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AmeriHealth Caritas Northeast Hosts Conference to Help Health Care Providers Deliver Comprehensive, Whole-Person Care and Reduce Costs

Providers given new tools to address non-medical factors that prevent good health

AmeriHealth Caritas Northeast, a Medical Assistance (Medicaid) managed care plan serving 22 northeastern Pennsylvania counties and part of the AmeriHealth Caritas Family of Companies, held a special conference to support efforts by health care providers to enhance the quality of care and identify non-medical threats to wellness by treating the whole person in order to continuously improve their patients' health.

More than 30 health care providers and case workers attended the first AmeriHealth Caritas Northeast Patient-Centered Medical Home (PCMH)/Centers of Excellence (COE) conference at the Pittston Memorial Library in Pittston. The objective of the conference was to strengthen relationships between the managed care organization and health care providers. The conference was needed after primary care physicians requested additional information about resources and services offered by AmeriHealth Caritas Northeast.

In the PCMH model of care, teams—led by a primary care provider—treat the complex needs of patients with whole-person, comprehensive, coordinated and patient-centered care. Research shows that the PCMH model can improve health outcomes while reducing costs.1 A PCMH also encourages physicians and their teams of caregivers to identify and address social, economic, educational and environmental barriers to good health. These non-medical factors—like poverty, food insecurity and safe housing—affect a wide range of health risks and outcomes.

The importance of whole-person care was highlighted during the conference as an example of its effectiveness in addressing the opioid crisis.

The Scranton-Wilkes Barre region has been hit hard by the opioid crisis.

Luzerne County, where Wilkes Barre is located, reported a total of 283 deaths in 2017 and 2018. Lackawanna County, whose largest city is Scranton, reported 180 deaths during the same period.2

PCMH’s focus on whole-person care necessitates coordination with Centers of Excellence (COE), which ensure that people with opioid-related substance use disorder stay in treatment to receive follow-up care and are supported within their communities. Managed care teams coordinate care and provide warm transitions to new parts of the treatment process.3

Whole-person care is the goal of AmeriHealth Caritas’ Opioid Blueprint, which looks beyond the physical health needs of those battling addiction to address the behavioral and social dynamics that are part of their well-being. The Opioid Blueprint is designed to meet the unique needs and challenges of Medicaid members, who confront many challenges navigating everyday life which make opioid dependencies even more difficult to overcome and require more comprehensive support.4

“We wanted this conference to reinforce our message to our health care providers of the importance of meeting patients where they are,” said AmeriHealth Caritas Northeast Market President Marge Angello, who is also a registered nurse. “We are committed to supporting our providers and case workers with the tools and information that they need to enhance the quality care of patients in a cost-effective manner. By working together, we can provide quality and reduce costs.”

References

1Patient-Centered Medical Home (PCMH). https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/
2Open Data PA. https://data.pa.gov/Opioid-Related/Estimated-Drug-Overdose-Deaths-by-County-2017-2018/azzc-q64m/data
3Keeping People in Care. http://www.dhs.pa.gov/cs/groups/webcontent/documents/document/c_230390.pdf
4The Opioid Crisis: Protecting Medicaid Members. https://www.amerihealthcaritas.com/assets/pdf/opioid-crisis-protecting-medicaid-members.pdf