Health Promotion in Kansans with Disabilities Kansas Medicaid’s CMS Transformation Grant Kansas Health Policy Authority in collaboration with the University of Kansas Medical Center & Ingenix Presented by Theresa I. Shireman, Ph.D. University of Kansas Medical Center

Collaborative Effort Kansas Health Policy Authority (KHPA) Kansas Health Policy Authority (KHPA) Becky Ross Becky Ross Sharon Johnson Sharon Johnson Debbie Huske Debbie Huske University of Kansas Medical Center (KUMC) University of Kansas Medical Center (KUMC) James Backes, Pharm D James Backes, Pharm D Allen Greiner, MD Allen Greiner, MD Aimee James, PhD Aimee James, PhD Ingenix Impact Pro Ingenix Impact Pro Developer of solutions that are focused on improving health care through the use of information and technology Developer of solutions that are focused on improving health care through the use of information and technology

Statement of Project Need Persons with disabilities Persons with disabilities Less likely to receive preventive health care services Less likely to receive preventive health care services High rates of chronic comorbidities High rates of chronic comorbidities High rates of medication use High rates of medication use Compliance problems Compliance problems Face variety of barriers to quality health care Face variety of barriers to quality health care Case managers Case managers Support/coordinate vocational & social services Support/coordinate vocational & social services New responsibility for medical services coordination New responsibility for medical services coordination Ultimate goal… improve beneficiary health! Ultimate goal… improve beneficiary health!

Project Goals & Objectives Increase use of age- and gender-appropriate preventive health care Increase use of age- and gender-appropriate preventive health care Increase receipt of chronic disease monitoring services Increase receipt of chronic disease monitoring services Improve compliance with chronic medications Improve compliance with chronic medications

Project Description: Agencies Case managers recruited from selected agencies: Case managers recruited from selected agencies: Community Developmental Disability Organizations (CDDOs) Community Developmental Disability Organizations (CDDOs) Independent Living Centers (ILCs) Independent Living Centers (ILCs) Serve primarily physically disabled Serve primarily physically disabled Located throughout state of Kansas Located throughout state of Kansas

Project Description: Impact Pro Claims-based predictive modeling tool Claims-based predictive modeling tool Lists all paid claims incurred in most recent 12 month experience period including hospitalizations, doctor visits, medications, and other services Lists all paid claims incurred in most recent 12 month experience period including hospitalizations, doctor visits, medications, and other services Uses ETG grouper logic to create condition specific episodes Uses ETG grouper logic to create condition specific episodes Identifies gaps in care and opportunities for care interventions Identifies gaps in care and opportunities for care interventions Standard Impact Pro rules based upon clinical consensus Standard Impact Pro rules based upon clinical consensus Ability to fully customize rules to identify members Ability to fully customize rules to identify members Accessed via Web Accessed via Web Case Managers access the Impact Pro Reporting System on-line Case Managers access the Impact Pro Reporting System on-line

Project Description: Training Live training sessions Live training sessions KUMC faculty KUMC faculty Medical & pharmacy home Medical & pharmacy home Basic chronic disease management Basic chronic disease management Basic chronic medication management Basic chronic medication management Small group activities Small group activities Ingenix Impact Pro™ Ingenix Impact Pro™ Computer-assisted training Computer-assisted training

Project Description: Case Managers’ Support Project website Project website Training materials Training materials Useful links Useful links Monthly e-newsletters Monthly e-newsletters Developed by KUMC faculty & staff Developed by KUMC faculty & staff Range of topics: chronic diseases, physical health, dental care, medications Range of topics: chronic diseases, physical health, dental care, medications Consultation with team MD & RPH Consultation with team MD & RPH based: triaged by project manager based: triaged by project manager

Project Evaluation: Case Manager Assessments Surveys Surveys Baseline & conclusion of intervention Baseline & conclusion of intervention Focus groups Focus groups Conclusion of intervention Conclusion of intervention Identify barriers & facilitators of implementation & program success Identify barriers & facilitators of implementation & program success Team leaders & selected case managers Team leaders & selected case managers

Project Evaluation Changes in… Changes in… receipt of preventive care receipt of preventive care receipt of chronic care monitoring receipt of chronic care monitoring medication adherence medication adherence Pre- vs. post-intervention claims data Pre- vs. post-intervention claims data Within participating agencies Within participating agencies Across participating & non-participating agencies Across participating & non-participating agencies