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A Medicaid expansion program in Wisconsin is introducing many Medicaid beneficiaries reluctantly to managed care but with an early, effective introduction to its telephonic care coordinators, Independent Health Care Plan (iCare) is successfully engaging these new members.
Over half of new iCare Medicaid members are reached within 15 days by telephonic care coordinators to begin to initiate a relationship and a majority of members have a health risk assessment (HRA) completed over the phone within the first 90 days. Through these completed HRAs and identification of high-risk members and resulting interventions, iCare has been able to reduce high emergency department (ED) use that was not appropriate.
During Medicaid Member Engagement: A Telephonic Care Coordination Relationship-Building Strategy, a 45-minute webinar on May 16th, now available for replay, Lisa Holden, vice president of accountable care, iCare, shared how iCare has structured its care coordination team, including both telephonic and boots on the ground staff to find, engage and assess Medicaid members.
You'll learn how iCare:
- Utilizes its telephonic care coordinators to change the perception of care management from its initial, early contact with new members and conducts an HRA with that initial call if the member is ready to engage;
- Holds its care coordination staff accountable for member engagement and HRA completion goals through audits and a series of protocols to find and contact members;
- Leverages health coaches as community health workers in the communities in which they reside so they have a good working knowledge of that neighborhood and can find members who have not been reached telephonically, dig into any social health determinants that may impact members and conduct HRAs along with care coordinators for those members who don't engage telephonically;
- Addresses Medicaid members with high ED utilization through a pilot program, "Better Care for You," which provides financial incentives to align that member with a typical primary care relationship and a partnership with community paramedics to provide transportation and home visits to high ED utilizers to help identify reasons behind this often inappropriate high utilization;
- Supplements its telephonic care coordinators with intervention specialists for trauma informed care, alcohol and drug abuse so that members remain with the same care coordinator as they move through risk stratification levels; and
- Partners with home health agencies in its service area with a "Follow to Home" program, incenting these home health agencies to identify risk factors that lead to readmission through a series of increasing financial incentives when patients are not readmitted to the hospital at 30, 60 and 90 days, respectively.
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WHO WILL BENEFIT FROM THIS CONFERENCE?
Presidents, CEOs, medical directors, quality improvement executives, physician executives, performance improvement professionals, Medicaid executives, patient and member engagement directors, and strategic planning directors and consultants.