Montana Health Program Shifts to FQHC-Led Care Coordination
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The document summarizes Montana's transition from an out-of-state disease management program to a new in-state care coordination program called the Health Improvement Program (HIP). The HIP uses locally-based community health centers and their nurses/health coaches to provide both disease management for high-risk patients and prevention services. It highlights lessons learned in developing the HIP and reasons why providers and health centers appreciate the new locally-focused program versus the previous out-of-state model.
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Montana Health Program Shifts to FQHC-Led Care Coordination
- 1. Montana Health Improvement Program: New Roles for FQHCs in State Delivery System Reform Janice Gomersall, MD, FAAFP Medical Advisor, HIP, Montana Medicaid NASHP Conference October 4-6, 2010
- 10. Northwest CHC Libby Flathead CHC Kalispell Partnership CHC Missoula Cooperative Health Center Helena Cascade CHC Great Falls Bullhook CHC Havre Butte CHC Community Health Partners – Livingston Sweet Medical Center Chinook Central Montana CHC Lewistown RiverStone CHC Billings Ashland CHC Custer Co. CHC Miles City Fort Peck Tribal Health Center Poplar
- 17. Janice Gomersall
- 22. For questions, (or to avoid a really bad time) please contact Wendy Sturn at (406) 444-1292 or [email_address] or Janice Gomersall, MD at jgomers@bresnan.net Montana Medicaid Health Improvement Program Janice Gomersall
Hinweis der Redaktion
- Rattlesnake
- Flathead Lake looking at Glacier
- Predictive modeling software is purchased by the state.
- All sites have access, learn how to profile, sort through care opportunities; phone training for everyone who has been hired, plus end user training sessions through webinars (i.e. care managers)
- Data collection was to cost $230,000 with a contract company; CMS did not consider it a benefit so would not match it 70/30; MT state would not let the cost go through at only 50/50 match. When Mck was contracted, the IT was part of the contract and the whole contract was matched 70/30. SF-12 could be administered at 3 months or 6 months depending on how long we expect pt to be in the program.
- It is a subprogram of Passport; we separated out the advice line; just renamed from our DM program. Passport is a waiver program as it requires Native American participation; considered a ‘benefit’ so has to be an opt out program. No Caroline does a SPA (state plan), Idaho only does a telephonic/education program so is only matched 50/50.
- Current program is $2.8 to 2.9 million/yr; previous program was $3.1 million/yr. Eventually will have 35 FTE care managers. 17 are RN, 1 NP (Poplar, WolfePoint School Health), rest are a combo of LPN, MSW, Health Educator
- Flathead Lake