A Comprehensive Survey of Managed Care Organization (MCO) Medication Adherence Intervention Programs Part I: Patient and Intervention Targeting
|
|
|
- Alexandrina Baldwin
- 10 years ago
- Views:
Transcription
1 A Comprehensive Survey of Managed Care Organization (MCO) Medication Adherence Intervention Programs Part I: Patient and Intervention Targeting August of 14
2 Executive Summary Additional annual healthcare costs due to non-adherence per patient ($) Medication non-adherence Medication non-adherence is a complex and costly problem 1/3 of Americans do not take their medications as prescribed. 1 $290 billion in avoidable US costs each year. 2 8,000 6,000 4,000 2,000 CHF Hypertension Diabetes Hyperlipidemia 1. Haynes, R.B.NCPIE Prescription Month, October "Thinking Outside the Pillbox A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease." New England Healthcare Institute, 1 Aug Web. 30 July < sue_brief_final.pdf>. Medication adherence programs Managed Care Organizations (MCOs) use medication adherence intervention programs to uplift their patients adherence. Study: 30 MCOS were interviewed about their current medication adherence programs and future plans. 0 Roebuck MC, Liberman JN, Gemmill-Toyama M, Brennan TA. Medication Adherence Leads to Lower Health Care Use and Costs Despite Increased Drug Spending. Health Affairs. Jan 2011; 30: Note: Medication adherence impact on annual medical spending for dyslipidemia, diabetes, hypertension, and congestive heart failure patients is calculated using claims data. Identify interviewees Conduct interviews Analyze outcomes Small MCOs (<200,000 members) and large MCOs ( 200,000 members) Conducted 30 phonebased interviews over a 10-week period in Spring 2014 Interviewed 19 small MCOs and 11 large MCOs Quantitative data analyzed before and after stratification into small and large MCOs Survey research This survey research outlines the current trends in MCO medication adherence programs as well as identifies the key differences between small and large MCOs The paper is divided into 2 parts which outline the 3 major components of these programs. Part I: Patient and intervention targeting 1.Which patients will get interventions? 2.When do patients get interventions? Part 2: Intervention techniques 3.What are the interventions and how are they executed?
3 Landscape of medication adherence programs (Outline of survey) 1 Which patients will get interventions? Part I: Patient and intervention targeting 2 - Disease segmentation When do patients get interventions? - How patients are selected for interventions - Use of predictive analytics for medication adherence 3 What are the interventions and how are they executed? Part II: Intervention techniques - Intervention channels - Where interventions are conducted - Effectiveness measurements 3 of 14
4 Part I: Patient and Intervention Targeting 1 Which patients will get interventions? 2 When do patients get interventions? 4 of 14
5 1 Which patients will get interventions? Summary of findings Targeted disease states (pgs. 6 & 7) MCOs target chronic cardiovascular diseases as a top priority for intervention programs. MCOs intervene with these patients, because: Patients suffering with cardiovascular diseases are often associated with a high-risk of medication non-adherence. Medicare Part D sponsors are required to target beneficiaries suffering from multiple chronic diseases. Cardiovascular diseases (hypertension, heart failure, diabetes, and hyperlipidemia) count towards this requirement. Most MCOs plan to expand their intervention programs to target more disease states. Most notably Asthma, Depression, and COPD. 5 of 14
6 1 Most MCOs target cardiovascular disease states To which of the following diseases do your current intervention programs apply? Respondents having medication adherence intervention programs in specific diseases (%) Certified Disabled Rheumatoid Arthritis Multiple Sclerosis Vaccinations Schizophrenia Bipolar Disorder Lower Back Pain Prenatal Counseling Migraine Cancer Osteoporosis Antiretrovirals Depression COPD Asthma Myocardial Infarction Heart Failure Hyperlipidemia Hypertension Diabetes 7% 10% 17% 20% 17% 30% 30% 50% Most intervention programs target cardiovascular disease states 90% 9 9 0% 20% 40% 60% 80% 100% 6 of 14
7 1 MCOs are planning to expand to other diseases Are there any disease states you are considering to expand to in the future? Subject Breakdown of respondents Respondents planning to expand to more disease states All MCOs 65% Expansion of disease states % of all small MCOs 7 % of all large MCOs 50% 0% 20% 40% 60% 80% The most popular disease states for expansion are COPD, asthma, and depression 7 of 14
8 2 When do patients get interventions? Summary of findings How patients are selected to receive interventions (pg. 9) MCOs use three common methods to select patients for interventions: triggers, predictive analytics, and retrospective adherence measures. For MCOs that use triggers, Late to fill are the most common events used to trigger interventions. For the few MCOs that use predictive analytics, prioritizing the patients who are at-risk of becoming non-adherent is the most common method to select patients for interventions. For MCOs that use retrospective adherence measures, MPR (medication possession ratio) is the most common metric to classify a patient as non-adherent. Predictive analytics (pgs. 10 & 11) Most MCOs are interested in expanding their current medication adherence programs. Predictive analytics allow MCOs to tailor their adherence programs to specific goals and ultimately influence patient behavior. While very few MCOs currently use predictive analytics, a large number plan on incorporating a platform that will personalize interventions and more effectively reduce total medical costs. 8 of 14
9 2 MCO methods to start interventions How are patients selected to receive interventions through your intervention programs? Triggers Below are three common methods MCOs use to select patients for interventions Predictive analytics Retrospective adherence measures 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 30% First fill 3 New diagnosis 80% Late to fill 3 Script coming due 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 7% Predictive Analytics - priortizing patients at-risk for nonadherence 80% 60% 40% 20% 0% 40% Retrospective adherence measures Most MCOs intervene with patients who have an MPR (Medication Possession Ratio) below 80% for a certain amount of months. Most MCOs use some combination of methods to determine when patients get interventions. For example, many MCOs intervene with patients who are late to fill their prescriptions (triggers) and/or have an MPR below 80% in the last 6 months (retrospective adherence measures). MCOs also select patients for interventions using patient questionnaires such as Morisky medication adherence scale, scheduled targeting, and intervening with every patient of a given condition. 9 of 14
10 2 MCO plans to expand current programs Do you plan on expanding your medication adherence intervention programs? Subject Description Respondents planning to expand programs Expansion of adherence programs Includes adding intervention types, more frequent interventions, etc. 75% 0% 20% 40% 60% 80% Do you use predictive analytics to identify patients who will be non-adherent in the future? Subject Predictive analytics Description MCOs currently using predictive analytics MCOs planning to use predictive analytics in the future Respondents 7% 60% 0% 20% 40% 60% 80% 10 of 14
11 2 Ideal predictive analytics platforms How they work Enhanced predictive analytics platforms: Identify interventions most likely to engage patients and influence their behavior Avoid wasteful spending on interventions with patients who will not need them Use flexible machine learning technology that continually learns Medical claims Pharmacy claims Laboratory results Intervention data Patient demographics Predictive analytics platform Capabilities Predict patients medication adherence for each medication Predict most effective and costefficient interventions for each patient Prioritize patients for interventions Evaluate interventions and identify key areas for improvement Since these platforms are dynamic and self-learning, they can rapidly adapt to new intervention techniques. This enables more rapid cycle innovation and deployment of new intervention approaches in a rigorous data-driven manner. 11 of 14
12 Summary of findings 1 Which patients will get interventions? MCOs target chronic cardiovascular diseases as a top priority. Most MCOs are interested in expanding to other disease states including asthma, depression, and COPD. 2 When do patients get interventions? The three most common methods to select patients for interventions are triggers, predictive analytics, and retrospective adherence measures. Predictive analytics While very few MCOs currently use predictive analytics to predict a patient s medication adherence, many are planning to incorporate more enhanced platforms. These enhanced platforms identify interventions that will most likely engage patients and avoid wasteful spending on interventions with patients who will not need them. 12 of 14
13 Part II: Intervention Techniques Sneak peek 3 What are the interventions and how are they executed? A. Intervention channels Most commonly used intervention channels and types of messaging. B. Where interventions are conducted Whether interventions are conducted in-house and/or outsourced. C. Effectiveness measurements Most commonly used metrics to evaluate programs. Thank you for reading Part I: Patient and Intervention Targeting 13 of 14
14 Authors Affiliations and methodological issues About AllazoHealth AllazoHealth is a predictive analytics firm focused on anticipating patients behaviors and predicting how to change those behaviors. Its AllazoEngine technology incorporates partial or complete population data to forecast individual patients adherence to each of their medications, anticipate how medication adherence interventions will influence those patients, and target the right interventions to the right patients at the right time. Allazo provides its services to PBMs, health insurers, ACOs and providers both a stand-alone analytics solution and a full-service medication adherence solution. For further information contact [email protected] (888) ext. 705 [email protected] (888) ext. 707 Collaborators: Clifford Jones Ian Sullivan Upal Basu Roy, Ph.D., MPH Michael Boice David Coutts, Ph.D. Stefanie Mazlish, MBA Aishwarya Nagarian, Pharm.D., MBA Slanix Paul Alex, Pharm.D. Sudarshan Phani, Ph.D. Kalee Shah Aneesh Sheth, Ph.D. Kamilia Sip, Ph.D. Tracey Van Kempen. About The Solution Lab The Solution Lab is a non-profit consulting organization based in New York. It staffs top tier graduate (PhD, MD, and MBA) students and professionals on interdisciplinary teams for short term management consulting projects in the Pharma/biotech/healthcare space. For further information contact [email protected] Methodological issues The questionnaire only recorded data from MCOs who agreed to participate in the survey. This is a potential source of non-response bias. Some of the questions (including graphs on pages 9 & 10) were added midway through the interview process. These graphs represent a reduced sample space. Not all MCOs agreed to answer each question. 14 of 14
The Honorable Alphonso Maldon, Jr. Chairman Military Compensation and Retirement Modernization Commission P. O. Box 13170 Arlington, Virginia 22209
The Honorable Alphonso Maldon, Jr. Chairman Military Compensation and Retirement Modernization Commission P. O. Box 13170 Arlington, Virginia 22209 Dear Chairman Maldon: The National Association of Chain
Health Care System. Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer
Creating a More Connected Health Care System Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer Agenda Our Role in the Changing Health Care System CVS/minuteclinic: Growth and
Robert Okwemba, BSPHS, Pharm.D. 2015 Philadelphia College of Pharmacy
Robert Okwemba, BSPHS, Pharm.D. 2015 Philadelphia College of Pharmacy Judith Long, MD,RWJCS Perelman School of Medicine Philadelphia Veteran Affairs Medical Center Background Objective Overview Methods
HEdis Code Quick Reference Guide Disease Management Services
HEdis Code Quick Reference Guide Disease Management Services Respiratory Conditions Appropriate Testing for Children With Pharyngitis (ages 2-18) [Commercial, Medicaid] Appropriate Treatment (no antibiotic)
Employee Population Health Management:
Employee Population Health Management: a stepping stone for accountable care Richard Boehler, MD, MBA, FACPE President and Chief Executive Officer St. Joseph Hospital, Nashua N.H. Learning to Manage Populations
Medication Therapy Management (MTM) Program
Medication Therapy Management (MTM) Program Regence offers a Medication Therapy Management (MTM) program to ensure you are receiving the most effective medications, while also helping to reduce the risk
Statement Of. The National Association of Chain Drug Stores. For. U.S. Senate Special Committee on Aging. Hearing on:
Statement Of The National Association of Chain Drug Stores For U.S. Senate Special Committee on Aging Hearing on: 10 Years Later: A Look at the Medicare Prescription Drug Program 2:30 p.m. 366 Dirksen
Connected drug delivery systems : Increase patient compliance and enable comprehensive, coordinated treatments
Connected drug delivery systems : Increase patient compliance and enable comprehensive, coordinated treatments Eric Dessertenne, PharmD, MBA Head of Business Development & Commercial Operations [email protected]
White Paper. Medicare Part D Improves the Economic Well-Being of Low Income Seniors
White Paper Medicare Part D Improves the Economic Well-Being of Low Income Seniors Kathleen Foley, PhD Barbara H. Johnson, MA February 2012 Table of Contents Executive Summary....................... 1
Re: CMS-1345-P; Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations; Proposed Rule
Department of Health and Human Services Attention: CMS 1345 P P.O. Box 8013, Baltimore, MD 21244 8013 Re: CMS-1345-P; Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations;
VHA Home Telehealth and Remote Patient Monitoring. Sandy Murphy [email protected] Department of Veteran Affairs VISN 21 Telehealth Program Manager
VHA Home Telehealth and Remote Patient Monitoring Sandy Murphy [email protected] Department of Veteran Affairs VISN 21 Telehealth Program Manager Professional Definition: the wider application of care
FULL COVERAGE FOR PREVENTIVE MEDICATIONS AFTER MYOCARDIAL INFARCTION IMPACT ON RACIAL AND ETHNIC DISPARITIES
FULL COVERAGE FOR PREVENTIVE MEDICATIONS AFTER MYOCARDIAL INFARCTION IMPACT ON RACIAL AND ETHNIC DISPARITIES Niteesh K. Choudhry, MD, PhD Harvard Medical School Division of Pharmacoepidemiology and Pharmacoeconomics
The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved.
The Value Quadrant of Healthcare Reform ACOs in PPACA Provider Organizations or networked groups Accountable for quality, cost and overall care of defined population of Medicare FFS benes Key metrics to
Brief Research Report: Fountain House and Use of Healthcare Resources
! Brief Research Report: Fountain House and Use of Healthcare Resources Zachary Grinspan, MD MS Department of Healthcare Policy and Research Weill Cornell Medical College, New York, NY June 1, 2015 Fountain
Medicaid Managed Care EQRO and MLTSS Quality. April 3, 2014 IPRO State of Nebraska EQRO
Medicaid Managed Care EQRO and MLTSS Quality April 3, 2014 IPRO State of Nebraska EQRO IPRO provides a full spectrum of healthcare assessment and improvement services that foster the efficient use of resources
Insight Into Evolving Payment and Delivery Models
Insight Into Evolving Payment and Delivery Models Overview Objectives Provide an overview of Accountable Care Organization (ACO)-like payment and delivery models Demonstrate Genentech s commitment to patient
PRESCRIPTION MEDICINES: COSTS IN CONTEXT
PRESCRIPTION MEDICINES: COSTS IN CONTEXT 2015 Since 2000, biopharmaceutical companies have brought MORE THAN 500 NEW TREATMENTS AND CURES to U.S. patients In the last 100 years, medicines have helped raise
Prescription drug costs continue to rise at
Prescription Drugs Developing an Effective Generic Prescription Drug Program by John D. Jones Pharmacy benefit managers (PBMs) use a variety of pricing strategies. When employers have a thorough knowledge
Physical and Mental Health Condition Prevalence and Comorbidity among Fee-for-Service Medicare- Medicaid Enrollees
Physical and Mental Health Condition Prevalence and Comorbidity among Fee-for-Service Medicare- Medicaid Enrollees Centers for Medicare & Medicaid Services September, 2014 i Executive Summary Introduction
Wasteful spending in the U.S. health care. Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs
Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs by Christopher J. Mathews Wasteful spending in the U.S. health care system costs an estimated $750 billion to $1.2 trillion
Population Health Management Systems
Population Health Management Systems What are they and how can they help public health? August 18, 1:00 p.m. 2:30 p.m. EDT Presented by the Public Health Informatics Working Group Webinar sponsored by
Population Health Management: Advancing Your Position in the Journey to Value-Based Care
Population Health Management: Advancing Your Position in the Journey to Value-Based Care Webcast Session One: An Integrated Approach to Population Health Management 11 August 2015 Welcome & Introductions
c. determine the factors that will facilitate/limit physician utilization of pharmacists for medication management services.
Consumer, Physician, and Payer Perspectives on Primary Care Medication Management Services with a Shared Resource Pharmacists Network Marie Smith, PharmD and Michlle Breland, PhD University of Connecticut,
11/2/2015 Domain: Care Coordination / Patient Safety
11/2/2015 Domain: Care Coordination / Patient Safety 2014 CT Commercial Medicaid Compared to 2012 all LOB Medicaid Quality Compass Benchmarks 2 3 4 5 6 7 8 9 10 Documentation of Current Medications in
UK Patients with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion
Insight Driven Health UK Patients with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion Accenture s research shows patients with chronic
The Rising Tide of Pharmacy Benefit Cost and Complexity: A health plans roadmap to optimizing pharmacy services relationships
The Rising Tide of Pharmacy Benefit Cost and Complexity: A health plans roadmap to optimizing pharmacy services relationships New pharmacy benefit challenges After several years of manageable pharmacy
Health Management Survey Findings: Employers in Brazil, with Some Comparisons with US Employers August 2011
Health Management Survey Findings: Employers in Brazil, with Some Comparisons with US Employers August 2011 2011 The Benfield Group, LLC 2 Background Survey designed by Benfield and CPH Health Fielded
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic
Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification
Disease Management UnitedHealthcare Disease Management (DM) programs are part of our innovative Care Management Program. Our Disease Management (DM) program is guided by the principles of the UnitedHealthcare
ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT
ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT Accountable Care Analytics: Developing a Trusted 360 Degree View of the Patient Introduction Recent federal regulations have
Optum One Life Sciences
Optum One Life Sciences April 15, 2015 Creating a profound and lasting impact on the health system Lower the cost trend > $100 billion 22 hours per day > 50% > $80 billion Unnecessary costs due to improper
Manitoba EMR Data Extract Specifications
MANITOBA HEALTH Manitoba Data Specifications Version 1 Updated: August 14, 2013 1 Introduction The purpose of this document 1 is to describe the data to be included in the Manitoba Data, including the
Hospitalization Risk Screening Tool for Primary Care Providers and Teams
Thank you for your interest in testing the prototype HARMS-8 tool for identifying critical intervention areas for patients with high risk medical conditions. While there is a growing expectation that primary
Statement Of. The National Association of Chain Drug Stores. For. U.S. Senate Committee On Armed Services. Personnel Subcommittee.
Statement Of The National Association of Chain Drug Stores For U.S. Senate Committee On Armed Services Personnel Subcommittee Hearing on FY2014 Budget April 17, 2012 2:00p.m. Russell Senate Office Building
Intervention Databases: A Tool for Documenting Student Learning and Clinical Value. Program Overview. Background
Intervention Databases: A Tool for Documenting Student Learning and Clinical Value Debra Copeland, B.S., Pharm.D., R.Ph. Margarita DiVall, Pharm.D., BCPS Ruth Nemire, B.S.Ph., Pharm.D. Beverly Talluto,
HL7 & Meaningful Use. Charles Jaffe, MD, PhD CEO Health Level Seven International. HIMSS 11 Orlando February 23, 2011
HL7 & Meaningful Use Charles Jaffe, MD, PhD CEO Health Level Seven International HIMSS 11 Orlando February 23, 2011 Overview Overview of Meaningful Use HIT Standards and Meaningful Use Overview HL7 Standards
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using
MDFlow Case Management & Disease Management (CM/DM) System
MDFlow Case Management & Disease Management (CM/DM) System The COMPLETE and CUSTOMIZED Case and Disease Management Solution for Healthcare Payers (HMOs, PPOs and MA Plans) Accountable Care Organizations
Risk Adjustment Models for Medicare Part D Capitation Payments Modeling
Risk Adjustment Models for Medicare Part D Capitation Payments Modeling John Kautter Melvin J. Ingber Gregory C. Pope Sara Freeman RTI International AcademyHealth 2011 RTI International is a trade name
University of Michigan Health Risk Assessment (HRA) and Trend Management System (TMS)
University of Michigan Health Risk Assessment (HRA) and Trend Management System (TMS) CIGNA has entered into a long-term agreement with the University of Michigan, which gives it access to intellectual
Kaiser Permanente: Health Education. Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center
Kaiser Permanente: Health Education Mei Ling Schwartz, MPH Director, Health & Physician Education Kaiser Permanente Panorama City Medical Center Who Is Kaiser Permanente? Founded in 1945, Kaiser Permanente
About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs.
1 Aaron McKethan PhD ([email protected]) About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. In partnership
ESCO- Information Technology Requirements With An Example of Solutions
ESCO- Information Technology Requirements With An Example of Solutions Pramen Applasamy DCI Application Manager Doug Johnson, MD DCI Vice Chairman of the Board July 15, 2014 15-WEEK WEBINAR SERIES EVERY
Overview of Research Programs January 2013
Overview of Research Programs January 2013 University of Mississippi School of Pharmacy 6 academic departments Medicinal Chemistry, Pharmaceutics, Pharmacognosy, Pharmacology, Pharmacy Administration,
A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY
A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY Table of Contents I. Introduction... 2 II. Background... 2 III. Patient Safety... 3 IV. A Comprehensive Approach to Reducing
Report on comparing quality among Medicare Advantage plans and between Medicare Advantage and fee-for-service Medicare
O N L I N E A P P E N D I X E S 6 Report on comparing quality among Medicare Advantage plans and between Medicare Advantage and fee-for-service Medicare 6-A O N L I N E A P P E N D I X Current quality
Medicare Advantage Stars: Are the Grades Fair?
Douglas Holtz-Eakin Conor Ryan July 16, 2015 Medicare Advantage Stars: Are the Grades Fair? Executive Summary Medicare Advantage (MA) offers seniors a one-stop option for hospital care, outpatient physician
Electronic Prior Authorization. Patient Care
Electronic Prior Authorization and HIT Solutions to Improve Patient Care Todd Sega, PharmD. Sr. Manager, Pharmacy Affairs October 20, 2014 Objectives 1. Identify epa transactions types and how transactions
HEDIS CY2012 New Measures
HEDIS CY2012 New Measures TECHNICAL CONSIDERATIONS FOR NEW MEASURES The NCQA Committee on Performance Measurement (CPM) approved five new measures for HEDIS 2013 (CY2012). These measures provide feasible
ACO Project Overview and Key Elements. Presented to FSSA September 3, 2013. 2013 Franciscan Alliance, Inc.
ACO Project Overview and Key Elements Presented to FSSA September 3, 2013 2013 Franciscan Alliance, Inc. Background of Presentation House Enrolled Act 1328 requires the Indiana Family and Social Services
Accountable Care Organizations (ACOs): Potential to Foster Quality While Reducing Costs
Accountable Care Organizations (ACOs): Potential to Foster Quality While Reducing Costs Debra Ness Co-Chair, Consumer-Purchaser Disclosure Project President, National Partnership for Women & Families David
Chronic Disease and Health Care Spending Among the Elderly
Chronic Disease and Health Care Spending Among the Elderly Jay Bhattacharya, MD, PhD for Dana Goldman and the RAND group on medical care expenditure forecasting Chronic Disease Plays an Increasingly Important
CIRCULAR 13 OF 2014: MANAGED CARE ACCREDITATION - FINAL MANAGED HEALTH CARE SERVICES DOCUMENT
CIRCULAR Reference: Classification and naming conventions of Managed Health Care Services Contact person: Hannelie Cornelius Accreditation Manager: Administrators & MCOs Tel: (012) 431 0406 Fax: (012)
8/14/2012 California Dual Demonstration DRAFT Quality Metrics
Stakeholder feedback is requested on the following: 1) metrics 69 through 94; and 2) withhold measures for years 1, 2, and 3. Steward/ 1 Antidepressant medication management Percentage of members 18 years
CMS Innovation Center Improving Care for Complex Patients
CMS Innovation Center Improving Care for Complex Patients ECRI Institute Dr. Patrick Conway, M.D., MSc CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality Director, Center for
HEDIS, STAR Performance Metrics. Sheila Linehan, RN,MPH, CPHQ Director of QM, Horizon BCBSNJ July 16, 2014
HEDIS, STAR Performance Metrics Sheila Linehan, RN,MPH, CPHQ Director of QM, Horizon BCBSNJ July 16, 2014 Goals Discuss what HEDIS and Star Metrics are Discuss their impact on Health Plans Discuss their
Innovations@Home. Home Health Initiatives Reduce Avoidable Readmissions by Leveraging Innovation
How Does CMS Measure the Rate of Acute Care Hospitalization (ACH)? Until January 2013, CMS measured Acute Care Hospitalization (ACH) through the Outcomes Assessment and Information Set (OASIS) reporting
Healthier Patients and a Healthier Bottom Line: Improving Your Pharmacy Practice Through Prescription Adherence Management
Healthier Patients and a Healthier Bottom Line: Improving Your Pharmacy Practice Through Prescription Adherence Management John Sykora, RPh, MBA Owner, Abrams and Clark Pharmacy Long Beach, CA October
Technology and Hawaii s Independent Physician:
Technology and Hawaii s Independent Physician: From EMR / EHR and Meaningful Use to Transformation Presentation for the Honolulu Subarea Health Planning Council Carl Barton, Director of Business Development
Electronic Medical Record Access Outweighs Privacy Concerns for Chronic Patients in Norway
Insight Driven Health Electronic Medical Record Access Outweighs Privacy Concerns for Chronic Patients in Norway Accenture research shows persons with chronic conditions in Norway are more concerned about
Electronic Health Record (EHR) Incentive Program. Stage 2 Final Rule Update Part 2
Office of Medical Assistance Programs Electronic Health Record (EHR) Incentive Program Stage 2 Final Rule Update Part 2 November 7, 2012 Medical Assistance HIT Initiative 1 Office of Medical Assistance
COMBINED PREDICTIVE MODEL FINAL REPORT
COMBINED PREDICTIVE MODEL FINAL REPORT DECEMBER 2006 ACKNOWLEDGEMENTS The following individuals are the principal contributors to the development of the Combined Predictive Model: Health Dialog David Wennberg,
Quality Improvement Program
Quality Improvement Program Section M-1 Additional information on the Quality Improvement Program (QIP) and activities is available on our website at www.molinahealthcare.com Upon request in writing, Molina
SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES
Summary Table of Measures, Product Lines and Changes 1 SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES General Guidelines for Data Collection and Reporting Guidelines for Calculations and Sampling
U.S. Contract Research Outsourcing Market: Trends, Challenges and Competition in the New Decade. N8B7-52 December 2010
U.S. Contract Research Outsourcing Market: Trends, Challenges and Competition in the New Decade December 2010 Table of Contents Notes on Methodology 8 Market Introduction and Segmentation Introduction
Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights
Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs [email protected] November 2013 1 Contents Overview of
SUMMARY TABLE OF MEASURE CHANGES
Summary Table of Measure 1 SUMMARY TABLE OF MEASURE CHANGES Guidelines for Physician Measurement Effectiveness of Preventive Care Guidelines for Physician Effectiveness of Care Adult BMI Assessment Weight
Quality Improvement in Primary Care Settings
Quality Improvement in Primary Care Settings Eboni Price Haywood, MD, MPH Chief Medical Officer, Tulane Community Health Medical Director, Tulane Community Health @ Covenant House Team Approach to Quality
Primary Care Quality Care Indicators - Accuro EMR Prevention
Quality Indicators Primary Care Quality Care Indicators - Accuro EMR Prevention Data needs to be entered as indicated in order to auto populate the worksheet Date of colon cancer screening Exemption from
Population Health Management Program
Population Health Management Program Program (formerly Disease Management) is dedicated to improving our members health and quality of life. Our Population Health Management Programs aim to improve care
Treating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health
Treating Depression to Remission in the Primary Care Setting James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health 2007 United Behavioral Health 1 2007 United Behavioral Health Goals
An Introduction to Medication Adherence
An Introduction to Medication Adherence Medication Adherence Project (MAP) A project of the Cardiovascular Prevention & Control Program and the Fund for Public Health in New York Drugs don t work in patients
ACO Program: Quality Reporting Requirements. Jennifer Faerberg Mary Wheatley April 28, 2011
ACO Program: Quality Reporting Requirements Jennifer Faerberg Mary Wheatley April 28, 2011 Agenda for Today s Call Overview Quality Reporting Requirements Benchmarks/Thresholds Scoring Model Scoring Methodology
Using EHRs for Heart Failure Therapy Recommendation Using Multidimensional Patient Similarity Analytics
Digital Healthcare Empowering Europeans R. Cornet et al. (Eds.) 2015 European Federation for Medical Informatics (EFMI). This article is published online with Open Access by IOS Press and distributed under
Pharmacology 260 Online Course Schedule Spring 2012
Pharmacology 260 Online Course Spring 2012 The topics listed below do not necessarily correspond to a 1 - hour lecture period. You should cover the topics for each week at some time during that week. Readings
Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION
Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for