilize community resources

8. Experience HealthNDMedicaid Health Management Program Telephone Health Information Line (THIL) • 24 Hour/7 Day A Week • Inbound and Outbound Calls (All eligible recipients) • Staffed by Experience HealthND nurses

9. Experience HealthNDMedicaid Health Management Program Physician/Provider Support Services • Program information, toolkits & orientation to Program objectives • Ongoing feedback on patient status, progress & needs that facilitate treatment plan & health outcomes • Collaboration between medical providers & community resources • Use of national evidence-based practice guidelines

10. Experience HealthNDMedicaid Health Management Program Physician/Provider Support Services (continued) • Program Webinars • Program web-site available to include education programs, clinical guidelines and professional links… (www.provider.experiencehealthnd.com) • Provider Advisory Committee

11. Experience HealthNDMedicaid Health Management Program • Collaboration with community service organizations • Community Resource Coordinator supports RNCMs • Program service, referral and education partnerships • Health Management partnerships with Experience Health ND Community Outreach & Partnerships

12. Experience HealthNDMedicaid Health Management Program Experience HealthND Thank you… ND: Communications /Provider/Presentations 10.31.11 For further information please contact Abbey Linstad Fraser, CRC at 701-205-2526 or alinstad@uspreventivemedicine.com