New Initiatives
The Best is Yet to Come
With CareSource leading the way with bold new initiatives adopted to serve more members more effectively, the coming year promises to be brighter indeed.
Health Care Reform
Passed by Congress on March 23, 2010, health care reform (Patient Protection and Affordable Care Act) included many provisions that will be critical to our mission of improving health care for the underserved. The new law incorporates a significant expansion of the Medicaid program, giving access to health coverage to an additional 16 million uninsured Americans. In Ohio, alone, close to one million individuals are expected to become eligible for Medicaid coverage and will potentially have the option of choosing CareSource as their health plan in 2014.
Montgomery County Care
To strengthen the health care safety net for the county’s most vulnerable populations, Montgomery County Care – a partnership program with CareSource, Montgomery County and Community Health Centers of Greater Dayton – plans an expansion that will help members manage chronic diseases more effectively. With a system that includes primary care through the Community Health Centers and access to specialists, the program provides cost-effective health care for the county’s underserved adults. Projections indicate that the expansion will also help reduce reliance on emergency services and inpatient hospital admissions.
Health Care Home Collaboration Expands
Working closely with providers throughout Ohio, CareSource is stepping up efforts to achieve truly integrated care. Our patient-centered medical home program, Health Care Home, has increased its partnerships with our Health Care Home providers, putting processes and best practices into place that will ensure better health outcomes for even more of our members. Through the assignment of “champions” at each Health Care Home provider office and a case manager for each practice, we are seeing transformational changes and our increased HEDIS* scores indicate continued improvement in care, service and quality.
* 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.
Facts about Montgomery County Care Members:
- 20% suffer from hypertension
- 9% have diabetes
- 7% have asthma
- More than two-thirds are in their 40s or 50s
- 80% live in the city of Dayton
Care Transitions Program
Throughout 2010, many CareSource Care Transitions program activities were expanded and enhanced in Ohio and Michigan. Serving as the overarching program for several key care management programs, the Care Transitions program is focused on one goal: to improve communication with key stakeholders – which will, in turn, improve care coordination for all members. The result is improved care, better outcomes and a greatly reduced number of avoidable emergency room visits and inpatient admissions.
To assist in achieving this goal, partnerships have been developed with numerous community-based outreach and safety-net organizations focusing on behavioral health, prenatal and well child care, and emergency services.
CareSource Advantage® – Special Needs Plan Expansion
CareSource Advantage® is a plan for members who are eligible for Medicare and Medicaid. In 2010, the Special Needs Plan (SNP) service area expanded into Southeast Michigan to serve major metropolitan areas, including Wayne, Oakland and Macomb counties. Currently, we provide access to members in 10 counties throughout Michigan. In Ohio, we expanded to an additional 37 counties, for a total of 54.
Bridge to Home – Michigan
Ensuring a member’s post-discharge needs are fully met, the Bridge to Home discharge planning program arranges timely and appropriate discharge to the next level of care. CareSource Michigan case managers assist each hospital-bound member with coordination of all transitional needs and appropriate outpatient services. The member’s medical home is also involved with each phase of the transition. Our case managers ensure that the member will have access to necessary medication upon discharge and transportation to follow-up appointments with the medical home.
In this first year of the program, the Bridge to Home team decreased readmission rates by 13 percent.
Partnership with text4baby™
CareSource partnered with text4baby, offering expectant and new moms a convenient way to help care for their newborns. Text4baby delivers free health information to mobile phones. Topics include immunizations, breastfeeding, safety, car seats, developmental milestones, nutrition and more.
The National Healthy Mothers, Healthy Babies Coalition launched this educational program to provide women with the accurate information they need during pregnancy and throughout their child’s first year. Together, CareSource and text4baby will help them care for their own health – and give their babies the best possible start in life.