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Innovations in Medicaid Managed Care

March 2005 

Health insurance plans are implementing a multitude of creative programs to improve quality and efficiency in Medicaid.

Download the full report. 

Report by Topic

1. Caring for Members with Asthma 
2. Caring for Members with Diabetes 
3. Promoting Well-Child Care 
4. Providing Prenatal and Postnatal Care 
5. Improving the Coordination of Care 
6. Addressing Cultural Diversity 
7. Providing Additional Services:
• Outreach to link new members with services 
• Member incentives to encourage use of preventive care (see also p.74)
• 24-hour nurse hotline 
• Help with smoking cessation 
• Health coaching for patients with chronic obstructive pulmonary disease 
• Weight management services for children 
• Faith-based wellness activities for women 
• Coordinated care for patients with sickle cell disease 
• Social services to help members with basic needs 
• Dental care 
• Video consultations for members in rural areas 

Report by Company

Affinity Health Plan 

• Healthy Streets Program: Encouraging Medicaid Enrollees to Use Health Care Services 
• Mammography Incentive Program 

AMERIGROUP Corporation 

• Taking Care of Baby and Me 
• Coordinating Care for Members with Chronic Disease 

AMERIGROUP, Inc. 

• Partnership with the Children’s National Medical Center 

Arizona Physicians IPA, Inc. 

• Immunization Reminder Program 

Blue Cross of California State Sponsored Programs 

• A Point-of-Service Pharmacy Consultation Program 
• Partnering with Physicians to Promote Child Immunization 
• The People of Promise Community Partnership 
• Rural-Urban Telemedicine Consultations 

BlueCross BlueShield of Minnesota 

• Promoting Effective Home and Community-Based Care for Dually Eligible Seniors 

BlueCross BlueShield of Tennessee 

• Tennessee Caring for Kids Initiative 

BlueCross BlueShield of Western New York 

• The Asthma Health Management Program: A Three-Part Strategy 

CareSource 

• Case Management for Children with Ongoing Health Care Needs 
• An In-House, 24-Hour Nurse Hotline 

Fallon Community Health Plan 

• Helping Medicaid Members to Quit Smoking 

Great Lakes Health Plan 

• One-on-One Assistance from Respiratory Therapists 

Group Health Cooperative 

• The Teen Pregnancy and Parenting Clinic 

Health Net of California, Inc. 

• Asthma - Be in Charge!^sm Program 
• Diabetes - Be in Charge!^sm Program 
• Be in Charge!^sm Weight Management for Children and Adolescents 

HealthPartners 

• Improving Preventive Care for Adolescents 

Kaiser Foundation Health Plan 

• Understanding Barriers to Child Immunization 

Keystone Mercy Health Plan 

• The Healthy Hoops Asthma Management Program 
• Health Ministry Program for Women 
• Coordinating Care for Members with Sickle Cell Disease 

L.A. Care Health Plan 

• Addressing Members’ Limited English Proficiency 

Medica Health Plans 

• Promoting Well-Child Screenings 
• The Way to Better Health: A Member Incentive Project 

Medica Health Plans and Metropolitan Health Plan 

• The MATCH Program: A Grassroots Partnership 

Neighborhood Health Plan 

• Working with Physicians to Promote Effective Asthma Care 
• The Care Partnership Program for Patients at Risk of Hospitalization 
• Helping Members Meet Basic Needs 

Optima Health 

• LifeCoaching for Behavior Change 
• The LifeCoach Model 
• A Home- and Community-Based Strategy for Healthy Moms and Babies 

Passport Health Plan 

• Helping Members Treat Asthma Effectively 
• Diabetes Education and Reminders 
• Using the “Screen Team” to Increase EPSDT Rates 
• The Mommy & Me Program 
• Case Management for Adults with Disabilities 
• Cultural and Linguistic Services to Promote Member Understanding 

Santa Clara Family Health Plan 

• Using Physician Incentives and Member Outreach to Promote Well-Child Care 
• Using a Member Advisory Committee to Promote Accountability and Understanding 

UCare Minnesota 

• The Asthma Action Program 
• Incentives to Check Children’s Blood Lead Levels 
• UCare Tooth Care 

UniCare Health Plan of Virginia 

• A Four-Part Strategy to Improve Care for African American Members with Asthma 

UPMC for You 

• Telephone Outreach to Promote Preventive Care for Children