Recorded presentation

Jacqueline Roberts Simmons, MD, MPH, CPE, Chief Medical Officer, Passport Health Plan, 305 W. Broadway, Louisville, KY 40202, 502-585-7065, jackie.simmons@amerihealthmercy.org and Adewale Troutman, MD, MA, MPH, Director Louisville Metro Health Department, U of L School of Public Health, 400 East Gray Street, Louisville, KY 40202-1704.

The presentation will provide attendees with a case study of Passport Health Plan, a not for profit, sole source Medicaid health plan for 130,000 members in the Louisville, Kentucky area and 15 surrounding counties. All Medicaid members, other than those in long-term care facilities, are enrolled in the plan. Nearly all services are provided through Passport to low-income people, the chronically ill and disabled, foster children, newborns and their mothers, and children of low income working families. Passport Health Plan is a provider sponsored health plan that began operations in November of 1997 and has demonstrated cost savings of $110.1 million over a five-year period.

Presentation handouts will include HEDIS graphs that show Passport’s rates in comparison to nationally reported Medicaid mean rates and will document Passport’s improvement in 97 percent of all measures from calendar year 1999 to 2002. -Children birth to 15 months receiving the recommended 60 or more well child visits increased 216 percent from 1997 to 2002. -Early Periodic Screening Diagnosis and Treatment (well child care) compliance increased 247 percent from 1997 to 2002. -Adolescent immunizations rates increased 162 percent from 1999 to 2002. -Adolescent well care visits increased 101 percent from 1998 to 2002.

Presenters will give examples of Disease Management programs, efforts to ensure participation, methodology for measurement and tracking and implementation of special programs for the Medicaid population. Physician profiling techniques and pharmacy cost management programs will also be presented.

Learning Objectives: AT the conclusion of the session, the participant in this session will be able to

• Build public/private partnerships to improve public health through community coalitions and resources.
• Develop incentives for physicians to improve compliance with EPSDT and disease management programs.
• Control pharmacy costs through the use of managed care principles and provider participation. Define initiative tools such as academia detailing and preferred drug list.
• Create patient education and prevention programs to manage chronic disease.

Keywords: , Medicaid Managed Care

Presenting author's disclosure statement:
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.

Recorded presentation