Kansas Assists High-Risk Medicaid Patients With AHRQ Tools
Kansas changed stakeholder communication and evaluation strategies for its care management program as a result of participating in the Medicaid Care Management Learning Network, an AHRQ Knowledge Transfer project. The Learning Network serves State Medicaid agencies that operate care management programs for chronically ill beneficiaries in fee-for-service plans or primary care case management programs. Kansas is one of 17 States participating in the Learning Network.
Through AHRQ's Knowledge Transfer Program, the Learning Network provides expertise to participating States in four key areas critical to ensuring a quality-driven care management program, as follows:
- Helping patients become active in their care.
- Encouraging provider participation in care management programs.
- Creating program interventions aligned with the State's measurement strategy that will impact patient care.
- Designing valid and reliable evaluations to determine program success.
Kansas officials began operating a pilot care management program in March 2006. The program focuses on high-risk Medicaid beneficiaries with asthma, diabetes, congestive heart failure, and other conditions who live in Sedgwick County, the State's most populous county. Kansas partners with a local vendor, Central Plains Regional Health Care Foundation, to deliver in-person and telephone care management services through the use of an interdisciplinary team of nurse care managers and social service specialists.
State officials improved their communication with program stakeholders—including providers and patients—through teleconferences with the AHRQ project team, workshops, and peer-to-peer learning. Through the AHRQ-supported Learning Network workshops and AHRQ's publication, Designing and Implementing Medicaid Disease and Care Management Programs: A User's Guide, Kansas staff received an overview of the importance of stakeholder engagement.
Workshop sessions focused on developing effective program messages, being "memorable" with stakeholders, and practicing messages through role-playing. As a result of Kansas officials' effective program messaging, providers and patients contacted their State legislative representatives and successfully saved the program when it was nearly eliminated in the State legislature.
The AHRQ project team also provided technical assistance on program evaluation during phone calls, in addition to the workshops. AHRQ's publication, Monitoring and Evaluating Medicaid Fee-For-Service Care Management Programs: A User's Guide, also provided the State an overview of the importance of program evaluation and gave recommendations on the following:
- Selecting a study time frame.
- Selecting a study population.
- Determining the focus of the evaluation.
Workshop sessions focused on aligning measures with interventions and reviewing evaluation methods. The AHRQ project team also provided feedback to Kansas officials on the Year 1 Evaluation Report, including recommendations on statistical significance reporting, the structure of the evaluation report, and strategies to make the report more accessible to stakeholders. State staff incorporated all AHRQ comments into the final report. Specific comments focused on providing better narration and descriptions of figures and tables and to include the statistical significance more consistently.
In reference to AHRQ's feedback on the evaluation report, Susan Wood, former program manager, Kansas Health Policy Authority, writes, "The ability for Kansas to resource the AHRQ staff as our partners, utilizing their knowledge and experience to focus on the science or evidence of our program evaluation, was invaluable."
For more information on the Learning Network, go to: http://www.ahrq.gov/qual/medicaidmgmt/.