Health Promotion in Kansans with Disabilities

Kansas Medicaid’s CMS Transformation Grant Kansas Health Policy Authority in collaboration with the University of Kansas Medical Center & Ingenix Presented by Theresa I. Shireman, Ph.D.

University of Kansas Medical Center

Collaborative Effort

   Kansas Health Policy Authority (KHPA)    Becky Ross Sharon Johnson Debbie Huske University of Kansas Medical Center (KUMC)  James Backes, Pharm D   Allen Greiner, MD Aimee James, PhD Ingenix Impact Pro   Developer of solutions that are focused on improving health care through the use of information and technology www.ingenix.com

Statement of Project Need

   Persons with disabilities  Less likely to receive preventive health care services    High rates of chronic comorbidities High rates of medication use  Compliance problems Face variety of barriers to quality health care Case managers   Support/coordinate vocational & social services New responsibility for medical services coordination Ultimate goal… improve beneficiary health!

Project Goals & Objectives

 Increase use of age- and gender-appropriate preventive health care  Increase receipt of chronic disease monitoring services  Improve compliance with chronic medications

Project Description: Agencies

 Case managers recruited from selected agencies:  Community Developmental Disability Organizations (CDDOs)  Independent Living Centers (ILCs)  Serve primarily physically disabled  Located throughout state of Kansas

Project Description: Impact Pro

   Claims-based predictive modeling tool  Lists all paid claims incurred in most recent 12 month experience period including hospitalizations, doctor visits, medications, and other services  Uses ETG grouper logic to create condition specific episodes Identifies gaps in care and opportunities for care interventions   Standard Impact Pro rules based upon clinical consensus Ability to fully customize rules to identify members Accessed via Web  Case Managers access the Impact Pro Reporting System on-line

Project Description: Training

 Live training sessions  KUMC faculty  Medical & pharmacy home  Basic chronic disease management  Basic chronic medication management  Small group activities  Ingenix Impact Pro™  Computer-assisted training

Project Description: Case Managers’ Support

   Project website  Training materials  Useful links Monthly e-newsletters   Developed by KUMC faculty & staff Range of topics: chronic diseases, physical health, dental care, medications Consultation with team MD & RPH  Email based: triaged by project manager

Project Evaluation: Case Manager Assessments

 Surveys  Baseline & conclusion of intervention  Focus groups  Conclusion of intervention  Identify barriers & facilitators of implementation & program success  Team leaders & selected case managers

Project Evaluation

 Changes in…  receipt of preventive care  receipt of chronic care monitoring  medication adherence  Pre- vs. post-intervention claims data  Within participating agencies  Across participating & non-participating agencies