Live Online Q&A for 2/13/2014 Webinar Forum

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?

Hello, I am a family nurse practitioner with environmental health. I was recently hired on because we are now moving into clinical services. We have developed a program that incorporates clinic services (detailed exposure history evaluations, assessments, as needed labs, etc) with healthy home assessments and interventions. We are currently focusing on our poorly controlled asthmatic pediatric patients in the local Houston area as well as patients with elevated lead levels and also other environmental exposure concerns.

Please comment on the training that CHWs and Nurses receive to be trained in the case management of the healthy homes program. Did CHWs receive reimbursement? If so, I am interested in how this was presented to Medicaid so that the non-licesed health professionals were reimbursed.