The Oregon Department of Human Services' Division of Medical Assistance Programs has selected a vendor to manage its statewide Medicaid disease and medical care management programs.
APS Healthcare, a specialty healthcare solutions vendor based in White Plains, N.Y., will coordinate Oregon's integrated statewide care management program.
The integrated program will assist Oregon's Medicaid and SCHIP fee-for-service clients to access healthcare, minimize catastrophic health events and improve health outcomes through education and interventions that help promote behavior change.
"After a thorough review of APS Healthcare's service proposal and experience against our selection criteria, we determined APS was the best choice to meet the unique needs of our population," said Walter Shaffer, MD, medical director at the Oregon Division of Medical Assistance Programs at the DHS. "This program will deliver critical health coordination services to Oregonians, improving their health status and reducing our overall healthcare expenditures."
The program emphasizes coordination of care and collaboration with local healthcare providers as well as early intervention with clients at high risk for health issues.
Eligible Oregonians can access a telephonic nurse advice line 24 hours a day that connects clients with referrals to community providers and facilitates the establishment of a medical home – a primary care provider who provides preventive medical services and care for chronic or acute health issues.
Locally-based nurse health coaches will monitor and evaluate the participant's progress, help eliminate barriers to care and encourage behavior changes intended to improve health outcomes and reduce overall costs.
"We are very excited to begin our collaboration with essential community providers to focus on supportive services that change behaviors and lead to improved outcomes," said Jerry Vaccaro, MD, president and chief operating officer of APS Healthcare.
APS will partner with, among others, the Department of Medical Informatics and Clinical Epidemiology at the Oregon Health and Science University, which will work with the state and APS to assess the program's impact.
APS will also form a clinical advisory committee of state medical organizations to establish and maintain communication with the provider community.
"We look forward to working with APS to develop metrics to evaluate the program's impact," said Ariel Linden, of the Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University. "Feedback from the program is invaluable in measuring and identifying areas for enhancement to make the program better over time."
The new program, scheduled to start Monday, will initially be available to more than 66,000 individuals.