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Please note we have a broad array of resources to supplement your efforts to increase preventive screenings and to reduce non-emergent ER utilization. These programs provide important utilization information to providers and health education/reminders to members. We encourage all of our PCP’s to utilize these resources.
The following links provide more information about how we can assist providers with:
The following materials provide more information to assist providers with:
Breast Cancer Screening Rates
The following are a few examples of current interventions performed by our Health Management team to help improve breast cancer screening rates:
- Distribute reminder postcards to Plan members.
- Educate members through targeted mailings, newsletter articles, on-hold messages and telephonic outreach.
- Distribute annual provider reports identifying eligible panel members in need of a breast cancer screening.
- Host the mobile mammography unit in areas with low mammography rates for plan members.
How Health Management Can Assist Providers
- Make outreach calls to your panel members to assist with Mobile Mammography appointments.
- Provide educational resources that you can use to educate your panel members about preventive care including mammography.
- Provide bi-annual provider reports identifying eligible panel members in need of a breast cancer screening.
For More Information
For additional information and resources about breast cancer screenings, please call the Health Management department at (502) 585-8364.
Cervical Cancer Screening Rates
The following are a few examples of current interventions performed by our Health Management team to help improve cervical cancer screening rates:
- Distribute reminder postcards to Plan members.
- Educate members through targeted mailings, newsletter articles, on-hold messages and telephonic outreach.
- Maximize opportunities with internal departments who come in contact with female members to remind them to get screened.
- Distribute annual provider reports identifying eligible panel members in need of a cervical cancer screening.
How Health Management Can Assist Providers
- Continue to provide additional member education and reminders through distribution of the Women’s Magazine 2008.
- Provide educational resources that you can use to educate your panel members about preventive care including cervical cancer screening.
- Provide bi-annual provider reports identifying eligible panel members in need of a cervical cancer screening.
For More Information
For additional information and resources about cervical cancer screenings, please call the Health Management department at (502) 585-8364.
Chlamydia Screening Rates
The following are a few examples of current interventions performed by our Health Management team to help improve chlamydia screening rates:
- Educate members through member newsletter articles.
- Distribute adult preventive health, perinatal care, and child and adolescent preventive health guidelines to members and practitioners.
- Increase provider awareness of recommended screening for chlamydia through provider newsletter articles and information on the web site.
How Health Management Can Assist Providers
- Continue to provide additional member education and reminders through distribution of the Women’s Magazine 2008, as well as the EPSDT program and the Mommy & Me program.
- Provide educational resources that you can use to educate your panel members about preventive care including chlamydia screenings.
For More Information
For additional information and resources about chlamydia screenings, please call the Health Management department at (502) 585-8364.
EPSDT Screening and Participation Rates
The following are a few examples of current interventions performed by our Health Management team to help improve EPSDT screening and participation rates:
- Distribute report to providers identifying members due for EPSDT screens.
- Make outreach calls to parent or guardian advising that member is due for an EPSDT screen.
- Submit referrals to departments of health (DOH) requesting home visits for EPSDT-eligible members identified as lost to care.
- Send reminder postcards to parent or guardian of newborns to select a PCP and schedule a well child exam.
How Health Management Can Assist Providers
- Verify if a Plan member is eligible for an EPSDT screen.
- At your request, EPSDT program representatives will reach out to members identified as lost to care.
- Assist members with scheduling EPSDT appointments as needed.
- Provide educational resources that you can use to educate your panel members, parents, and guardians about EPSDT services.
For More Information
For additional information and resources about EPSDT screenings, please call the EPSDT department at (502) 585-7907.
Emergency Room Utilization
The following are a few examples of current interventions performed by our Health Management team to help improve ER utilization rates:
- Follow-up daily on members seen in University of Louisville Hospital on previous business day.
- Send educational mailings to members seen in Hardin Memorial Hospital and Kosair Children’s Hospital ER’s for non-emergent care.
- Send ER reports to PCP’s identifying all panel members seen eight or more times in a rolling 12 months.
How Health Management Can Assist Providers
- Expand the daily ER reporting and follow-up to other area hospitals.
- At your request, Health Management can reach out to a member you have identified as in need of case management related to ER use.
- Outreach to members to encourage follow-up with your office after an ER visit.
- Provide educational resources that you can use to educate your panel members on appropriate use of the ER and how to contact your office after hours.
For More Information
For additional information and resources about ER utilization, please call the Health Management department at (502) 585-7942.
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