CHCS - Center for Health Care Strategies

Improving the quality and cost-effectiveness of publicly financed health care

Project Spotlights

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Title and Description Date

Extending Lessons from a Medicaid Pilot to Improve Care for Medicare and Dual Eligible Beneficiaries

This spotlight highlights UPMC Community Care, a new program for Medicare beneficiaries with serious mental illness in Allegheny County, Pennsylvania. The program, which integrates physical and behavioral health care for enrollees, is based on a model of care piloted through CHCS' Rethinking Care Program.
February 28, 2013

New York's Chronic Illness Demonstration Project: Lessons for Health Homes

This profile from the Center for Health Care Strategies details experiences of the CIDP initiative, which included six regional pilots focused on improving care for Medicaid beneficiaries with chronic physical and behavioral health needs.
December 19, 2012

Improving Medicaid High-Risk Care Management Overview: King County Care Partners

This profile tells the story of Darlene, one of the many Medicaid beneficiaries in Washington State who benefited from improved care coordination and integrated services through the King County Care Partners project. It provides a first-hand perspective of the pilot effort which was designed to integrate physical and behavioral health care services for adult Medicaid beneficiaries with both physical and behavioral health conditions. 

November 15, 2012

‘Identify, Stratify, and Target:' Taking National Level Analysis of Multimorbidity Patterns to the Local Level in Massachusetts

Identifying and targeting interventions toward high-need, high-cost Medicaid beneficiaries is one strategy employed by states and health plans to improve the quality and cost-effectiveness of health care. This spotlight highlights an analysis recently completed by Network Health, a Massachusetts-based  health plan, which utilized methods from CHCS' Faces of Medicaid analysis of multimorbidity patterns, to identify, stratify and target resources toward its highest-risk members. 
November 2, 2012

Improving Medicaid Care Management for People with Serious Mental Illness in Pennsylvania

This profile tells the story of Shervene, one of the many Medicaid beneficiaries who benefited from improved care coordination and integrated services through Pennsylvania's Serious Mental Illness (SMI) Innovations Project. It provides a first-hand perspective of the pilot effort which was designed to integrate physical and behavioral health care services for adult Medicaid beneficiaries with serious mental illness and co-occurring physical health conditions.
October 1, 2012

Arkansas Charts a Course for HIE and Quality Reporting

Arkansas' Regional Quality Improvement program established a statewide health information exchange and a multi-payer quality measurement reporting strategy to improve chronic care delivery. This case study describes the program's collaborative process and its support for meaningful use of health information technology to position providers for American Recovery and Reinvestment Act incentives. 

August 31, 2010

A “High-Touch” Approach to Improving Oral Health for Newark Children

CHCS' New Jersey Smiles initiative engaged the state Medicaid agency, health plans, and other regional partners to improve access to dental care among low-income and minority children. This case study describes how the collaborative worked with Newark Head Start programs and community dentists to increase the number of preschool NJ FamilyCare/Medicaid children completing dental visits and establishing dental homes.

March 30, 2010

Rochester Regional Quality Improvement Initiative Supports Providers in Diabetes Care

Supporting physicians in better diabetes care delivery can significantly improve clinical outcomes for patients with diabetes and control spending for this high-need, high-cost population. With this in mind, a cross-payer coalition of health plans, state and county health departments, and other stakeholders in New York's Monroe County are working with physicians to achieve recognition under the Diabetes Physician Recognition Program of the National Committee for Quality Assurance.

August 31, 2009

Rhode Island Pilots Innovative, Cross-Payer Patient-Centered Medical Home Model

Through an innovative cross-payer pilot, Rhode Island is helping physician practices achieve patient-centered medical home recognition from NCQA.  The pilot is testing the power of cross-payer alignment to support a sustainable model for chronic care delivery in primary care settings. 

July 30, 2009

Washington State Medicaid: An Evolution in Care Delivery

This case study examines Washington State's adaptable "learn-as-you-go" approach to designing, testing, evaluating, and refining multiple strategies to improve the quality and cost-effectiveness of care for Medicaid beneficiaries with complex needs.

December 23, 2008

Using Pay-for-Performance to Support HIT Efforts in Missouri

Missouri, one of seven states participating in the Center for Health Care Strategies Pay-for-Performance Purchasing Institute, developed an innovative P4P program that encourages providers to adopt a web-based care plan to improve the efficiency and delivery of chronic care.

April 29, 2008

Collaborating to Improve Birth Outcomes in New Jersey

In 2006, the five health plans in New Jersey began collaborating with the state Medicaid program and other stakeholders to standardize methods for identifying high-risk pregnancies in three urban areas. One year later, key accomplishments include a prenatal risk assessment form, a central data repository, an expedited enrollment process for pregnant women, and plans to take the program statewide.

October 22, 2007

Johns Hopkins Healthcare: Demonstrating a Return on Investment for Integrated Substance Abuse Treatment and Medical Care Management

As a participant in CHCS' Business Case for Quality in Medicaid Managed Care initiative, Johns Hopkins Healthcare achieved cost savings and reduced hospital stays by combining medical and substance abuse case management for consumers.
September 27, 2006

Inland Empire Health Plan: Using Performance Incentives to Improve Preventive and Chronic Care

Inland Empire Health Plan, a nonprofit HMO in California's Riverside and San Bernardino counties, is a veteran among Medicaid health plans in its use of provider incentives.
March 7, 2006

ValueOptions New Jersey: Shortening Residential Care Stays for Teens

Through CHCS' Best Clinical and Administrative Practices workgroup Improving Managed Care Quality for Adolescents with Serious Behavioral Health Disorders, ValueOptions New Jersey set a goal to identify and reduce the number of children remaining in out-of-home treatment settings who are ready to be discharged.
February 14, 2006

SoonerCare: Improving Care for Native Americans with Diabetes

Through participation in the Improving Health Care Quality for Racially and Ethnically Diverse Populations BCAP workgroup, SoonerCare set a goal to improve care for adult Native Americans in Oklahoma with diabetes. 
January 3, 2006

Hudson Health Plan: Improving Preventive and Dental Care for Adults in Need

Hudson Health Plan set a goal to improve primary and dental care for adults with special care needs as part of a Best Clinical and Administrative Practices workgroup. The plan increased primary care visits from 67 percent in 1999 to 74 percent in summer 2005 and primary dental visits from 42 percent to 53 percent.
November 29, 2005

Interpreting Success: One Consumer at a Time

Through a Covering Kids and Families Access Initiative Grant, the Buncombe County, North Carolina Department of Social Services identified and addressed key reasons consumers used emergency services for primary care. 
October 10, 2005

Standardizing Disease Management Reporting for a Multi-State Plan

Molina Healthcare, Inc., a rapidly growing health plan specializing in Medicaid and SCHIP, applied the BCAP Typology to develop a standardized approach to quality improvement for members with asthma and diabetes in California, Michigan, Utah, and Washington.
August 10, 2005

Early Child Development Services Can Nip Problems in the Bud

Through participation in the Enhancing Child Development Services in Medicaid Managed Care BCAP workgroup, CommunityCARE of Louisiana, the state's primary care case management program, increased the number of provider referrals for 0-3-year-olds identified with a developmental delay. The plan established developmental monitoring office programs and expanded the number of acceptable tools that providers can use for ages one to six. 
July 27, 2005
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