Rachel Copeland, MDHHS Debra Darling, Institute for Health Policy, - - PowerPoint PPT Presentation

Rachel Copeland, MDHHS Debra Darling, Institute for Health Policy, MSU

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• Learning Goals:
• Describe MHP population health and quality

improvement initiatives

• Provide an overview of required performance

improvement measures

• Identify opportunities for collaboration

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• Managed Care since 1997
• New Medicaid Contract: January 2016
• 11 Medicaid Health Plans
• Population health framework
• Focus on evidence and value-based care delivery

models

• Service areas based on Prosperity Regions

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• Population Health Management Goal: To reduce

racial/ethnic disparities

• Implement a program and other procedures to

address social determinants of health and Health Equity

• Two Healthcare Effectiveness Data and

Information Set (HEDIS)measures selected for disparity reduction:

• Postpartum Care
• Childhood Immunization Status – Combo 3

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• Chlamydia Screening
• Largest racial/ethnic disparity of the Health Equity Project

last three years

• Goal: To describe and implement programs/efforts

to improve screening and treatment rates, and narrow health disparities

• Target: Men ages 16-18 and women ages 16-24 years
• Data analysis by race/ethnicity/gender

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52.0% 54.0% 56.0% 58.0% 60.0% 62.0% 64.0% 66.0% 68.0% 70.0% 72.0% 74.0% 76.0% 78.0% 2012 2013 2014 2015

Chlamydia ydia Screening ning by Race/Ethnic hnicit ity y 2012-20 2015 15

White African American Hispanic/Latino Michigan Medicaid All Managed Care Plans National Medicaid 50th Percentile 8

• Participation in MDHHS approved community-lead

initiatives to improve population health in each service area region

• MHPs have identified some of the following social

determinants of health: family, transportation, housing stability

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• Emergency Department Utilization
• Develop an in-depth understanding of ED utilization
• Design interventions that move toward systematic approach to

address complex issues impacting utilization

• Intervention focus: high-volume, high-risk, or problem-

prone areas

• Goals: To improve health outcomes; enhance

coordination of services; partner with non-traditional healthcare providers; increased cost-effectiveness

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• Collaboration and integration between Medicaid

Health Plans (MHPs) and Pre-paid Inpatient Health Plans (PIHPs)

• Joint care management processes
• Shared performance metrics
• Follow-up after Hospitalization for Mental Health Illness

within 30 days

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• Women’s Health:
• Breast Cancer Screening
• Cervical Cancer Screening
• Chlamydia Screening
• Prenatal Care
• Postpartum Care
• Low Birth Weight
• Low-Risk Cesarean Section
• Adolescent Immunizations
• Smoking Cessation Strategies: Medical Assistance with

Smoking and Tobacco Use (Consumer Assessment of Healthcare Providers and Systems-CAHPS)

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51.6% 64.3% 48.2% 63.2% 54.9% 61.6% 57.4% 0% 25% 50% 75% 100% AI/AN n = 91 Asian/NH/OPI n = 384 AA n = 10460 Hispanic n = 1580 Other/ Multiracial n = 51 White n = 19465 All Plan n = 33342 Percentage Race/Ethnicity Post-Partum Care, By Race/Ethnicity Michigan Medicaid All Managed Care Plans HEDIS 2015

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• Childhood Immunizations
• Well-Child and Adolescent Well Care Visits
• Access to Primary Care Visits
• Chronic Conditions (Diabetes & Asthma)
• Child and Adult BMI
• Blood Lead

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• In July 2014, Center for Medicaid and CHIP

Services (CMCS) launched the Maternal and Infant Health Initiative, in collaboration with states to:

• Increase the rate and content of postpartum visits
• Increase the use of effective methods of contraception
• Supports collection and reporting of data to CMCS on

a developmental quality measure

• Measure assesses progress on the goal to increase

the use of effective methods of contraception

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• Assessment of MHP Family Planning Services
• Survey of primary care and OB/GYN provider

regarding reproductive counseling and Long- Acting Reversible Contraception (LARCs) - Pending

• Pilot in 3-4 practices related to reproductive health

counseling

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g Acti ting, ng, Rever ersibl sible e Con

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traceptio ion (LAR ARC) C) Lon

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Intrau rauterin terine e Device, vice, Hormo rmone ne Releas leasin ing Intrau rauterin terine e Device, vice, Copper pper MOST OST EFFECT FECTIV IVE, E, PERMA MANENT ENT Female emale Steri rili lizati zation Male le Ste teril ilizat zatio ion MODERA DERATELY TELY EFFECTIVE FECTIVE Lon

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g Acti ting ng Hormo rmone e Injectio jection Vagin inal al Ring ing Oral al Contraceptiv

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es "The he Pill" l"

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• Population Health
• Community Collaboration
• Health Equity
• Low Birth Weight (LBW) by prosperity region
• Performance Measurement
• Other:
• MHP Performance Improvement Project (PIP):

Timeliness of Prenatal Care

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• Medicaid Managed Care Sample Contract
• http://www.michigan.gov/documents/contract_7696_7.pdf
• Minority Health Equity Report
• http://www.michigan.gov/documents/mdhhs/2016_Health_Equity_Base_Report_Dr

aft_3.17.17_R eadyToSubmit_UpdatedGraphic_572318_7.pdf

• HEDIS Aggregate Report
• http://www.michigan.gov/documents/mdhhs/MI2016_HEDIS-

Aggregate_F1_552834_7.pdf

• Federal Contraception pages
• https://www.medicaid.gov/medicaid/quality-of-care/improvement-

initiatives/maternal-and-infant-health/contraception/index.html

• https://www.medicaid.gov/medicaid/quality-of-care/improvement-

initiatives/maternal-and-infant-health/

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Rachel Copeland CopelandR1@michigan.gov 517-284-1160 Debbie Darling Debra.darling@hc.msu.edu 517-432-9822

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