BATON ROUGE— Louisiana residents with chronic illness who are enrolled in Medicaid will soon have greater help managing their conditions, thanks to new program innovations the Department of Health is moving forward.

The Chronic Care Management Program is a statewide Medicaid quality improvement initiative that will create a more coordinated system of care to help individuals with chronic conditions such as asthma, diabetes and congestive heart failure to better control their illnesses, resulting in better health outcomes and cost containment throughout the system.  Additional illness diagnoses will be added as the program is implemented.

According to the U.S. Centers for Disease Control and Prevention, more than 75 percent of the nation’s $2 trillion in annual medical care costs is spent on individuals with chronic conditions or diseases.

“This plan will improve quality of life for people suffering from chronic illness while providing Louisiana’s taxpayers with more value for the dollars spent funding the Medicaid program", said LDH Secretary Alan Levine.  "We must increase the value of every dollar we spend."

The Chronic Care Management Program will also reduce unnecessary hospitalizations and emergency room visits.  Louisiana has one of the highest rates of avoidable hospitalizations in the country.

The program will identify people “at risk” for high use of medical service based on their illnesses and the care typically required to remain healthy. All eligible Medicaid members meeting the specified criteria will be enrolled in the program with the option to participate or decline services. Individuals choosing to participate will receive an initial health screening and assessment. 

Licensed health care professionals, or “care managers,” will support the care plans for each enrollee as ordered by their physician, and will provide assistance and education related to medication management, access to their physician, self-monitoring and best practices for management of chronic conditions.   A call center will provide 24-hour health-related support, while information technology will be used to help improve reporting of real-time test results, reduce unnecessary visits, and ensure appropriate interventions.  
 
“This program is a prescription for proper preventive care,” said Secretary Levine.  “Individuals receive specialized plans, meet with their care managers to help them understand and follow these plans, and have access to real-time information when they need it.”

Request for Proposals is scheduled to be released on Aug. 4, 2009 to select a contractor to administer the program. The contractor will use predictive modeling to identify individuals for participation in the Chronic Care Management Program, provide outreach and education on chronic illness, develop and implement physician-driven plans of care, perform assessments, and provide counseling and monitoring. The contractor also will provide face-to-face and telephonic disease management for participants, and maintain a toll-free call line.

The Request for Proposals will be made available on the Department of Health and Medicaid Web sites.

Other states that have implemented comparable chronic care management programs within their Medicaid programs have experienced improved health outcomes and cost containment through better coordination of care and early intervention, treatment and compliance.

An analysis showed costs were reduced for the congestive heart failure enrollees in Indiana by more than $700 per member per month, which would yield savings as high as $29 million if projected for that state’s entire Medicaid program.  A UCLA study revealed a disease management program in Florida reduced hospitalizations and emergency room use dramatically.

The Louisiana Medicaid Chronic Care Management Program is anticipated to begin in January 2010.

The Louisiana Department of Health strives to protect and promote health statewide and to ensure access to medical, preventive and rehabilitative services for all state citizens. To learn more about LDH, visithttp://www.dhh.louisiana.gov.

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