Care Management

As more Americans live with chronic illnesses, frailties, and disabilities, the nation's health care system should provide appropriate, high quality, and timely care for these individuals. CHCS works with states and health plans to develop comprehensive care management approaches in Medicaid.

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Title and Description	Date	Type
The Super-Utilizer Summit: Resources to Support Emerging Programs The summit brought together leaders from more than 10 states, super-utilizer programs across the country, the Centers for Medicare & Medicaid Services, several Robert Wood Johnson Foundation (RWJF) Aligning Forces for Quality alliances, health plans, and other key stakeholders to share strategies for changing how our health care system interacts with these individuals. The meeting was supported by RWJF and the Atlantic Philanthropies.		Meeting Highlights
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 2013	Case Studies
Introduction to Medicaid Care Management Best Practices This brief provides a glimpse of some of the innovative programs being implemented in states across the country that use care management approaches to address the complex physical, behavioral, and psychosocial needs of Medicaid's highest-risk populations.	December 2011	Policy & Issue Briefs
Hospital Readmissions among Medicaid Beneficiaries with Disabilities: Identifying Targets of Opportunity Preventing unnecessary hospital readmissions among Medicaid beneficiaries offers tremendous potential for states to improve health care quality and control spending. This Faces of Medicaid data brief examines readmission rates among Medicaid beneficiaries with disabilities and identifies new opportunities to reduce recurring hospitalizations.	December 2010	Policy & Issue Briefs
Strategies for Finding and Engaging Medicaid Beneficiaries for Complex Care Management This October 5, 2010 webinar outlined the strategic approach that Washington State is using to significantly enhance consumer engagement and improve the impact of care management for adults with mental illness and/or chemical dependency, as well as physical health comorbidities.	October 2010	Webinar Resources
Enhanced Medical Home for Medi-Cal's SPD Population This policy options paper outlines possible approaches to the design of an enhanced medical home model that would provide access to a primary care provider, as well as targeted care management support for high-risk beneficiaries.	September 2009	Resource Papers
Enhanced Primary Care Case Management Programs in Medicaid: Issues and Options for States This report examines enhanced Primary Care Case Management (PCCM) programs in five states -- Oklahoma, North Carolina, Pennsylvania, Indiana, and Arkansas. The paper builds on an in-depth evaluation that Mathematica Policy Research, completed of Oklahoma's SoonerCare Choice enhanced PCCM program.	September 2009	Resource Papers
Effective Care Management: Promising Approaches for Medicaid Beneficiaries with Complex Needs This webinar outlined the core components of effective care management interventions based on a review of Medicare care coordination pilots as well as other programs nationally. The discussion focused on the key attributes distinguishing successful programs and suggested ways to enhance care management to improve quality and control spending growth.	August 2009	Webinar Resources
Evaluation of Oklahoma SoonerCare Medicaid Managed Care Program This evaluation, by Mathematica Policy Research, examines Oklahoma's Medicaid program over the last 15 years, with an emphasis on the state's decision in 2003 to end its urban capitated managed care program and expand its rural PCCM program statewide.	January 2009	Reports
Rethinking Care for Medicaid's Highest-Need, Highest-Cost Populations This initiative is working to design and test better approaches to care for Medicaid's highest-need, highest-cost beneficiaries by linking regional pilots with a national learning network.	April 2008	Initiative
Medicaid Best Buys: Improving Care Management for High-Need, High-Cost Beneficiaries This brief outlines important steps for states to consider in designing comprehensive programs for this complex need population. It also highlights three states that are pioneering new care management approaches.	March 2008	Policy & Issue Briefs
Purchasing Strategies to Improve Care Management for Complex Populations: A National Scan of State Purchasers This report outlines how states are identifying high-risk beneficiaries and developing tailored care management approaches to meet their needs. It also details state experiences in testing new financing mechanisms and more robust measurement strategies designed specifically for adults with chronic illnesses and disabilities.	March 2008	Reports
Care Management Definition and Framework This tool, developed through CHCS' Managed Care for People with Disabilities Purchasing Institute, can help guide state purchasers regarding "must have" care management components to better serve adults with complex and special needs.	October 2007	Fact Sheets
Evaluation of the Medicaid Value Program: Health Supports for Consumers with Chronic Conditions This study offers important lessons to improve care for Medicaid’s highest-risk and highest-cost beneficiaries. The evaluation examined 10 care management approaches implemented within the Medicaid Value Program: Health Supports for Consumers with Chronic Conditions	August 2007	Reports
Medicaid Value Program Case Studies The following case studies describe the interventions that were tested by each of the 10 Medicaid Value Program grantees to improve care for a targeted subgroup of beneficiaries with multiple chronic conditions.	August 2007	Case Studies
Medicaid Value Program Logic Models Each of the Medicaid Value Program teams worked with Mathematica Policy Research to develop a “logic model” that detailed the reasoning behind their intervention.	August 2007	Technical Assistance Briefs & Tools
Disability Care Coordination Organizations The paper outlines seven key recommendations for states to consider as they design and implement DCCOs for adults with disabilities	May 2006	Resource Papers
Medicaid Quality Improvement Action Steps Through a decade of working with national Medicaid leaders, CHCS has identified eight essential strategies critical to comprehensive chronic care.	April 2006	Fact Sheets
Environmental Scan: Health Supports for Consumers with Chronic Conditions This report synthesizes literature, expert interviews, and on-the-ground experience to describe the issues and problems associated with improving the care and health of Medicaid consumers with multiple chronic conditions and to outline potential best practices in key areas.	November 2005	Reports
Medicaid Value Program: Health Supports for Consumers with Chronic Conditions February 2005 - August 2007	February 2005	Initiative