Intern’s power pointSummer 2016

Kayla Keir- Keys to Your Care-Maternity Overview

Keys to Your Care is an engagement program that provides incentives to pregnant Keystone First members. Eligible members can receive up to 8 $10.00 gift cards for their prenatal visits. At 38 weeks, if the member has attended > 81% of their prenatal visits they are eligible to receive a portable pack n’ play. When the mother has delivered and has gone to their post-partum visit they will receive either a $25 gift card or 2 packs of diapers.

Program Goals• improve HEDIS scores• prenatal doctor’s appointment compliance to improve birth outcomes and stay

healthy. • decrease in the number of neonate babies and increase in the number of healthy

newborns.

Challenges & ExperienceKayla Keir

Challenges• Member complaints

• Shift from 38 weeks to 36 weeks for Crib distribution

• Provider complaints• Too many phone calls

Experience• Baby shower• Breastfeeding conference• Jiva input• Inbound message detection• Bi-weekly KTYC Conference calls

HEDIS MEASURESKayla Keir

Last Year KF members with early detection:With Keys to Your Care, KF members with early detection:

Last Year KF members who went to their post-partum visit:With Keys to Your Care, KF members who attend the post-partum visit:

Last Year KF members who attended > 81% of their prenatal visits:With Keys to Your Care, KF members who attend > 81% of their prenatal visits:

John Burgoyne- Claims Report

Prepared weekly claim report for vendor StellarRx by pulling:– AWC (Adolescent Well Care) Claims– OB Claims

Pulled claims report for Community Based Care Management (CBCM) implemented programs for:

– Hep C– HIV – Sickle Cell – Asthma Navigator

Pulled OB claims for Active Keys to Your Care (KTYC) members in their 36th week of gestation (Pregnancy?)

– Determined which members attended greater than 81% of their visits based on HEDIS criteria

John Burgoyne

Process of getting OB Visit Percentages John Burgoyne

• Receive a list of members who are 36 weeks pregnant

• Bring Excel file containing member info into Microsoft Access

• Pull claims adding any needed fields to existing member info

• Export results back into excel to organize data and count unique

visit dates for each member’s claims

• Determine, based on HEDIS criteria, whether members have

attended at least 81% of their pregnancy visits

– Determines eligibility to receive a crib under KTYC Maternity

Thomas Higgins- CBCM Initiative Sheet

CBCM Initiative Sheet Sent to DHS– Community Paramedics– RHMG

• In Home Visit Program• Wellness Program

– St. Christopher’s Hospital for Children– School Based Health Center Asthma Management – NHS Wellness Recovery Team– Community Based Integrated Care Collaboration– Perinatal Center Of Excellence– Violence Intervention Program at CHOP

St. Christopher’s Hospital for Children Thomas Higgins

Visited St. Christopher's to show them their Hospital Quality Enhancement Program Report Card

– Heard their proposal for a new CBCM program in their Center For Urban Child and Center for Children with Special Health Care Needs

– Promote Keys To Your Care

PH/BH Integration and TiPS Thomas Higgins

Attended weekly meetings regarding PH/BH Integration and TiPS– Write Ups for these programs and NHS Wellness Program for the RFP. – Organizing PH/BH integration files – Looking over TiPS contract for changes in the contract

Benjamin Gosline-Public Affairs & Marketing Intern

Market Differentiator:• Non-traditional style of marketing.

Main Focus:• Provide hands-on community outreach programs.• Ensures that our members are provided access to education, health care screenings and

innovative programs to improve health measures.

Keystone First’s Market Strategy: High Touch-Community Outreach• COS Team (Community Outreach Solutions).• 4 Your Kids Care/ Adolescent Well Visits.• Events (ex. Healthy Hoops, Baby Showers, Intern Service Project, Shelter Initiative,

Wellness Center Initiative).

Events Benjamin Gosline

Baby Shower:• Event held for expecting mothers in association with the BrightStart Program.• Lunch provided, giveaways, music, health information, etc.

Intern Service Project: Project HOME• Interns visited Kate’s Place (1929 Samson Street Philadelphia, PA).• Provided entertainment, screening, food and demonstrations for the residents.

Healthy Hoops:• aims to help children and their families learn how to better control their asthma and

otherwise adopt healthy lifestyles.• Includes hands-on asthma education, health screenings and basketball clinics.

Adolescent Well Visits/ Dental Screening Benjamin Gosline

• Provides check ups to members.• Targets members with care gaps.• Utilizes incentives as means of enticing members.• Participated in many screening events.

Positive aspects:• Ensuring that each member is receiving the health care they need at accessible

locations.• Furthering community outreach as Keystone First.

Complications:• Mainly compliance related.• Members forget about the scheduled appointment (reminded by a phone call).• Members decide to not go to the appointment(many times when they confirmed that

they were).

Wellness Center Initiative/ Shelter Outreach Initiative Benjamin Gosline

• 2 Impactful ProjectsWellness Center Initiative: • Key Goal: Create an environment where we help our members become better.

consumers of health care while showing our members the path to improving health status.

• Facilitated first brainstorming meeting within our department.• Converted written ideas into a presentable Excel format.

Shelter Initiative:• Key Goal: Create relationships to assist members living in transition.

COS Team (Community Outreach Solutions) Benjamin Gosline

• Opportunity to be a part of Keystone First’s, “feet on the street”.

• Work in their assigned geographic locations of the city where the plan has high numbers of chronically ill members with whom Keystone First struggles to maintain contact.

Importance of Literature Benjamin Gosline

Significance:• Used at various events and screenings.• Informs members on specific conditions they may have.• Helpful everyday tips.

Keeping Everything Organized:• Keep track of the many pieces we have (91 in total).• Easier to know which pieces we need to order.• Much easier for Outreach Specialists to get the pieces they need.

Steven Bradley’s Experience in Member Communications

Articles– Throughout my time, I was able to write articles on three different

subjects: post-partum depression, lead, and internet safety. – While doing my research from looking on the Internet and stored

materials, I gained more exposure to health-related information I never knew before.

– With many of the old materials stored in database free for me to use, I was able to create informative pieces on the various subjects.

– I also was able to gain some more insight and knowledge on the writing style that is used for the Member Communication materials, which will be of great use as I begin my college career at the end of this month.

Experience (cont.) Steven Bradley

Reports– As I started my internship experience, the department was going through

processes of Readiness review.– This became the first project that involved a lot of proof reading of

materials coming from Creative Services, and I was able to complete this in a timely manner so that the review can be sent up to the state department.

– This managed to show me the importance of the tracking grids along with the database within my computer system, as it helped me find the original pieces needed for comparisons.

– I also gained a deeper sense of detail from the constant comparison between the original and updated versions of the documents needed for the report.

Experience (cont.)Steven Bradley

– I also gained more experience preparing and creating reports through using Excel during my time here.

– By creating and editing grids for things such as Scheduled Events, PA Member Materials, and Outreach Indexes. Doing this I was able to gain more knowledge on how the grids are created and organized in a certain manner.

– It broadened my knowledge of the program so I may utilize more often in my future.