The Care Transformation Collaborative of Rhode Island (CTC), a patient-centered medical home initiative managed by UMass Medical School, explains how primary care practices can build a medical neighborhood by creating a community health team to provide behavioral health and social support services to patients with high-cost, complex care needs.
Breakthrough direct-acting antivirals set a new standard in the management of hepatitis C virus (HCV) with regard to cure rates and improved tolerability, but cost is a challenge. We designed and implemented a comprehensive HCV medication management program that helped one state Medicaid program avoid nearly $3.8 million in costs while ensuring members have access to clinically appropriate regimens.
Many individuals with disabilities are interested in working, but don’t know how doing so will affect their ability to receive public benefits like Social Security and Medicare. BenePLAN was established in 2000 to provide Massachusetts residents who receive public benefits with information to help them make informed decisions about going to work.
This annual report outlines the 2015 accomplishments of Care Transformation Collaborative (CTC) Rhode Island, a primary care initiative managed by UMass Medical School. CTC includes more than 80 primary care practices across the state
Our customized, results-oriented high-risk medication program dramatically reduced refills for this Medicare Part D client with targeted prescriber outreach. This indicates discontinuation of the prescription or change to a safer medication.
How the Massachusetts Medicaid Pharmacy Program, which is managed by UMass Medical School, developed the Pediatric Behavioral Health Medication Initiative. The initiative was in response to studies and reports that found pediatric behavioral health medication polypharmacy regimes have been increasing.
Women with disabilities are at risk for poor birth outcomes. Little is known about specific potentially disabling health conditions and their effects on pregnancies. We found that disability risk identified through hospital claims is associated with poor infant and maternal outcomes.
More than 150 adults with acquired brain injury in Massachusetts transitioned from long-term care settings to the community from November 2010 to August 2013. Some individuals transitioned with an increase in risk incidents. A registered nurse care manager was engaged to address the needs of those at high risk. The results show there was a decrease in hospitalizations and emergency room visits.
An assessesment of the impact of the MassHealth, the Massachusetts Medicaid program, Children's Behavioral Health Initiative implemented in 2007. The initiative, requires behavioral health screening at well-child appointments, substantially increased the percentage of children receiving behavioral health screenings.
How mapping and visualization tools can enhance the use of data to characterize a population’s health and social services needs, target interventions and compare outcomes across population subgroups. These tools are used to manage Massachusetts 1915c Medicaid Waiver programs, track operations, improve efficiency, report quality measures, monitor program integrity and plan for service needs.
Integration strategies and coordination benchmarks within the Massachusetts Medicaid Management Information System (MMMIS) are used to ensure accurate Medicaid and Medicare enrollment; fully engage service delivery options (including managed care and integrated care programs); and effectively cost-avoid, reprice, or cost-share to ensure the state’s lowest payment liability.
An examination of the choices that primary care physicians make in deciding to practice in a community health centers post health care reform. Researchers compared results of physician surveys conducted in 2008 and 2013.
This report describes the process of providing integrated care for patients with substance use disorders at three sites in central Massachusetts: Edward M. Kennedy Community Health Center, Family Health Center of Worcester, and Community Healthlink. It identifies common practices that improve care coordination and presents key findings.
Health insurance coverage data from state tax filings for 2011 and 2012 is used to address a gap in research that has focused on health insurance coverage in a given 12-month period and to provide a better understanding of the population in Massachusetts that is prone to remain uninsured over consecutive years.
Twenty-five women with physical disabilities across the U.S. who had had a baby in the past 10 years were interviewed for this study. The results shed light on the unmet needs and barriers to the care of women with mobility disabilities during pregnancy and childbirth. The study findings highlight the need for policy and practice recommendations for perinatal care of women with mobility disabilities.
A summary of the way the Worcester Division of Public Health was able to improve care for its patients after being awarded a Prevention and Welllness Trust Fund grant from the Massachusetts Department of Public Health.
An overview and review of a Perioperative Surgical Home pilot developed using the guiding principles of the patient-centered medical home. The PSH coordinates care and decisions from the decision to operate through return to primary care.
A detailed review of the teaching assistance and shared learning UMass Medical School provided in the area of behavioral health integration to participants of the Primary Care Payment Reform program, an alternative payment pilot developed by the Massachusetts Medicaid program, MassHealth.
A comprehensive look at The Southern New England Practice Transformation Network (SNE-PTN), which supports implementation of person-centered, high quality, efficient, and coordinated care. SNE-PTN is funded under the Centers for Medicare & Medicaid Services’ Transforming Clinical Practices Initiative.
A chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Health Law & Policy team at UMass Medical School. This updated edition includes MassHealth enrollment as of January 2016 and spending from state fiscal year 2015.
The study concludes that antiviral treatment with sofosbuvir and/or simeprevir was requested for a relatively small proportion of Hepatitis C-infected members of MassHealth, the Massachusetts Medicaid program, with nearly all approved. Prescriber prioritization or patient barriers to care, rather than prior authorization, determined access to treatment. Support may be needed to ensure patients with SUD benefit from advances in HCV treatment.