ZeOmega Inc. today announced that Indiana’s largest not-for-profit health plan — MDwise — has improved preventive care and related outcomes for at-risk children and adults in a pilot program supported by Jiva, the population health management solution from ZeOmega. MDwise saw a 50 percent improvement in adolescent well-care visits, and a 75 percent improvement in LDL related to diabetic care for the target individuals from the previous year. MDwise has also seen a 50 percent year-over-year improvement in adult preventive care in identified members.
MDwise recognized that a significant number of its members were non-compliant with routine medical preventive care, but were frequently visiting statewide community mental health centers (CMHC) for behavioral health services. The organizations decided to partner so that front-line case managers could intervene with mutual patients to close certain medical care gaps, particularly well-child visits and adolescent well-care visits. MDwise also hoped to leverage the initiative to improve LDL levels related to diabetic care.
“We provided the CMHCs with a list of members who hadn’t received needed preventive care, and essentially said, ‘Find kids who haven’t had their well-care visits and help get those visits scheduled with community primary care,’” said Dr. Caroline Carney, chief medical officer of MDwise. “We also set up an incentive program with the CMHCs based on the percentage of members who had a completed primary care visit.”
The project’s success relied on MDwise’s ability to bi-directionally share patient health information with the CMHCs. The primary goal was to increase communication between MDwise case managers and CMHC staff to improve overall patient health. Monitoring performance against certain quality achievement goals for quality scores (HEDIS) and satisfaction (CAHPS) was also a priority.
To execute the program, MDwise used Jiva’s provider and member portal functions to extend read-only status of patient records to the participating CMHCs, giving their staff and MDwise case managers a shared and complete view of patient medications, emergency room visits, gaps in care, and behavioral and medical health information. With this, CMHC clinicians could appropriately intervene with patients to improve their medical care. The Jiva-driven transparency also enabled them to determine whether a certain behavioral health issue prevented the member from receiving appropriate care.
“They can look at the member data we provide and get a full clinical picture of utilization of services and gaps in care,” Dr. Carney said. “Jiva was the one product we found there that just ‘got it,’ and it has been the force that has made this process that much easier. There’s so much utility in Jiva, and once the users are trained, it really helps us achieve our goals.”
All told, the program has generated a 50 percent improvement in adolescent well-care visits, and a 75 percent improvement in LDL related to diabetic care from the list of members shared with the CMHCs from the previous year. MDwise and the CMHCs have also seen a 50 percent year-over-year improvement in adult preventive care in identified members.
“This is an excellent demonstration of what innovative healthcare organizations can achieve with Jiva,” said Nandini Rangaswamy, ZeOmega’s executive vice president and chief strategy officer. “MDwise has been very creative in thinking out of the box and leveraging Jiva’s capabilities to achieve real, measurable and significant outcomes for its preventive healthcare program.”
To read the entire case study on how MDwise improved preventive care for at-risk children and adults, please visit http://www.zeomega.com/client-success-story-mdwisecmhc.
MDwise is Indiana’s only nonprofit health insurance company focused on giving uninsured and underserved Hoosiers the compassionate service and care they want and need. MDwise’s services are currently provided to more than 300,000 members in partnership with over 1,400 primary medical providers and a statewide array of specialists, hospitals and other providers. In addition, MDwise is a Qualified Health Plan issuer in the Health Insurance Marketplace. MDwise’s services offer a coordinated, comprehensive approach to managing the cost and utilization of Indiana’s health care services. For more information, visit www.MDwise.org.
ZeOmega’s powerful population health management platform delivers high-value, strategic solutions enabling payers and care-delivery organizations to improve individual health and provider performance. With deep domain expertise and a comprehensive understanding of complex population health challenges, ZeOmega serves as a “true-north” partner for clients—offering flexible deployment and delivery models that leverage an innovative platform designed to integrate workflow, analytics, content and communication capabilities. By consistently meeting customer expectations and project benchmarks, ZeOmega has earned a sterling reputation in the industry for responsiveness and reliability. For more information, visit www.zeomega.com or call 214-618-9880. Follow ZeOmega on Twitter, LinkedIn or Facebook.