As many states explore carve-out arrangements to meet the specialized needs of adults with chronic illnesses and disabilities, health plans are confronted with the difficult responsibility of assessing risks, coordinating services, establishing a “medical home,” and measuring access and quality for these members. Although innovative strategies to improve care for persons with chronic conditions exist, implementing and sustaining care management programs that offer high-quality and cost-effective care for this population is a challenging task for most health plans.

This BCAP Improving Care for Adults with Chronic Illnesses and Disabilities workgroup brought together 12 Medicaid health plans to identify and pilot best practices to improve the quality of care for adult members with disabling conditions. Participants included:

  • AXIS Healthcare, Minnesota
  • Amerigroup of Texas, Texas
  • CalOPTIMA, California
  • CareOregon, Oregon
  • Community Health Partnership, Wisconsin
  • Community Living Alliance, Wisconsin
  • HealthSource/Hudson Health Plan, New York
  • Heartland Health Plan, Oklahoma
  • Horizon/Mercy Health Plan, New Jersey
  • Johns Hopkins Health Care/Priority Partners, Maryland
  • Network Health, Massachusetts
  • Vermont Health Access, Vermont