MyHealthDIRECT Sparks 44% Jump in Preventive Services for Major Arizona Managed Care Organization

BROOKFIELD, Wis., Dec. 28, 2011  /PRNewswire/ -- It's well known that many of America's most serious health problems—and their associated cost—can be reduced or eliminated through early detection. Yet after years of effort, more than 95% of every health dollar in the United States still goes to treatment rather than prevention, according to a publication of the Centers for Disease Control*. Where is the disconnect?

For Health Choice Arizona, much of the problem used to involve getting patients connected with appropriate community health resources on a timely basis. Health Choice Arizona provides health care to 195,000 members in nine Arizona counties. As a managed care organization in the state's Medicaid program known as the Arizona Health Care Cost Containment System, Health Choice Arizona wanted to find a way to help those members with the lowest incidence of preventive service completion quickly schedule their appointments.

According to Mike Uchrin, Health Choice Arizona's Chief Operating Officer, low completion scores can have repercussions for patients and providers alike. "Many of our most vulnerable patient populations are in dire need of early periodic screening, diagnosis and treatment," Uchrin said. "These can take the form of 'well woman' exams, complete physicals, or other screenings. The state of Arizona rates such exams very highly. Health plans that do not meet standards set for 29 separate measures, including completion rates for preventive services and physicals, are subject to sanctions of up to $100,000 per standard."

In the past, Health Choice Arizona used a variety of approaches to make and keep preventive care appointments for their members. Reminders were mailed, messages were left on voicemail, and members were called by phone when requested to help schedule appointments. Oftentimes staffers would spend as many as 20 minutes per patient scheduling a single appointment, largely due to the difficulties in coordinating patient schedules with available providers.

Uchrin stated that the situation prompted his organization to seek a better solution. "Our research indicated that MyHealthDIRECT could be the missing link," he recalled. "We found it was one of the only systems out there designed to inventory, compare, and schedule patients with available providers."

MyHealthDIRECT, the nation's only "healthcare scheduling exchange", combines a system for building provider inventories with a unique scheduling platform. As Health Choice Arizona found, this comprehensive solution was ideal for facilitating the appointment process.

"Implementation of MyHealthDIRECT is straightforward and manageable—much easier than a typical technology implementation," Uchrin said.  MyHealthDIRECT account managers helped Health Choice Arizona seamlessly incorporate the program into existing workflows, and met with network providers to discuss the project, and build an inventory of appointment slots for the plan.  Training was conducted by the MyHealthDIRECT client services team in person as well as via the Web. Staff training for the Care Coordinators took just one hour.

Ivette Palacios, EPSDT (Early Preventive Screening, Diagnostics and Treatment) Supervisor for Health Choice Arizona, confirmed that the system was simple for staffers. "MyHealthDIRECT is incredibly intuitive and easy to use," she said, adding that appointment call times have decreased from the previous 20 minutes to less than five minutes, freeing staff to perform other tasks.

Less than one month after the MyHealthDIRECT contract was signed, the first appointment was made through the system. Results were dramatic. Compared to the prior situation, when members completed preventive services 47.72% of the time, members who made appointments through the MyHealthDIRECT system completed their appointments 68% of the time—an improvement of 44%.

At first, provider offices were understandably hesitant about making appointment slots available to an outside process, as they were already at capacity. Soon, however, they realized that the approach actually improved the existing process for appointment requests they were already getting by eliminating time spent on the phone. With MyHealthDIRECT providers receive automated confirmation for scheduled appointments; any slots left unused within two days prior to the appointment time are returned to the provider for use by other patients.

"Providers in our network like receiving appointments from us through MyHealthDIRECT," commented Linda Ross, program director. "The make an ample supply of appointment slots available to us." In the initial nine months after deployment, MyHealthDIRECT raised 1,200 appointment slots from the first two clinics to go live.

All told, MyHealthDIRECT, in concert with Health Choice Arizona's existing efforts, does more than help the managed care organization achieve state quality standards, avoid sanctions, and increase its attractiveness to new enrollees.  It also demonstrates a successful, innovative approach to improving quality of care.

"With MyHealthDIRECT driving the process, members don't have to wait on hold to have an appointment scheduled," noted Uchrin. "MyHealthDIRECT is an essential part of our approach to improve preventive service outcomes and to avoid several hundred thousand dollars of financial penalties."

*McGinnis, JM. "Observations on incentives to improve population health", Preventing Chronic Disease 2010;7(5). http://www.cdc.gov/pcd/issues/2010/sep/10_0078.htm.

About MyHealthDIRECT:

MyHealthDIRECT is the nation's only healthcare scheduling exchange that connects health plans, hospitals, care management organizations, public agencies and community collaboratives for the purpose of scheduling and booking timely and appropriate healthcare appointments on behalf of members and patients. Founded in 2006, MyHealthDIRECT offers a web-based solution that organizes open and available healthcare appointments in the community into a searchable and schedulable inventory of healthcare services. The MyHealthDIRECT solution promotes continuity of care, reduces unnecessary cost and utilization and ensures that patients are matched with appointments that best fit their needs and preferences. For more information on MyHealthDIRECT please visit www.myhealthdirect.com.

SOURCE MyHealthDIRECT