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The Alaska Medicaid Coordinated Care Initiative Is Here to Help

The Division of Health Care Services (Division) is proud to announce an exciting new program, the Alaska Medicaid Coordinated Care Initiative (AMCCI). The new voluntary program will provide one-on-one case management services including care coordination, scheduling appointments, addressing barriers, and referrals to specialists and social service supports.

Do you know someone like Jenny? Jenny worked regularly until, after experiencing several personal tragedies, she lost her job. Shortly thereafter, she lost her home. She now stays with friends when she can and shelters when she can’t. She says she’s sad most the time and sometimes skips meals. Jenny is a middle aged diabetic patient who doesn’t always take her medication. Jenny moves around a lot and sometimes can’t find her pills. The hospital is nearby. She goes to the emergency room when she feels sick.

Though Jenny’s story is an illustration, the health care community regularly receives visits from patients with similar complexities. With this new program, the Division hopes to help patients like Jenny. If you know a patient who may benefit from this program, please complete the Member Referral form linked to this website.

The AMCCI is designed to assist Alaska Medicaid members who use medical services more frequently than other members. Some members may seek care at the ER due to the lack of reliable transportation, because they work during their provider’s regular office hours, or they may have taken their medication incorrectly. Some patients may go the emergency room because they do not have access to a primary care provider. Certain patients have difficulty understanding how important it is to follow their provider’s instruction or the complexities of their healthcare needs. The Division hopes to gain a better understanding of the challenges and barriers faced by these members and the health care professionals who serve them.

The Division seeks to work closely with the medical and social service community to support and help coordinate care for patients with complex medical—and often social—issues. Because these patients may have trouble navigating the health care system, they may become frequent utilizers of the hospital emergency room for issues that may be better treated in a primary care setting. Helping these patients gain the ability to navigate and appropriately utilize the health care system and take control of their health, with the guidance of primary care providers and case managers, can make a dramatic impact on their well-being and on overall health care costs.

The primary objective of the AMCCI is to promote quality, cost effective health outcomes by ensuring that coordinated medical services are provided in the most appropriate setting. Other goals include focusing on prevention and enhanced integration of primary medical care and behavioral health services. And most importantly, the AMCCI hopes to make a difference by improving the health and quality of life for members like Jenny.

Background

During the summer of 2013 Alaska was one of six states and one territory (Colorado, Kentucky, New Mexico, West Virginia, Wisconsin, and Puerto Rico) selected by the National Governor’s Association (NGA) to develop an action plan to serve Medicaid members to ensure that their health care needs are met efficiently and cost-effectively.  Recently the NGA held an in-state retreat to provide technical and work plan assistance.

In order to better assure appropriate use of medical services, improved health outcomes, and to better control increasing Medicaid costs, the State Division of Health Care Services is undertaking this 24-month project. The Alaska Medicaid Coordinated Care Initiative will provide case management and care coordination for this group.

The Division’s Quality Assurance team has issued an RFP for case management services, which will be awarded during the winter of 2014.  The implementation of case management services is targeted to begin during the winter of 2014-2015. Once awarded, the selected vendor(s) will provide one-on-one case management services that will be personalized to each member’s medical needs.