Managed Care in Southwest Washington September 14 th 2016 | - - PowerPoint PPT Presentation
Molina and Fully Integrated Managed Care in Southwest Washington September 14 th 2016 | Presented by: Ian Parham Molinas History Founded in 1980 by Dr. C. David Molina Single clinic Commitment to provide quality healthcare to those most
| Presented by: Ian Parham
September 14th 2016
Molina’s History
2
Founded in 1980 by Dr. C. David Molina Single clinic Commitment to provide quality healthcare to those most in need and least able to afford it
National company that touches over 3.5 million Medicaid beneficiaries 28 states, 2 commonwealths + Washington DC
To provide quality health care to people receiving government assistance
We envision a future where everyone receives quality health care
Recognized for Quality, Innovation and Success
4
Molina Healthcare, Inc.
America’s top Medicaid plans by U.S. News & World Report and NCQA
Workplace Flexibility in 2011
by Hispanic Business magazine in 2009
care by The Robert Wood Johnson Foundation
2015
recognized by Time Magazine as one of the 25 most influential Hispanics in America
Molina in Washington
5
County (75%)
with Columbia United Providers CUP
Current State – Fragmented Financing and Care
7
8
What Does Better Look Like?
Better medical care and
for people living with chronic mental illness Better identification and treatment
health conditions in primary care Better integration
fragmented systems through care coordination – no falling through cracks
Triple Aim
Better health
Lower total cost of care Better Patient/ Provider experience Better inclusion of Social determinants
9
Provider Network
11
Primary Care
Naturopath)
Mental Health
Substance Abuse
Community Providers
(BH-ASO) for providing crisis service response 24 hours a day/7 days a week/365 days a year
Care Management Programs
Community Based Face to Face Care Coordination CHW Health Homes
Telephonic Case Management Telephonic Disease Management In person and Telephonic Transitions of Care 24/7 Nurse Advice line
12
Molina Healthcare Virtual Care (MVC)
14
Molina Healthcare is increasing services to members through their mobile phones
members to search for a doctor, change doctors
service history, etc.
and control over their health information
information- test launch in Clark County
Community Engagement
Community Involveme nt and Sponsorshi p Plan Enrollment and Retention Education, Outreach, and Advocacy Community Involvement and Sponsorship Enrollment and Access to Care Education, Outreach, and Advocacy
Organizations
access to healthcare
16
17
more than 1,000 member facing events and more than 800 meetings with community helpers and influencers across the state of Washington
communities, provide education in healthy living, and answers about health coverage and the healthcare systems in WA
team is local to many regional communities and also travels to remote locations providing information and outreach
Local Community Partnerships
key local Community Based Organizations in Clark County, through October.
celebration of outstanding community volunteers, has recognized three Clark County residents in recent years:
conferences, like “Integrated Care Conference”, “WA Behavioral Health” and “Latino Center for Health” in Vancouver.
2,000 books donated this year to local schools including Marshall, Pioneer, Sara J. Anderson, and Walnut Grove
18
– Member Services: (800) 869-7165 – Questions about Medicaid Eligibility: (800) 294-8620 – Community Engagement:
Carlos.mejiarodriguez@molinahealthcare.com 360-489-7969
Katterine.Nazario-Vasquez@MolinaHealthCare.Com 425-398-2659
Jorgearturo.rivera@molinahealthcare.com 425-424-7119
19
Questions?
20
11