In order to realize the cost savings as calculated how did you find the high cost super utilizers for intervention. Were they referred by the insurer, hospital, provider?

Is there a single place where the various publications and references on Cost Savings Data are collated?

This would be a tremendous service if someone could create it?

   Bob

Robert Vinetz, MD
Medical Advisor, Pediatric Asthma Disease Management Prog. (QueensCare Health Centers)

Co-chair, Asthma Coalition of Los Angeles County

Once a state submits a SPA that is approved. Does this mean that they will be able to draw down federal matching funds to cover the comprehensive services of asthma care?

Anyone aware of models for local health depts to pursue reimbursement for asthma education through home visiting? It is difficult to get credentialed by the Medicaid MCO's as a health dept. Any suggestions from CMS staff on some avenues to pursue this.

Wonderful presentation. I am wondering whether in determing health outcomes whether you were able to account for reductions in ER visits, hospitalizations, etc. that are likely to occur just over time rather than due to the intervention. For example, perhaps someone was enrolled because they had just had a severe asthma exacerbation and in six months time they may not have been expected to have another incident that serious.

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?