Kansas Predictive Modeling Technology to improve Preventive Healthcare in the Disabled Medicaid Population Abstract
In 2007, 27 states received Medicaid Transformation Grants under Section 6081 of the Deficit Reduction Act of 2005. The grants were rewarded to states that proposed innovative methods which in the end of the two years are designed to produce better health outcomes at lower cost.
The Center for Health Transformation is highlighting states that have received these Medicaid Transformation Grants, and will be following their progress for the next two years. In order for key decisionmakers and industry leaders from around the country to learn from others’ successes, it is our intention to provide this resource in order to showcase innovative practices from across the nation. In the future, this site will be interactive, allowing program directors to submit updates and comments regarding their program.
Persons with disabilities are generally less likely to receive age and gender appropriate preventive health care services such as Pap smears, mammograms, and dental care. However, disabled persons have higher rates of chronic medical comorbidities than their peers, with rates approaching those of the aged population. Disabled persons also fare poorly when it comes to management of their chronic conditions. Given their close relationships with beneficiaries, it seems reasonable to assume that case managers, with the appropriate resources, can intervene to improve the receipt of quality preventive health care.
We propose to provide case managers in pilot sites with a computerized, claims-based querying system (Impact Pro from Ingenix Public Sector Solutions, Inc.) and attendant algorithms that will allow them to ascertain the history of, and need for, preventive health care services for the beneficiaries they serve. Using these algorithms, they will be able to communicate with beneficiaries and their clinical providers the necessity and importance of quality care and improve beneficiaries’ health. By providing targeted case managers the Impact Pro tool to use Medicaid claims data to ensure screenings and preventive care opportunities are not missed, overall health outcomes should improve – resulting in savings to the Kansas Medicaid program. Effectiveness of the case manager intervention will be determined at the Center level based upon the proportions of their caseloads who receive the requisite screenings, where appropriate, and the level of monitoring of chronic conditions, also as appropriate. The two-year total budget request is $906,664.
