Medicaid Population: Making a Difference with Disease Management

With 60 percent of adult Medicaid enrollees afflicted with a chronic or disabling condition (most commonly diabetes, hypertension, asthma, psychoses and chronic depression), and nearly half this group suffering from a second condition, this population is in critical need of a healthy dose of disease management (DM), healthcare industry experts say. The number of DM programs serving Medicaid populations continues to rise as states look to these programs to control Medicaid cost increases.In this special report, "The Medicaid Population: Making a Difference with Disease Management," based on a recent audio conference, expert speakers delve into Medicaid concerns ranging from eligibility and patient engagement to marketing strategies and provider connections as they explain how DM programs can integrate and improve care for those in need.You'll hear from Jerry Kiplinger, executive director, APS Healthcare and Herb Schultz, vice president, government account management, McKesson Health Solutions, on how to serve the unique needs of the Medicaid population in disease management programs.This 46-page report is based on the January 25, 2006 audio conference "Serving the Needs of the Medicaid Population in Disease Management Programs" during which Kiplinger and Schultz provided an inside look at their organizations' Medicaid disease management programs.You'll get details on: * Addressing the challenges of patient enrollment; * Identifying eligible beneficiaries; * Working with public health entities; * Maximizing existing resources; and * Promoting patient engagement.Table of Contents * Case Study: APS Healthcare Advocates Total Health Management o A Multi-Faceted Approach o Care Coordination and Staff Support o A Patient-Centered Program o Overcoming the Obstacles o Creating a Workable System o Influence of Politics o Characteristics of the Medicaid Population o Optimizing Community Outlets * Case Study: Disease Management Making a Difference at McKesson Health Solutions o The Foundation for Effective Programs o Maximizing Existing Resources o Medicaid Models in the States o Serving DM Needs of Medicaid Populations o Interruptions in Medicaid Eligibility o Clinical Indicators in DM Cases o Trends, Outcomes and Solutions * Q&A: Ask the Experts o Expediting the Process o More Members Log On o Determining Eligibility o Medical Homes Promote Continuity of Care o Strategies for Patient Engagement o Developing the Care Plan o The Coach-Client Relationship o Producing and Distributing Provider Toolkits o Seeking Out Specialists o Setting Some Standards o Keeping a Consistent Program o The Reality of Internet Use o The Low-Down on Physician Engagement o Targeting the Aged Population o The Technical Side o Staff Ratios by Program o Marketing Expenses o Using the Nurse Advice Line o Expanding Treatment to Children o Continuing Medical Education o Assessing ROI o Population Parameters o Choosing a Provider Champion o Provider-to-Population Ratios o Assessing Program Progress * Glossary * For More Information * About the AuthorsMedicaid Population: Making a Difference with Disease Management, was published 2006 under ISBN 9781933402512 and ISBN 1933402512.