CareOregon, a Medicaid managed care plan, is a partnership between the Multnomah County Health Department, Oregon Health Sciences University, and Oregon Primary Care Association (an association of community and migrant clinics). To improve the health of the vulnerable population comprising its membership, the health plan instituted a Quality Bonus Program in 1996. Using HEDIS indicators and US Preventive Services Task Force guidelines, CareOregon collected baseline data on a variety of preventive measures.
After analyzing the data, the Plan focused efforts on three indicators: mammograms, well child exams and diabetic retinal exams. Using financial incentives, the Plan encouraged improvement efforts in its safety net provider groups. Multnomah County Health Department (MCHD), one of the partners, instituted a tracking and recall program in conjunction with an internal financial reward system for its seven primary care clinics.
In 1998, the Plan, as a whole, experienced dramatic improvement in the targeted measures. Well child exams improved from 54% to 77%, mammograms went from 45% to 63%, and diabetic retinal exams went from 27% to 49%. There was a halo effect as evidenced by dramatic improvements in other aspects of diabetic care (foot exams and microalbuminuria screening) and in pap smears for the population targeted for mammograms.
Presenters will describe the use of financial incentives, as well as the quality improvement activities at MCHD, which led to the exceptional achievements in this underserved population. Data from 1999, which is under analysis, will be described with respect to racial and ethnic disparities in outcomes.
Learning Objectives: At the completion of the session, the participant in the session will be able to: 1. Recognize that preventive health services can be delivered to vulnerable populations at rates equivalent to the general population. 2. Identify the factors critical to the successful provision of preventive care to vulnerable populations. 3. Understand the use of financial incentives to improve delivery of preventive health services
Keywords: Prevention, Quality Improvement
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed at CareOregon, Inc., a safety-net affiliated health plan, whose programs will be discussed.