| |
NEIGHBORHOOD HEALTH PLAN HONORED FOR ASTHMA PROGRAM BY EPA
Neighborhood Health Plan was one
of five organizations honored by the U.S. Environmental
Protection Agency (EPA) with the agency’s 2010 National
Environmental Leadership Award in Asthma Management. The award
winners were recognized at the National Asthma Forum in
Washington, D.C., on June 17 where hundreds of health-related
organizations, researchers, and policy makers gathered to
discuss effective community-based strategies to improve asthma
programs and provide high-quality care.
The recipients have demonstrated
outstanding leadership in improving the health of people living
with asthma. Twenty-three million people in the United States,
including 7 million children, suffer from asthma, which is one
of the leading causes of emergency room visits,
hospitalizations, and school absenteeism for children. One of
EPA Administrator Lisa P. Jackson’s priorities is improving air
quality, which has a substantial impact on people who suffer
from asthma.
"Millions of Americans, many of them children, face the enormous
challenges and costs of asthma every day," Administrator Lisa P.
Jackson said. "The organizations we're honoring today are using
innovative programs to make life easier for those suffering from
asthma. With their efforts and EPA's continued work to clean the
air we breathe, we're on the right path to reduce the impact
asthma has on our families, our communities and our economy."
As part of its commitment to improving the lives of its 200,000
members and in response to alarming rates of asthma among the
Plan’s target population, Neighborhood Health Plan introduced
its innovative Asthma Disease Management Program (ADMP) in 2000.
NHP provides an Asthma Home Visitation Program (AHVP) to all
members living with asthma in need of in-depth asthma education
and/or home environmental assessment. NHP implemented an
Enhanced Asthma Home Visit program in 2005 based on the positive
outcomes of a one year Inner City Asthma Study (ICAS) of
non-clinician home-based environmental intervention to reduce
exposure to environmental triggers and allergens. The AHVP
empowers patients to proactively manage their asthma by
providing multilingual, low-literacy education to patients and
their families during in-home environmental assessments and
interventions. In addition, the ADMP helps primary care
providers improve asthma care by enhancing programs at primary
care sites; using a robust and comprehensive asthma registry;
and increasing provider awareness and compliance with asthma
treatment guidelines. To further address the appropriate
management of asthma, NHP’s website provides access to several
provider-focused resources. By collaborating with
community-based initiatives, including the Boston Asthma
Initiative, the Greater Brockton Asthma Coalition, and State and
regional partners, the ADMP’s active leadership strengthens
Massachusetts’ community-wide approach to asthma management.
Over the past decade, the rates of annual asthma
hospitalizations and emergency department visits for
Neighborhood Health Plan’s asthma population have fallen by more
than 30 percent.
ACAP ALSO PART OF FACULTY AT THE EPA NATIONAL ASTHMA FORUM
EPA recently held the 2010
National Asthma Forum. Hundreds of providers, health plans,
health departments, community asthma coalitions, researchers,
policy makers, and other leaders gathered to discuss the most
effective community-based strategies for improving asthma
program outcomes, building successful and sustainable asthma
care programs, and extending the reach and impact of great
programs to deliver high-quality asthma care to everyone in
need.
Deborah Kilstein, ACAP’s Director for Quality Management and
Operational Support participated as a panelist in a keynote
session entitled Communities in Action— Assets for Delivering
High Quality Asthma Care. The session was designed to
provided an overview of the critical findings from the landmark
study by the George Washington University School of Public
Health and Health Services, "Changing
pO2licy: The Elements for Improving Childhood Asthma," which
identified five essential elements for improving health outcomes
for children with asthma. The report served as a foundation for
the session in which panelist’s were asked to describe how their
organizations address the report’s recommendations.
PHARMACY CALL FOCUSES ON IDENTIFYING GAPS IN CARE
On June 10th , ACAP hosted a
Pharmacy Roundtable. The focus of the call was a presentation by
Jeffrey Kreitman, Clinical Pharmacist with AmeriHealth Mercy
Health Plan on the health plan’s innovative,
internally-developed, Pharmacy Gaps in Care (GIC) program. The
program reviews pharmacy (and sometimes medical) claims to
evaluate members who are on incomplete therapy. When a case
manager requests a member's profile, the program stops at the
GIC page to display the member's gaps and allows access to more
detailed information about the gap before proceeding to the
medication profile. Alternatively, the case manager can work a
queue of their members with gaps, or managers can simply select
a gap and view all members encountering a similar gap in care.
ACAP PLANS DISCUSS INTERSECTION OF HEALTH PLAN ACCREDITATION
STANDARDS AND PATIENT-CENTERED MEDICAL HOME RECOGNITION PROGRAM
At the Medicaid Managed Care
Congress in Baltimore last week, Mark Reynolds of NHPRI and Dr
Thiele of CareSource raised the issue of the interrelationship
between the NCQA health plan accreditation standards and the
NCQA Patient-Centered Medical Home recognition program as it
relates to the case management standards. In follow-up to that
question, ACAP hosted a call on June 10th with Tricia Barrett,
NCQA’s VP, Product Development.
At issue is how health plans will be evaluated during the
accreditation process if case management and other functions
have been delegated to a patient-centered medical home.
According to Ms. Barrett, NCQA is considering whether certain
factors can be scored using the delegation process. ACAP health
were asked to indentify the specific accreditation standards and
factors that should be considered if this model is recommended.
QUALITY NETWORKING CALL ON HEALTH CARE DISPARITIES LOOKS AT
HEALTH LITERACY ISSUES
On June 16th, a dozen health
plans participated in the Quality Networking call on health care
disparities. The focus of the call was the interrelationship
between health literacy and disparities. Dr. Gregory Preston,
Medical Director, gave a overview of an interesting and
effective pilot program implemented at Cook Children’s. The
program uses the Newest Vital Sign screening tool developed by
Pfizer to assess and identify parents with low health literacy
levels. As a result of the assessment, the health education
methodology was altered where needed and more intensive
follow-up was provided by the case management team. Preliminary
results have been very promising. More information about the
Newest Vital Sign tool, including an article entitled Quick
Assessment of Literacy in Primary Care: The Newest Vital Sign
that appeared in the Annals of Family Medicine, can be found at
the
Pfizer Clear Health Communication Initiative website.
PUBLIC COMMENT ENDS SOON FOR NCQA PATIENT-CENTERED MEDICAL HOME
2011 STANDARD
June 28 is the final day to
comment on proposed updates to the PCMH 2011 standards. Public
Comment is a key part of the development process for all NCQA
programs. NCQA appreciates the time and effort that
organizations invest in providing feedback, and considers all
suggestions made during the Public Comment period.
The PCMH 2011 standards build on the strengths of Physician
Practice Connections®-Patient-Centered Medical HomeTM (PPC®-PCMHTM).
They apply to the full spectrum of practice configurations, from
small to large or electronically enabled to paper-based, in a
variety of practice locations and for newly applying practices,
as well as for those seeking renewal of Recognition.
Click here to access the public comment on the PCMH 2011 update.
In addition to emphasizing
patient-centric, coordinated care and moving toward performance
benchmarking within practices, the revised standards seek to:
- Encourage better integration
across practices through enhanced quality improvement
requirements
- Strengthen program
requirements
- Integrate behaviors
affecting substance abuse and mental health issues
- Align with the Centers for
Medicare & Medicaid Services' proposed Measures of
Meaningful Use (for ARRA incentives)
The revised program has been
restructured from nine standards (in PCMH) to six standards.
NCQA proposes additional advanced requirements: reporting
standardized clinical and patient experience results and
establishing formal relationships with specialists and
facilities. As with the current program, NCQA will not require
all items to be met for achieving Recognition.
PUBLIC COMMENT PERIOD FOR NEW URAC PATIENT CENTERED HEALTH CARE
HOME EDUCATION AND EVALUATION (PCHCH) PROGRAM
URAC will launch its 45 day
public comment period for its new PCHCH Education and Evaluation
Program by the end of June 2010. The PCHCH Education and
Evaluation Program is a complimentary suite of three toolkits to
help healthcare practices determine their readiness to become a
Patient Centered Health Care Home, as well as steps which can be
taken to advance from a basic to advanced a truly
patient-centered practice. The PCHCH Evaluation and Education
Program is scalable and flexible in design, and can be adopted
by individual or multi-site practices, physician groups, health
plans, insurers, and pilot programs. The three toolkits can be
used individually or in any combination, and include a
Healthcare Practice Assessment Toolkit, a Patient
Satisfaction/Experience Toolkit, and a Performance Measures
Toolkit. This PCHCH Education and Evaluation Program is a
voluntary, step-wise, educational approach towards building
PCHCH infrastructure and competencies, and thus stands alone as
a unique, educational and evaluation product for URAC. End users
can decide how to use the toolkits, with the potential for
payers and pilots programs to set their own benchmarks for
practice qualification for funding incentives and payment
bonuses. The multi-stakeholder URAC PCHCH Advisory Group
developing the program represents every sector of the health
care community, and has provided expert guidance as the program
has progressed substantially since the Advisory Group’s kick-off
meeting on March 17, 2010. For more information, contact
urac.gr@urac.org.
|
|
