Health Care Coordination Program Honored With URAC National Best Practices Award

Program Reduced Hospital Admissions by 31 Percent

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Oct 18, 2010, 10:00 ET

INDIANAPOLIS, Oct. 18 /PRNewswire-FirstCall/ -- URAC, a leading independent health care quality accrediting organization, has awarded the Oklahoma Medical Risk Management (MRM) program the Bronze Award in Health Information/Decision Support at the 2010 Best Practices in Health Care Consumer Empowerment and Protection Awards. The awards honor programs that advance patient safety and empower consumers.

The Oklahoma Health Care Authority (OHCA) and Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) developed the program in partnership with research firm Care Management Technologies. Eli Lilly and Company, an Indianapolis-based pharmaceutical company, provides funding for the program to promote excellence in patient care.

"For patients who see multiple physical and behavioral health care providers, care is often fragmented. We're proud to support a program that addresses this issue and is making a positive impact in patients' lives," said Alex Azar, vice president, Lilly.

How the Program Works

The Oklahoma MRM program helps improve health care coordination for Medicaid patients under the age of 18 who have both physical and mental health conditions and receive care from multiple physicians. The program provides a patient's health care providers with detailed profiles on his or her health care history. For example, the profile:

Notifies health care providers of co-occurring medical and health conditions
Provides a 90-day prescription profile
Provides information on recent medical events, psychiatric events, and emergency room and hospital admissions
Identifies concerns related to drug interactions, side effects or prescribing practices that don't adhere to national best practice guidelines
Identifies when patients are late in refilling prescriptions
Sends alerts for health screenings the patient should receive based on their risk factors

"As leading agencies responsible for Oklahoma's health care system, it is important that we work together to find better and more efficient ways to deliver medical services to the people of Oklahoma," says Terri White, state secretary of health and ODMHSAS commissioner. "Our focus on treating all aspects of a person's health, physical and mental, and the understanding of the mind and body connection, will result in significantly improved treatment outcomes for the people we serve. The documented success of this effort, and a commitment to holistically treat the person, will reshape how we deliver services in the future and improve the overall health of our state."

In addition, for patients without a consistent medical or psychiatric caregiver, the MRM program provides a health liaison who works with the state to suggest options for care to help patients connect with an appropriate provider.

"Through our SoonerCare (Oklahoma Medicaid) program, we have implemented the medical home concept of care for our SoonerCare Choice members. Under this model, the member's primary care provider coordinates the majority of a member's health care needs. However, not everyone falls under the Choice program. The MRM program extends that medical home concept to our members who would not otherwise receive this comprehensive oversight of their care," said Mike Fogarty, chief executive officer, OHCA.

Program Results

A study of the Oklahoma MRM program showed that, over a seven-month period, program participants saw a: (1)

31 percent reduction in hospital admissions
17 percent reduction in the number of physicians prescribing behavioral medications
13 percent reduction in physician office visits
10 percent reduction in emergency room visits

"We are very pleased with these outcomes, and the implications they have regarding improved quality of care for this population," said Joe O'Hara, chief operating officer, Care Management Technologies. "We appreciate the chance to partner on an important program such as this with Oklahoma."

Operation and implementation of the program is done solely by the state of Oklahoma and Care Management Technologies. If the state decides to share data with Lilly, the data is blinded and aggregated and does not contain information about individual patients or providers.

URAC Awards Details

Award entries were evaluated by a 30-member panel of independent judges. The judges included experts in program evaluation, care coordination, health information technology, employer and purchaser decision-making and patient safety. A complete list of winners may be found at www.urac.org.

About Lilly

Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world's most urgent medical needs. For additional information on Lilly's patient care and disease management programs, visit www.lillyforbetterhealth.com.

About URAC

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system and provides a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit www.urac.org.

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(1)Data provided by Care Management Technologies.

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SOURCE Eli Lilly and Company