Management structure

Innovations

State Medicaid Program Adopts Multiple Policies to Significantly Increase Screening Rates and Enhance Access to Services for Young Children at Risk of Developmental Disabilities 06/10/13

The Oregon Health Authority (which oversees the State Medicaid program) initiated a series of policy changes to promote earlier detection, more effective referrals, and better coordination of care for pediatric patients with developmental delays, leading to a significant increase in screening rates and enhanced access to early intervention services.

Statewide Measurement and Reporting System Stimulates Quality Improvement in Targeted Clinical Areas, Becomes Standard for Local and National Pay-for-Performance Programs 04/23/13

A statewide measurement and reporting system serves as a single, comprehensive, credible source of information on provider performance, leading to significant improvements in performance over time and to adoption and use of the system by local and national payers and other organizations.

State–Federal Program Provides Capitated Payments to Plans Serving Those Eligible for Medicare and Medicaid, Leading to Better Access to Care and Less Hospital and Nursing Home Use 03/13/13

A combined State-Federal program pays health plans a capitated fee to provide and coordinate acute, primary, long-term care as well as social services to those eligible for Medicare and Medicaid, leading to enhanced access to care, fewer inpatient admissions and nursing home placements, and high levels of beneficiary and provider satisfaction.

Statewide Health Information Exchange Generates High Levels of Participation and Many Reports of Improved Quality and Efficiency 02/26/13

The nation's first statewide health information exchange, the Delaware Health Information Network gives clinicians immediate access to patient-specific health data from other providers, leading to higher quality and more efficient care.

School-Based Health Centers Enhance Access to Mental Health Services for Adolescents, Particularly African-American and Hispanic Males 02/21/13

Connecticut's 78 school-based health centers offer a broad array of confidential mental health services to elementary, middle, and high school students co-located with traditional primary and acute medical services. The school-based centers have enhanced access to mental health services and generated high levels of satisfaction for students (particularly African-American and Hispanic males), and have led to less missed class time.

Multistakeholder Community Collaborative Spurs Development of Initiatives That Collectively Have Improved Blood Pressure Control Among Hypertensive Individuals 02/19/13

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.

County-Based Accountable Care Organization for Medicaid Enrollees Features Shared Risk, Electronic Data Sharing, and Various Improvement Initiatives, Leading to Lower Utilization and Costs 02/14/13

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.

System Gives Authorized Users Access to Interstate Information on Controlled Substance Prescriptions, Assisting Them in Identifying Cases of Potential Misuse 02/08/13

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.

Community Partners Offer Financial Incentives and Support for Primary Care Practices, Improving Access and Reducing Utilization for Children on Medicaid 02/06/13

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.

Behavioral Health Clinic Offers Onsite Primary Care to Low-Income Asians With Severe Mental Illness, Enhancing Access and Facilitating Improvements in Physical Health 01/25/13

A behavioral health clinic maintains an onsite primary care clinic that provides culturally competent care to low-income Asian Americans with serious mental illness, enhancing access to such care and facilitating modest improvements in physical health.

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