Care Management Toolkit

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  • 1/31/2019
  • Presentation: Case study - A medical home program powered by data
  • SelectHealth shares how they are incorporating pay-for-performance programs, provider engagement and chronic condition management approaches to support HCCs and quality gap in care closure. Presented at the Leveraging Analytics meeting in Fort Worth, Texas.
  • 12/10/2018
  • Templates: Medical Management Dashboards
  • Health Alliance Plan shares templates of medical management dashbaords for a variety of audeinces. Included are dashboards for Executves, Management, and the Frontline. Contains dummy data.
  • 11/9/2018
  • December 2018 Coding Work Group Case Studies
  • Geisinger Health Plan shares recently coded charts and questions to facilitate discussion on risk adjustment coding best practices during the December 6, 2018 Coding Work Group Session.
  • 10/25/2018
  • Building Payer-Provider Partnerships for Care Management
  • In this white paper, Navigant Consulting Inc. and the Health Plan Alliance share eight strategies for success in care management. Based on research among three leading provider-sponsored health plans (Health Plan Alliance members), the paper provides real-world examples of how payers and providers can collaborate successfully in developing care management strategies and reducing per member per month costs.
  • 8/9/2018
  • Presentation: Population Health and Care Management for Complex Patients
  • Adventist Health Plan shares how they used traditional population health approaches,complemented by a complex care management clinic and team of health care professionals, to manage a rural population of families, adults, and seniors and persons with disabilities (SPDs) to meet their health care and social needs in a quality, cost efficient manner.
  • 7/6/2018
  • Presentation: Exploring the Information Gap and Solutions
  • Change Healthcare consultants identify common problems and scenarios facing health plans and providers and discuss technology and solutions for developing encompassing data-sharing capabilities with the goal of improving health by engaging patients and communities. This presentation took place June, 2018 during the Health System/Health Plan Value Visit in Chicago.
  • 5/30/2018
  • Numerof: The State of Population Health
  • Numerof & Associates teamed with Dr. David Nash, Dean of Jefferson College of Population Health, to study the evolution of population health management. Report is based on a survey of 400+ C-suite healthcare executives.
  • 5/3/2018
  • White Paper: 10 Reasons to Outsource Your Health Risk Assessment
  • The Health Risk Assessment (HRA) is a critical tool for population health management, developing wellness interventions, and encouraging lifestyle changes to control healthcare costs. It's a valuable resource to help you tap into data to measure the health of your population, risks for chronic disease, and the outcomes of your wellness initiatives.
  • 2/13/2018
  • Presentation: Medicare Diabetes Prevention Program Follow Up Roundtable Discussion
  • Joe Ledbetter and Elizabeth Goff of IU Health Plans will provide an update on the status of their discussions with their Indianapolis YMCA and Natasha Goburdhun, VP of Business Development and Operations with the YMCA of the USA Managed Services Organization (MSO) will also share an overview of their organization and how they are working with YMCA's across the county who provide DPP services.
  • 1/23/2018
  • Presentation: Beyond DM: A Population Health Evolution
  • Representatives from Avera/DAKOTACARE share an overview of their organization's evolution from outsourcing case management and disease management programs to in-house programming to now merging the medical management teams from two separate health plans.
  • 11/16/2017
  • Presentation: Using data insights to support care management activities
  • In this presentation, Sentara shares how they are tailoring services for population health management and value based purchasing, and the efforts they are making to detect high-risk members, engage them, and design programs for care management to optimally promote high-quality, cost-effective healthcare.
  • 8/29/2017
  • Behavioral Economics Based Incentives for Digital Health
  • A NIH funded study completed by VAL Health to measure the impact of the VAL Health Rewards behavioral economics-based incentives on a digital tobacco cessation program. The result? The control group had a 17% program completion rate and the VAL Health intervention group had 54% program completion.
  • 8/1/2017
  • Presentation: Innovation Session: Blending enrollment with onboarding and care management phases
  • Many beneficiaries newly enrolling in MA do not participate in important Care Management programs, due primarily to the limited success of costly health plan engagement efforts. This session explores how process, technology and focused public/private collaboration can quickly address this shortcoming, beginning at the Point of Sale. In a new pilot approved by CMS for the 2018 AEP, Bloom Insurance Agency is testing the theory that gathering health status (HRA) and a complete provider and Rx profile in conjunction with the enrollment, will result in more seamless, efficient and effective care and a more loyal member from day one. In this session, Bloom shares details about the program?s goals, feedback from CMS thus far, and how they see sales, compliance, and quality all coming together for a better member experience and more efficient use of health plan resources.