Asthma is a controllable chronic disease yet it remains a significant health care problem in California’s Medi-Cal population. While a great deal has been done in recent years to improve asthma management, opportunities remain to further reduce the burdens associated with this disease. In recent years many Medi-Cal health plans have expressed interest in learning what they can do to support improvements at the point of care, i.e., within the physician office. The plans are eager to further understand and apply emerging practice site improvement models and to support improved chronic illness care.

The Plan/Practice Improvement Project (PPIP), made possible by the California HealthCare Foundation, was designed to help Medi-Cal health plans synchronize quality improvement and chronic care management approaches at the health plan and provider levels. This 18-month collaborative had an overarching goal of reducing emergency department use and hospital admissions by 50 percent for members with asthma in the practice intervention sites.

CHCS partnered with the Medi-Cal Managed Care Division, the National Initiative for Children’s Healthcare Quality (NICHQ), and the Improving Chronic Illness Care (ICIC) program to lead this collaborative of 10 Medi-Cal health plans and their providers.

The collaborative had two simultaneous, closely coordinated arms:

• An asthma improvement collaborative for providers conducted exclusively using web-based technology. Each participating managed care plan will identify and recruit three practice teams to participate in this virtual learning collaborative that will focus on practice site improvement using elements from the Chronic Care Model, asthma care guidelines, and best practices. Health plans will serve as coordinators and participants of the virtual learning sessions, enabling them to learn, first-hand, about the key elements of practice site improvement.
• A health plan “spread” collaborative, in which the plans will develop a systematic program to plan and implement spread of better asthma care to all of their primary care practices. Health plans will leverage learning from the virtual practice site collaborative (lessons in how to improve chronic care outcomes, how to work effectively with physician offices and patients with asthma), to develop strategies to meet the needs of the diverse range of Medi-Cal provider networks.