West Virginia - Healthier Medicaid Members through a Stronger Medicaid Program 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.

Click here for the complete grant application >>

Healthier Medicaid Members through a Stronger Medicaid Program will enable Medicaid to become a more pro-active program that is focused on member health rather than simply enrollment and claims processing. By creating a clinical claims data warehouse, the Medicaid program will build a foundation that will improve the health of Medicaid members. This transformation will create a sophisticated integrated health assurance organization that uses health information and clinical data, risk stratification, disease management and predictive modeling approaches to prevent disease and detect strategies to improve health and member lives.

The West Virginia Bureau for Medical Services is requesting $1,731,680 from the Center for Medicare & Medicaid Services (CMS) to support Healthier Medicaid through a Stronger Medicaid Program. This initiative will transform the current fragmented, disjointed system to a member-managed, integrated, pro-active system that provides Medicaid members with the information and tools needed to more effectively self-manage chronic conditions and avoid costly complications that consume disproportionate health care resources.