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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
What we will cover ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Previously…. ,[object Object],[object Object],[object Object],Janice Gomersall
Development  of Current HIP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Health Improvement Program  Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Disease Management vs.   Care Management ,[object Object],[object Object],Janice Gomersall
New Health Improvement Program ,[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Service  Providers  for the New HIP ,[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Janice Gomersall
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
Services  Provided by Specially Trained Nurses and Health Coaches at FQHCs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
INTERVENTION  for High Risk/ High Cost Patients ,[object Object],[object Object],Janice Gomersall
PREVENTION  for At risk Patients ,[object Object],[object Object],Janice Gomersall
Reporting of Data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Janice Gomersall
Some Reasons Why Health Centers Appreciate the Program ,[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Some Reasons Why Providers Appreciate the Program ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Lessons learned ,[object Object],[object Object],[object Object],[object Object],Janice Gomersall
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Janice Gomersall
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

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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
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  • 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
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  • 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

Notas del editor

  1. Rattlesnake
  2. Flathead Lake looking at Glacier
  3. Predictive modeling software is purchased by the state.
  4. 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)
  5. 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.
  6. 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.
  7. 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
  8. Flathead Lake