Anyone aware of models for local health depts to pursue reimbursement for asthma education through home visiting? It is difficult to get credentialed by the Medicaid MCO's as a health dept. Any suggestions from CMS staff on some avenues to pursue this.

Wonderful presentation. I am wondering whether in determing health outcomes whether you were able to account for reductions in ER visits, hospitalizations, etc. that are likely to occur just over time rather than due to the intervention. For example, perhaps someone was enrolled because they had just had a severe asthma exacerbation and in six months time they may not have been expected to have another incident that serious.

I'm hoping to hear more information about how exactly any Community Health Workers were funded using Medicaid dollars. On the call the presenter from Oregon mentioned that billing rates were established which suggests fee for service. I'd appreciate hearing more details. For example: 

-- On a fee for service basis, did the CHW program bill the state and/or did it bill managed care organizations? 

-- Do managed care organizations provide CHW services as part of the managed care funding they receive from the states (i.e., non-fee for service)? 

Pre/post evaluation designs of asthma interventions are weak since absent any intevention, utilization decreases over time due to regression to mean. Convincing (at least to researchers) studies require a control group. Are the pre/post data sufficient to convince plans, medicaid officials, etc. of the value proposition?

What percentage of clients offered the service participated in either program

Where can the Value Proposition Tool be found?

Thanks for informative presentation. 

Can you tell me what sort of credentialing requirements or other qualifications need to be met for community health workers supported with funding from Medicaid's Targeted Case Management program? 

Question for Multnomah County programs (or others)- Did you use self-reported ER visit and Hospitalization data or did you have access to EMRs or chart review?  When making the business case did you find that payers wanted to see health records based data or self reported from families was sufficient?  Are there other evaluation measures besides the ones mentioned by Multnomah county that would appeal to payers?

How long was the grant for the CAIR good for? I might have mis-read or mid-heard this part; Can you expand on the slide that indicated a $500,000+ cost savings (ER, Hosp. missed work days, etc.) ... it seemed like the grant was for 875,000 and trying to make sure I understand how that investment is justifiable.

I think the answer is that the $500,000 was an annual cost savings - just want to be sure I am understanding these numbers...

Thanks!

Mike

Last presenter mentioned extra work involved in getting services ready and prepped for billing.  Would they be willing to expand on that a bit?