Care management processes
A state-based, public–private partnership supports medical homes in managing the care of Medicaid managed-care enrollees, leading to higher quality and significant reductions in utilization and costs.
A collaborative initiative features standardized care elements and fixed per-patient payments for treatment of depression in the primary care setting, leading to high rates of remission and response to treatment and high levels of provider satisfaction.
A multistakeholder collaborative, the Rochester Blood Pressure Initiative supports the development and implementation of a variety of provider-, employer-, and community-based programs that have collectively improved blood pressure control among hypertensive individuals in metropolitan Rochester, NY.
A health plan supports providers in orthopedic clinics in distributing decision aids to patients and using shared decisionmaking, contributing to reductions in joint replacement surgeries and overall health care costs.
A county-based accountable care organization integrates medical, behavioral health, and social services and assigns a care coordinator to newly enrolled Medicaid beneficiaries to promote use of appropriate services, leading to fewer readmissions and emergency department visits and lower costs.
Partners in an accountable care organization share risk via an annual global budget and implement initiatives to improve efficiency and quality, leading to reductions in hospital use and overall health care costs.
A data exchange platform links individual State PMPs, helping authorized prescribers and pharmacists identify patients who appear to be crossing State lines to obtain drugs for potential personal misuse or illegal activity.
A comprehensive bundle of process improvement strategies improved patient turnaround time in the emergency department, which in turn led to fewer patients leaving before being treated.
The health department in New York City uses subsidies, upfront and ongoing technical support, and quality of care feedback to promote implementation and use of electronic health records by primary care practices in medically underserved areas, leading to better care for patients in these practices.
The Children's Healthcare Access Program offers financial incentives and support services to primary care medical homes serving children covered by Medicaid and their families; the program enhanced access to primary care, increased the percentage of children with asthma action plans, reduced emergency department visits and hospital admissions, increased well-child visits, and reduced costs.