Connecticut
Medicaid Managed Care Council
Quality Assurance Subcommittee
Legislative Office Building Room 3000, Hartford CT 06106
(860) 240-0321     Info Line (860) 240-8329     FAX (860) 240-8307
www.cga.state.ct.us/ph/medicaid
 

MEETING SUMMARY

JANUARY 27, 2000

Chair: Paula Armbruster

DSS Update

· The EPSDT special project is being completed, with chart review for the components of a comprehensive screen

· The draft report on children’s mental health services is being reviewed by the five agency commissioners and will be given to the legislature by Feb. 1, 2000.

Special Asthma Project: Qualidigm

Purpose of the study was to assess broader effects (in asthma quality management) of the first asthma project in which MCO’s identified focused, short cycled interventions targeted by each plan that voluntarily participated in the study. This was a descriptive study that demonstrated trends in asthma management, focusing on: influenza vaccinations and the prescription of inhaled inflammatory medication.

· Study population: children 6-18 years, continuously enrolled in the same plan for 11/12 months who had an index event of ambulatory, ED or hospitalizations with the principle diagnosis of asthma. Approximately 48% of the subjects were Hispanic and 33% were African American. A proxy for asthma severity was ED visits and/or hospitalization.

· Study design: chart review of those subjects that met the inclusion criteria.

· Results: All plans showed an improvement in the administration of flu vaccines and the prescription of inflammatory inhalants, even though their individual pre-study interventions did not target these items.

Discussion following the presentation:

· Asthma frequency of 9.7% in the HUSKY program, based on encounter data, was probably low compared to other state data.

· Primary care provider identified in the encounter data may not be the PCP identified by the MCO.

· Lack of communication with the child’s PCP about services provided in SBHC’s leads to care fragmentation and inadequate care management.

· Integration of data across systems of care within the Medicaid program, with standardized formats would improve care management.

Asthma Workshop

A discussion and planning of an asthma workshop will continue on Feb. 23 at 9 AM. One purpose of the workshop could be to establish an ongoing dialogue among providers and MCO’s regarding formulary changes and access to DME. There needs to be data to support specific issues.

The next meeting of the QA subcommittee is on February 23, 2000, with the asthma workshop group meeting at 9 Am and the subcommittee at 10:30 AM