2022 Pinnacle Awards Go to CareSource, Paramount Health Care
2022 PINNACLE AWARDS GO TO CARESOURCE, PARAMOUNT HEALTH CARE
Ohio Association of Health Plans (OAHP) honors innovation in care for chronic conditions, behavioral health needs
COLUMBUS, Ohio — The Ohio Association of Health Plans (OAHP) is recognizing CareSource and Paramount Health Care for innovative programs to help families dealing with behavioral health conditions and to improve communication and thus health outcomes for people with chronic health conditions.
OAHP honored the plans with its Pinnacle Award for 2022, announced at the organization’s Annual Convention & Trade Show in Columbus. The award is given each year to highlight OAHP member plans for innovative approaches to addressing challenges in health care.
“All our members do terrific work every day to decrease inequity in health care so Ohioans can live better,” said Kelly O’Reilly, OAHP president and chief executive officer. “I look forward every year to recognizing the best of the best with this award.”
CareSource: Child and Family Health Collaborative Behavioral Health Respite Care Program
The strain of caring for a child with a behavioral health condition affects all family members and can disrupt the home environment. That disruption can affect the child’s brain development, with negative impacts on personality traits, learning processes and the ability to cope with stress and emotions. The end result often is worsened outcomes in health, education and social relationships.
CareSource saw the opportunity to relieve family members’ stress — and thereby reduce disruption in the home — with respite care. A provider or caregiver offers short-term child care in or out of the child’s home, giving an exhausted adult a much-needed chance to step away.
“We know that families and caregivers need breathing room so they can come back refreshed and recharged,” said Steve Ringel, CareSource Ohio market president. “We are happy to bridge the gap for those caring for children with these needs.”
The respite program’s success is demonstrated by a dramatic drop in the number of claims for emergency department care (54%), inpatient behavioral health services (67%) and day treatment (36%) by families who received respite care between February 2021 and July 2021.
Even more important, the data suggest that having respite care available meant not only healthier family members, but healthier relationships among them. Many families told CareSource the relief provided by the program helped their children avoid being placed out of their homes or even out of the state.
Paramount Health Care — CareSignal Disease Management Program
All health-care companies use data from patient claims to assess needs and devise solutions, but Toledo-based Paramount recognized that the lag time involved in collecting that data limits the ability to use the information to directly help individual patients.
The company found a solution: checking on members in real time, using automated text messages or phone calls allowing those enrolled in the program to regularly report information on their depression, diabetes, chronic heart failure and COPD. In addition, some members reported their needs related to social determinants of health including lack of food, transportation or financial resources.
The messages ask members for data based on their conditions. Those with depression report mood ratings; those with diabetes give their blood-sugar levels, and so on.
The CareSignal platform creates real-time alerts to identify members whose conditions are worsening, allowing RN health educators to reach out within 24 hours. The program assigns each member a health risk level; those with medium and high risk receive regular, extra contacts from health educators.
Early results are promising; of 890 enrolled members, more than half of those with depression, diabetes, chronic heart failure or COPD who initially were classified as high risk have lowered their risk level. And reaching out in real time — within a day of a health problem being detected rather than months after a claim was filed — makes connecting easier.
Among Paramount health educators trying to reach members with concerns about their health, those reaching out based on claims data made a connection only 29% of the time, while those calling or texting based on CareSignal data were successful 86% of the time.
Said Kathryn Kossow, director of population health for Paramount, “With CareSignal, we’re calling members right when they need us — not following up on something that happened three months ago.”