New Care Coordination Program Will Improve Health Outcomes for Medicaid Beneficiaries
Mayor Bowser announced My Health GPS, a new care coordination program that will help Medicaid beneficiaries diagnosed with multiple chronic conditions get the care they need. As part of the My Health GPS program, interdisciplinary care teams from approved Medicaid primary care providers will organize and coordinate primary, acute, behavioral health, and long-term services and supports for eligible beneficiaries. Overall, the program aims to improve health outcomes while reducing inappropriate hospital utilization and hospital readmissions.
“The health and well-being of DC residents is my top priority and we continue to look for new ways to not only increase access to care, but increase the efficiency and quality of that care,” said Mayor Bowser. “My Health GPS will improve the health and wellness of our Medicaid beneficiaries while providing significant support to participating Medicaid providers who have committed to delivering patient-centered care.”
My Health GPS addresses some of the goals of the DC Healthy People 2020 Framework, a shared community agenda that monitors 150 objectives and targets and recommends over 85 strategies for improving population health in Washington, DC by 2020 using both traditional and non-traditional programs and stakeholder input. In addition, My Health GPS uses health homes for Medicaid beneficiaries with chronic conditions, a practice well-aligned with the Framework.
The twelve Medicaid primary care providers currently participating in the My Health GPS program include:
- Bread for the City
- Children’s National Health System
- Community of Hope
- Medical Home Development Group
- Family and Medical Counseling Service
- Howard University Faculty Practice Plan
- La Clinica del Pueblo
- Mary’s Center
- GW Medical Faculty Associates
- Providence Health Services
- Unity Health Care
- Whitman-Walker Clinic
“The My Health GPS program will address the unmet care management needs of beneficiaries who have had preventable utilization of emergency medical services, avoidable emergency department services and hospital admissions, and poor health outcomes,” said Deputy Mayor for Health and Human Services HyeSook Chung. “There is both quantitative and qualitative evidence to suggest that there is a need for improved care coordination and service integration.”
By 2019, My Health GPS is projected to serve approximately 25,000 District Medicaid beneficiaries with three or more chronic conditions.
“The goal of My Health GPS is to make it easier for District residents with complex health needs to navigate the health system. Considerable efforts have already been made by DC providers across the spectrum, with the assistance of both the DC Hospital and Primary Care Associations, as well as government agencies like the DC Department of Health Care Finance and the DC Department of Behavioral Health, but there is more to do to ensure that patients take full advantage of all of the available resources. Some of the important elements of this program include coordinating care when patients leave the hospital for post-acute settings like skilled nursing facilities; integrating behavioral health and specialty care into the primary care setting; coordinating care for people with multiple chronic conditions who are frequently hospitalized and spending time away from loved ones; and providing navigation and other case management services in hospital emergency department settings to help people become familiar with ways to get the right care, at the right time, in the right place,” said Director of the Department of Health LaQuandra Nesbitt.
Starting in fiscal year 2019, my Health GPS will implement a pay for performance (P4P) payment structure. Specific measurable goals of the P4P program include:
- improving beneficiaries’ experience of care, quality of life, and satisfaction;
- improving health outcomes such as lowering rates of avoidable emergency department use and reducing preventable hospital admissions and readmissions; and
- reducing healthcare costs.
Wayne Turnage, Director of the Department of Health Care Finance, sees the program as a promising step to incentivizing continuous quality of care improvement in Washington, DC.
“The use of a pay for performance strategy as part of the My Health GPS program sets clear and meaningful priorities for quality improvement and improved health outcomes for the District’s Medicaid beneficiaries,” said Director Turnage. “P4P offers a significant opportunity for providers to transform the way they deliver care and demonstrate innovative ways they can improve the health outcomes of their patients. It’s a win-win for all.”
My Health GPS will be the District’s second Health Home program. For more information, visit dchf.dc.gov.