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HomeMy WebLinkAboutMINUTES - 07272010 - PR.1RECOMMENDATION(S): Accept a report from Contra Costa Health Plan on its recent national honor for excellence in case management care and services in the category of Managed Care. FISCAL IMPACT: None. BACKGROUND: Contra Costa Health Plan’s (CCHP) Case Management program has been awarded the Managed Care Case In Point Platinum Award by Dorland Health in collaboration with the Commission on Case Management Certification (CCMC). The award was made, in April at the National Press Club in Washington, D.C. 1. CCHP’s Case Management program won this award because of its unique, innovative components, which support the individual medical and psychosocial needs of our CCHP members along the continuum of care from pediatrics through seniors. The program succeeds in ensuring cost-effectiveness and quality of care for its clients at all life stages. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 07/27/2010 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Susan A. Bonilla, District IV Supervisor Federal D. Glover, District V Supervisor Contact: Patricia Tanquary, 313-6004 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: July 27, 2010 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: KATHERINE SINCLAIR, Deputy cc: Tasha Scott, Barbara Borbon PR. 1 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:July 27, 2010 Contra Costa County Subject:Report to the Contra Costa Board of Supervisors regarding National Case Management Honor for the Contra Costa Health Plan BACKGROUND: (CONT'D) 2. To address the issue of inconsistent pediatric well visits for our Medi-Cal and Health Families population, the parents/guardians of identified children are contacted and encouraged to make an appointment via Case Management’s Good Health Check-Up program for either an initial health assessment or a well check. 3. Case Management staff makes appointments at one of the County’s eight Health Centers. Consideration is taken for siblings requiring visits as well. The Case Management staff schedules “family” appointments to better affect compliance with recommended well child visits and immunizations. 4. As an incentive, a gift card is mailed to children and adolescents who complete their scheduled appointments. Mailed reminder cards and reminder phone calls are other benefits of this program, which have proven successful in increasing the number of “kept” appointments. The Good Health Program closely monitors the “kept” rates for appointments scheduled through the program and strives to maintain kept rates of a least 80%. 5. The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. Current CCHP HEDIS rates reflect improvement in the rate of CCHP Medi-Cal members receiving adolescent well care – up more than 10%, well child visits in the 0-15month age range – up more than 8%, the 3-6year age range – up almost 4%- and improvement in childhood immunization status – up almost 8% between 2007 and 2009 as recommended by the American Academy of Pediatrics. This has been attributed in large part to the outreach activities of the Good Health Check-Up program during this period. 6. To better service the County’s medically indigent population, Contra Costa Health Plan’s Case Management Department provides an initial health screening of all newly enrolled persons into the HCCI program. Over 65% of all HCCI clients have chosen to participate in the health-risk screening process. The goal of these assessments is to quickly triage high-risk patients to Complex Case Management and other appropriate services. The assessments identify the need for urgent provider appointments as well as barriers to obtaining healthcare services. A Counselor contacts each HCCI recipient to complete the assessment and provide information and assistance with transportation, food resources, housing resources, assignment of a Primary Care Provider, scheduling of healthcare appointments and rapid triage to complex case management as needed. Special attention is given to those clients who over utilize emergency room services. This program has been successful in decreasing both in-patient days and emergency room utilization in this population. 7. SelectCare is the Health Plan’s Special Needs Plan (SNP). The purpose of the Program is to ensure that the frail elderly, the disabled, and those with multiple chronic illnesses receive comprehensive high quality, well-coordinated care and service. The program is focused on the delivery of cost-effective, appropriate health and social services for members with complex and chronic care needs. Case Managers work to identify, coordinate, and evaluate appropriate services, with the goal of assisting the member to remain in the least restrictive setting within their community. Case Management is performed through a process of telephonic assessment and review, and may be complemented with in-home visits. This program is directed at creating individualized care plans to meet the member’s unique medical and psychosocial needs.