Posted on: 13 February 2014 By: Sue.Thomas-Cox

In order to realize the cost savings as calculated how did you find the high cost super utilizers for intervention. Were they referred by the insurer, hospital, provider?

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MCEH


Thu, 02/13/2014 - 15:33

Referrals came through our web based system from medical providers and community.    When  we had less capacity we triaged based on how severe the level of asthma was, whether the asthma was in control, recent hosp or er visits.  However if we had capacity, we would take them in order of intake.   Our SPA did not require that a provider made the referral.   As long as they had an asthma diagnosis and were on Medicaid,  we would be reimbursed for the visit. 

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