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Enhancing Wellness Through Health Promotion and Care Management Seminars

This seminar series presented by Johns Hopkins HealthCare on September 15, 2014, focuses on Health Promotion and Wellness. Attendees will learn about health education, lifestyle management, and personalized health coaching to help members improve their overall wellness and reduce disease risk. Key topics include community health initiatives, health risk assessments, case management, and outreach processes designed to support individuals with unique health needs. Discover strategies for effective health management and enhance your knowledge of available support services.

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Enhancing Wellness Through Health Promotion and Care Management Seminars

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  1. Provider Educational Seminar Care Management: Part III 9/15/2014

  2. Care Management:Health Promotion & Wellness Overview: • Health Education and Health Coaching for members needing/wanting lifestyle management • Provide information, guidance, and assistance on a variety of health-related topics • Goal is to help member improve overall wellness and reduce risk of disease Presented by: Johns Hopkins HealthCare 9/15/2014

  3. Care Management:Health Promotion & Wellness Health Education: • Community and on-site classes • Community coalition participation • Consumer advisory board (Priority Partners) • Health fairs • Group programs on a variety of health topics including diabetes, asthma, nutrition and obesity, smoking cessation, teen health, family planning, and prenatal health Presented by: Johns Hopkins HealthCare 9/15/2014

  4. Care Management:Health Promotion & Wellness Health Coaching: • One-on-one monthly coaching sessions for six or more months • Convenient communication via telephone • Work with member to develop personal health action plan • Ongoing support and encouragement • Available to USFHP and some EHP members only • Work with members in Level 3 Presented by: Johns Hopkins HealthCare 9/15/2014

  5. Care Management:Health Promotion & Wellness Identification through Health Risk Assessments: • Now available online or by mail • Upon completion member receives detailed Personal Wellness Profile with overall wellness score, risk ratings, and recommendations for improving health • Direct contact with identified members Presented by: Johns Hopkins HealthCare 9/15/2014

  6. Care Management:Special Needs Coordination Priority Partners members with special needs include members who are: • Homeless • Physically or developmentally disabled • HIV/AIDS patients • Challenged to substance abuse problems • Language barriers • Pregnant women • Children who have a special health care need; in State-supervised foster care; with elevated blood lead levels Presented by: Johns Hopkins HealthCare 9/15/2014

  7. HEDIS • Healthcare Effectiveness Data and Information Set (HEDIS): a set of key performance measures designed to provide employers, government agencies, consumers, health plans and others with information needed to compare the performance of managed care organizations • The National Committee for Quality Assurance (NCQA) directs the HEDIS Program Presented by: Johns Hopkins HealthCare 9/15/2014

  8. HEDIS • Methodology for data collection: calculation of the measures are standardized across all plans, thereby allowing for comparisons • Benchmarks supplied by NCQA used for comparison purposes are: • The Maryland Average Reportable Rate 2005 • The National Medicaid HEDIS Means and Percentiles and Quality Compass • Plans are required to have data collection and methodologies audited by an NCQA certified auditor to ensure standardization of metrics Presented by: Johns Hopkins HealthCare 9/15/2014

  9. Care Management:Case Management – Moderate Intensity Overview: • Initial assessment • Health goal setting • TeleWatch condition monitoring • Medication adherence • Provider and member feedback Presented by: Johns Hopkins HealthCare 9/15/2014

  10. Care Management:Outreach Overview: • Answer member questions about benefits and access to care • Education on importance of preventive health care, immunizations, exams and diagnostics • Improve members compliance/adherence with care (program and appointment enrollment and follow-up) • Refer members to health education, special needs and case management for follow-up Presented by: Johns Hopkins HealthCare 9/15/2014

  11. Care Management:Outreach Process: • Review and distribute Health Risk Assessments results based on member status • Contact member (three attempts via phone and mail) • Identify barriers to care • Conference call with provider and member to coordinate appointment • Refer member to other care management divisions if appropriate Presented by: Johns Hopkins HealthCare 9/15/2014

  12. Care Management:Outreach Initiatives: • Childhood immunizations • Annual well-child visits • Emergency room • Prenatal/postpartum • Adopt-a-clinic • Referrals • Transportation Presented by: Johns Hopkins HealthCare 9/15/2014

  13. Care Management:Contact Information Case Management: • 1-800-557-6916 or populationhealth@jhhc.com Health Promotion and Wellness: • 1-800-957-9760 or healthcoach@jhhc.com Outreach: • 1-888-500-8786 or orferrals@jhhc.com Special Needs: • 1-800-261-2396, x 4906 or snc@jhhc.com Utilization Management: • 1-800-261-2421 Behavioral Health: 1-800-261-2429 or bhreferrals@jhhc.com Presented by: Johns Hopkins HealthCare 9/15/2014

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