APS Healthcare, a leading provider of specialty healthcare solutions, has been selected by the Oregon Department of Human Services (DHS), Division of Medical Assistance Programs, to manage its statewide Medicaid disease and medical care management programs. The integrated program will assist Oregon’s Medicaid and SCHIP fee-for-service clients to access healthcare, minimize catastrophic health events and improve health outcomes through education and interventions that help promote behavior change.
“After a thorough review of APS Healthcare’s service proposal and experience against our selection criteria, we determined APS was the best choice to meet the unique needs of our population,” said Walter Shaffer, MD, Medical Director, Oregon Division of Medical Assistance Programs, DHS. “This program will deliver critical health coordination services to Oregonians, improving their health status and reducing our overall healthcare expenditures.”
The program emphasizes coordination of care and collaboration with local healthcare providers; as well as early intervention with clients at high risk for health issues. Eligible Oregonians can access a telephonic nurse advice line 24-hours-a-day which connects clients with referrals to essential community providers and facilitates the establishment of a medical home — a primary care health provider who provides preventive medical services, and care for chronic or acute health issues. Locally-based nurse health coaches will monitor and evaluate the participant’s progress, help eliminate barriers to care and encourage behavior changes which will improve health outcomes and reduce overall costs.
“We are very excited to begin our collaboration with essential community providers to focus on supportive services that change behaviors and lead to improved outcomes,” said Jerry Vaccaro, MD, president and chief operating officer of APS Healthcare. “Our shared goal is to help the state make the best and most cost effective use of its healthcare resources.”
APS’ model leverages partnerships with Oregon providers to enhance coordination of care, identify and close gaps in needed services, and holistically address issues negatively impacting the health and wellness of clients. APS will partner with key Oregon stakeholders, including the Department of Medical Informatics and Clinical Epidemiology at the Oregon Health and Science University (OHSU), which will work with the state and APS to assess the program’s impact. APS also will form a Clinical Advisory Committee of state medical organizations to establish and maintain a consistently high level of communication with the provider community.
“We look forward to working with APS to develop metrics to evaluate the program’s impact,” said Ariel Linden, DPH, MS, Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University. “Feedback from the program is invaluable in measuring and identifying areas for enhancement to make the program better over time.”
The new program, scheduled to start June 1, 2009, will initially be available to more than 66,000 individuals.
About APS Healthcare
APS Healthcare is a leading provider of specialty healthcare solutions to more than 20 million members in the United States and Puerto Rico. The company partners with agencies in more than 20 states, representing more than 40 percent of the nation’s Medicaid population. APS delivers customized, integrated healthcare solutions that help people engage in behaviors that optimize their health status. By uniting all participants in the healthcare landscape — individuals, practitioners and payers – APS improves overall health and reduces total healthcare expenditures
Source: APS Healthcare
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