modern technology: improving the quality of care november 17, 2015 eqro quarterly meeting megan...
TRANSCRIPT
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MODERN TECHNOLOGY:IMPROVING THE QUALITY OF CARE
NOVEMBER 17, 2015 EQRO QUARTERLY MEETING
MEGAN THOMPSON, MSW
MEDICAID QUALITY BUREAUCLINICAL QUALITY REVIEW AND INITIATIVES UNIT
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Medicaid Quality BureauClinical Quality Review and Initiatives Unit
Create evidence-based strategies to improve performance
Compare managed care plans’ performance and looks for predictors of success
Ensure that all managed care plans adopt winning strategies
Provide clinical expertise to the entire Agency
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BARRIER DISCOVERY-RECAP
EQRO Meeting- 5/12/15
General barriers were discussed during the process mapping and failure modes effect analysis exercises. One of barriers that was discussed in detail was the barrier in communicating with enrollees.
Plan Visits- June 2015Medicaid Quality Management visited some of the managed care plans. Again, barriers in communicating with enrollees were discussed.
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SPECIFIC BARRIERS
No Phone Transient Population Failure to Update
Information Plans and Providers are
unable to communicate with enrollees
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WHY IT’S A PROBLEM
Lack Of Communication
Lack Of Compliance
=
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POTENTIAL SOLUTIONS
1) Increase Awareness and Access to Lifeline
2) Improve the method of demographic data collection (in collaboration with DCF)
3) Utilize modern technology (apps/texting/telemedicine)
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1) LIFELINE
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LIFELINE
Federal Program, Operated by the Florida Public Service Commission
Provides a discount on phone service for qualifying low-income consumers
May choose landline or cell phone
Drawback: Not ‘app’ compatible
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LIFELINE
Automatic Qualification
Medicaid enrollees participate in the Lifeline program
Lifeline Coordinated Enrollment Process
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LIFELINE• 957, 792 (1/8) eligible
households participated in Lifeline (June 2014)
• 50% of all Lifeline-eligible Florida Households receive lifeline assistance
• SNAP is the largest qualifying program for Lifeline assistance in Florida
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Why Lifeline?
Likely to have
canceled or cut off service due to
financial burden.
Preventing disruption in service keeps phone numbers accurate
longer.
44% of those
with income less that 30k
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SUGGESTIONS
Add lifeline application link to managed care websites
(in case it was overlooked during Medicaid enrollment process)
Educate case managers about lifeline
http://www.floridaopc.gov/lifeline.cfm
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SUGGESTIONS, CONT.
-Require Phone Number Update on Application (paper)
-Default to share phone number and address with DCF, unless opted out.
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SUGGESTIONS, CONT.
Add a link to the Florida Health Finder, Medicaid
Resources Page:
“Telephone Assistance”
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2) DCF DATA COLLECTION
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Improvement to DCF’s Access Website
Blank Demographic Fields
Phone Number/Address on the first page
Messaging to enrollees who have not updated recently (method TBD)
Notice Message after demographic page (recheck info for your benefit)
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DCF DATA COLLECTION
SOURCE: http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/
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Improvement to DCF’s Access Website
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3) MODERN TECHNOLOGY
Smartphone Apps - SMS Text Messaging - Social Media - Telemedicine
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MODERN TECHNOLOGYWho Has A Cell Phone?
Source: Pew Research Center Internet Project Survey, January 9-12, 2014
January 2014: Among Adults, the % who have a cell phone
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MODERN TECHNOLOGY (SMART PHONE APPS)
Federal Government Recognition
The House Energy and Commerce Committee met on 9/18/15 to consider how to incorporate mobile devices like smartphones in order to improve the Medicaid Program
Improve Access to Care
Reduce Medical Costs
Enhance Quality of Care*Full Article and Link on the next slide
In T
he
New
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How Mobile Devices Could Benefit Medicaid Beneficiaries - mHealthIntelligence
Link!
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MODERN TECHNOLOGY(SMART PHONE APPS)
Medicaid Apps (3 states have them, will discuss further)
Other Apps (appt. reminder, healthy behaviors, etc.)
Check Reviews
Encourage the use of FREE apps
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MODERN TECHNOLOGY(SMART PHONE APPS/SOCIAL MEDIA) TEXAS
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MODERN TECHNOLOGY(SMART PHONE APPS/SOCIAL MEDIA) TEXAS
November 2014
$5 million dollars for 4 releases paid to a contracted telecommunications vendor.
Funding received from a federal grant.
Created based on the web version.
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Month NOV DEC JAN FEB MAR APR MAY JUN
Mobile Document Uploads (Case Level Uploads) 7,963 37,827 52,531 39,276 57,301 64,555 69,735 81,231
Website (SSP) Document Uploads (Case Level Uploads) 33,891 38,255 46,845 42,201 48,175 43,263 41,313 39,060
% Mobile / (Mobile + Website) 19.03 49.72 52.86 48.21 54.33 59.87 62.80 67.53
MODERN TECHNOLOGY(SMART PHONE APPS/SOCIAL MEDIA) TEXAS
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MODERN TECHNOLOGY(SMART PHONE APPS) MICHIGAN
January 2015
Downloaded 3,500 times
(there are 2 million enrolled in Medicaid)
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MODERN TECHNOLOGY(SMART PHONE APPS) MICHIGAN
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MODERN TECHNOLOGY(SMART PHONE APPS) ARIZONA
August 3, 2015
Governor Ducey announced his plan to MODERNIZE ARIZONA’S MEDICAID program
With the AHCCS CARE-
Choice, Accountability, Responsibility, Engagement
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MODERN TECHNOLOGY(SMART PHONE APPS/SOCIAL MEDIA) ARIZONA
In T
he
New
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Link!Will Arizona’s Medicaid beneficiaries use smartphone apps? |MobiHealthNews
In T
he
New
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If you build the health app, will the Medicaid recipients come? - Modern Healthcare Modern Healthcare business news, research, data and events
Link!
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MODERN TECHNOLOGY
(TEXT MESSAGING)
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http://www.hrsa.gov/healthit/txt4tots/environmentalscan.pdf
The HHS Task Force recommended that
HHS develop evidence of the effectiveness of health text messaging
programs through formal evaluations of
current and future initiatives.
MODERN TECHNOLOGY(TEXT MESSAGING)
http://www.hhs.gov/open/initiatives/mhealth/recommendations.html.
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MODERN TECHNOLOGY(TEXT MESSAGING)
The messages address topics such as
Breastfeeding * car seat safety * developmental milestones * emotional well being * exercise and fitness * immunizations * labor and delivery * nutrition * prenatal care *
safe sleep * and stop smoking *
The text messages also provide 1-800 numbers and other resources to learn more.
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MODERN TECHNOLOGY(TEXT MESSAGING)
Launched in February 2010
Over 281,000 had enrolled by the end of January 2012.
96% percent of enrollees report that they would recommend the service to a friend.
Education campaign of the National Healthy Mothers, Healthy Babies Coalition (HMHB).
HMHB works with a broad range of partners (over 700, including the CDC) to encourage the women they reach to take advantage of this free service.
http://www.cdc.gov/women/text4baby/
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MODERN TECHNOLOGY(TEXT MESSAGING)
http://caremessage.org/mobile/#mobile-story
Create automated, interactive, and engaging conversations via text and voice messaging with thousands of patients.
Use evidence-based disease management programs to educate and empower your patients.
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MODERN TECHNOLOGY (SMART PHONE APPS) CONT.
Apps That Encourage Healthy Behaviors
Quit Smoking Monitor Nutrition Track Drinking Habits Track Physical Activity
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MODERN TECHNOLOGY (SMART PHONE APPS) CONT.
22 percent of young children own a cell phone (ages 6-9)
60 percent of tweens (ages 10-14)
84 percent of teens (ages 15-18
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MODERN TECHNOLOGY
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Facebook: 73%
Pinterest: 24% Instagram:
26% Twitter: 21%
MODERN TECHNOLOGY (SOCIAL MEDIA)
Source: Pew Research Center Internet Project Survey, January 9-12, 2014
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40% of consumers:information found via social media affects the way they deal with their health
41% of people said social media would affect their choice of a specific doctor, hospital, or medical facility
Sources: NIH, MedTechMedia
MODERN TECHNOLOGY (SOCIAL MEDIA)
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TELECARE AND TELEMEDICINE
Telecare: Technology that allows patients to stay safe and independent in their own homes, through the use of telecommunications technology
• Telephones• computers and
mobile monitoring
Telecare involves continuous remote monitoring of patients in order to receive alerts about real-time emergencies and to track lifestyle changes over time.
TELECARE: REMOTE MONITORING
TELEMEDICINE
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• Telemedicine: Use of Technology to deliver health care, health information or health education at a distance
• Two types: real-time and store and forward
TELEMEDICINE
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Telemedicine services are available to recipients in both the Managed Medical Assistance (MMA) and fee-for-service programs for the following services:
Behavioral health Dental Physician Interpretation of diagnostic testing results by Florida licensed
physicians.
Plans participating in the MMA program are allowed to offer telemedicine for most covered services with Agency approval.
TELEMEDICINE
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The following interactions are not Medicaid reimbursable telemedicine services:
Telephone conversations; Video cell phone interactions; Electronic mail messages; Facsimile transmissions; Telecommunication with the enrollee at a location other than the provider office
location in Florida where an approved service is being furnished through telemedicine; and
“Store and forward” visits and consultations that are transmitted after the enrollee or provider is no longer available.
TELEMEDICINE
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TELEMEDICINE IN FLORIDA MEDICAID
Dates of Service: Calendar Year 2014
EncountersTotal Recipients: 771
Rendering Providers: 61
Total Claims: 1417
Fee For Service
Total Recipients: 631
Rendering Providers: 41
Total Claims: 1109
Source: DSS Claims Analysis Universe as of September 29, 2015
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KIOSKS
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TELEHEALTH HEALTH SPOT CENTER
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“Many people who have used it so far during the beta launch are on Medicaid – which means that instead of a potential $600 emergency
room visit, Medicaid insurance companies pay about $60.”
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TELEMEDICINE APPS
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-The American Telemedicine Association projected there will be 800,000 telehealth consults in the U.S. in 2015;
-Teladoc is expected to conduct more than 525,000 of those consults, almost twice the amount of the rest of the industry combined.
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Teledoc and Doctor on Demand to Partner with CVS
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Increase Awareness and Access to Lifeline
Improve the method of demographic data collection (in collaboration with DCF)
Utilize modern technology (apps/texting)
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Discussion
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Medicaid Quality Bureau:Clinical Quality Review
and Initiatives Unit (CQRI)We are Here to Ensure Quality Health Care
for Florida Medicaid Patients
Marie A. DonnellyBureau Chief
Phone: (850) [email protected]
Dr. Elicia Coley, Pharm.D., BSN
CQRI Unit Director (850) 412-4147
Megan Thompson, MSWGovernment Analyst II
(850) [email protected]