The West Virginia Health Initiatives Project (WVHIP) is a pilot program in eight counties designed to evaluate the effectiveness of a diabetes disease management initiative within the Medicaid PAAS (Physician Assured Access System) Program. The project is a collaborative effort among the WV Department of Health and Human Resources, Bureau for Medical Services, Bureau for Public Health, and the National Pharmaceutical Council, Inc. WV ranks 11th in U.S. states in diabetes prevalence. The model embraces four steps: patient registry, best practice treatment guidelines, feedback reports, and community-based interdisciplinary teams. The initiative includes training for PAAS Providers and their staff; Medicaid reimbursement to PAAS providers for extended physician diabetic care management services and for diabetes education to assure referrals to certified diabetes educators; and feedback reports to PAAS providers about their diabetic patientsí hospital and emergency room utilization and cost profiles. Initial data shows that Medicaid costs for diabetes patients in WV is $22,000 annually versus $3,000 for the average Medicaid patient (1995, 1996 Medicaid claims data). Initial analysis of the Medicaid claims data indicate low compliance with the approved guidelines for services such as: dilated eye examinations (WV is 9%; pilot area ranges from 3.5% - 20%), lab/blood tests (WV is 34%; pilot range is 16.6% to 36%), including HgA1C levels, and regular visits. These services are some of the indicators that will be measured for evaluating the effectiveness of the interventions implemented by WVHIP. Final measures of effectiveness will include clinical measures, services or care provided, and cost indicators. See www.wvdhhr.org/Bureau for Medical Services/
Learning Objectives: At the conclusion of the session, the participant will be able to: (1) List the four components of the West Virginia Disease State Management Model; (2) Relate the components to their own situation; (3) Relate the principles of disease state management to the community-oriented primary care model
Keywords: Diabetes, Information Technology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 129th Annual Meeting of APHA