Disease Management and FREE Health Programs
Midwest Health Plan (MHP) has implemented McKesson’s Disease Monitor system to support its Disease Management Programs. The system provides automated support for the identification of members with Asthma and Diabetes who are overdue for screenings, have abnormal lab values, have atypical pharmaceutical patterns, or who have been to the ER or hospital for asthma or diabetes. Using McKesson, Midwest sends members and providers targeted mailings based on members’ utilization and pharmacy patterns.
Examples of letters that are being mailed on a monthly basis include the following:
Diabetes:
- Reminder Letters: HbA1c, LDL-C, Eye Exam, microalbumin test, office visit
- Lapse in medicine letter to PCP (if member has not filled medicine)
- Letter informing PCP of members who had more than 3 oral hypoglycemic prescriptions in the past 45 days.
- Referral to MHP case management for members hospitalized 3 or more times in last 90 days.
Asthma:
- No reported use of a corticosteroid after hospitalization
- Chronic oral corticosteroid use letter to PCP
- Lack of transition to inhaled corticosteroids letter to PCP
- Beta-agonist Bronchodilator overuse letter to PCP
- Lack of annual influenza vaccination letter to member
- Lack of follow-up after ER visit letter to member
- Referral to MHP case management for members hospitalized 3 or more times in last 90 days.
Members are automatically enrolled in our disease management programs based on the rules defined within McKesson. Providers may also enroll members in the Diabetes or Asthma program by calling Midwest at
1-313-586-6071.
Programs include:
Diabetes Control Network
This program is for members with Diabetes. When enrolled, members will receive information on how to take care of their diabetes. To refer your patient into this program, call 1-313-586-6071. After joining, the member will be sent information on what diabetes is, how to control blood sugar, taking medications the right way, exercising, eating right, eye and foot care and other important information.
Asthma Focus
This is for members with Asthma. When enrolled, members will receive educational information in the mail. To refer your patient into this program, call 1-313-586-6071. After joining, the member will be sent information on asthma triggers, use of medications, peak flow meter use, an asthma action plan to complete with PCP, information on stopping smoking, and much more.
Assistance to Stop Smoking
Our “I Can Quit” Smoking Cessation Program can help members quit smoking. This is a telephone health coaching program. The program includes: five proactive phone calls by a dedicated health coach over a 12 month period. Health coaches offer strategies to increase self-efficacy, identify barriers to change, and provide techniques to cope with and overcome barriers. For more information on our “I Can Quit” Smoking Cessation Program or to refer any of your patients to the program, call the Health Management Department at 1-313-586-6071.
ROSEBUD® Pregnancy Program
Midwest Health Plan offers the ROSEBUD Special Delivery Program to help members achieve a healthy pregnancy. The goal of this program is early recognition of potential problems and education on healthy lifestyles. A nurse that specializes in obstetrics and high-risk pregnancy care will contact the member by telephone to discuss their pregnancy and general health. The nurse will help determine if there are any risks for early delivery or other pregnancy complications, and provide education and support. To refer your patients to this program, call the Health Management Department at 1-313-586-6071.
Maternal Infant Health Program (MIHP)
The Maternal and Infant Health Program is for pregnant women and their baby up to 1 year of age. This program helps pregnant members and infants get the proper food, support, and transportation for all health services. It will also help emphasize the importance of getting prenatal care, well childcare, and shots when they are scheduled. If you would like to refer members for this program, call the Health Management Department at 1-313-586-6071.
Services include:
- Prenatal teaching
- Childbirth education classes
- Nutritional support and education
- Newborn baby assessments
- Referrals to community resources and help in finding baby cribs, car seats, clothing, etc
- Help with transportation to pregnancy related appointments
- Support to stop smoking
Preventive Health Reminders
Midwest Health Plan sends out preventive health reminders to members that may be due for services. These reminders include:
- Child Immunizations
- Adolescent Immunizations
- Lead Testing
- Well Child Visits/Well Adolescent Visits
- Diabetes Care
- Mammogram and Cervical Cancer Screening
- Colorectal Cancer Screening
Preventive Health Guidelines
Preventive guidelines are included in the new member welcome packet with a current immunization schedule. The guidelines are also on the website under the Preventive Health section. If you would like to request a copy of the guidelines, please call 1-313-586-6071.
Health Risk Appraisals
Midwest Health Plan sends Health Risk Appraisals (HRA) to all new members in an effort to learn more about the current health status of our members. The member has a chance to fill out the survey and return it for a $5 gift card. The member can also request information on various diseases and health topics.
New Mom Packet
All new mothers receive a new mom packet from Midwest Health Plan. In this packet, new mothers are encouraged to obtain timely postpartum care and will receive a $10 gift card for having their post partum visit. Postpartum care must be completed 21 to 56 days after delivery to qualify for the gift card.
Also, in the packet, is the Edinburgh Postnatal Depression Screening tool. Members are encouraged to complete the form and return it to MHP for a $5 gift card. All returned screens are scored according to the Edinburgh guidelines. If the score indicates a member is at risk for postpartum depression, a second screen is sent. If the score on the repeat screen still suggest she is at risk for postpartum depression, she is sent a booklet called Depression During and After Pregnancy and encouraged to contact her PCP for further evaluation. Results of both screenings are mailed to the PCP to assist with any follow up care that may be needed.
Health Education Materials
Midwest Health plan has educational materials available for members on the following topics:
- Asthma
- Diabetes
- High Cholesterol
- High Blood Pressure
- Depression
- Pregnancy
- Well Woman Care
- Colorectal Cancer
- Controlling Weight
- Domestic Violence
- Healthy eating
- Immunizations
- Well Child Care
- Lead Poisoning
- Sexually Transmitted Diseases
- Stroke
Member Incentive Programs:
Preventive health reminders are sent to members due for services. An incentive form is included to have the member’s doctor sign and return to MHP, verifying that the service was completed. Please call the Health Management Department at 313-586-6071 with any questions.
Members are eligible to receive gift cards after they have obtained the following services:
|
Service
|
How to receive gift card
|
| Child Vaccines |
Complete all before age 2 and return form |
| Adolescent Vaccines |
Complete all before age 13 and return form |
| Adolescent Well Visit |
1 well visit each year- Return form |
| Post Partum Visit |
Post Partum visit 21 -56 days after delivery-return form |
| Post partum depression screening |
Return form |
| Health Risk Assessment |
Return form |
| Breast Cancer Screening |
Return form |
| Cervical Cancer Screening |
Return form |
Diabetes Services
(Dilated eye exam, HbA1c,
urine testing for nephropathy, LDL) |
Return form |
Aged, Blind and Disabled Population
MHP also has a member incentive program for our aged, blind and disabled members. Annually, all members that are in the ABAD category are sent letters asking them to see their PCP for an office visit. If the member sees their PCP, they are sent a gift card.