Abstract
Asthma and diabetes are major chronic conditions in the United States, particularly in the Medicaid population. The majority of care for these diseases occurs at ambulatory practice sites. The New York State Department of Health Office of Health Insurance Programs (OHIP) worked with IPRO, the New York State Medicare quality improvement organization, to develop and implement a quality improvement project (QIP) for these conditions. The approach was based upon the Chronic Care Model and used an iterative academic-detailing methodology. Clinics and community health centers volunteered to participate and used IPRO-collected data with audit and feedback to improve their practices. Several metrics significantly improved for asthma (e.g., use of anti-inflammatory long term controller agents, assessment of asthma severity, use of asthma action plans) and for diabetes (e.g., lipid testing and control, A1c testing). Key organizational elements of success included senior medical leadership commitment and practice site quality improvement team meetings. OHIP has used the QIP experience to begin patient-centered medical home implementation in New York State.
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NCQA Disclaimer-The Physician Practice Connections®-Patient Centered Medical Home™ (PPC®-PCMH™) Recognition Program is developed, owned and managed by the National Committee for Quality Assurance (NCQA). To learn more about PPC-PCMH, refer to the program’s website at www.ncqa.org/ppcpcmh.aspx. NCQA is not involved in any determination of clinician incentive payments under the New York State Statewide Medicaid Medical Home Initiative.
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Acknowledgements
The authors wish to thank Dr. Foster Gesten, Medical Director, Office of Health Insurance Programs for his review of the manuscript; Ms. Katja Ocepek-Welikson and Mr. Ti-Kuang Lee of IPRO for their assistance in the data analysis.
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An erratum to this article can be found at http://dx.doi.org/10.1007/s10900-011-9375-5
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Silver, A., Figge, J., Haskin, D.L. et al. An Asthma and Diabetes Quality Improvement Project: Enhancing Care in Clinics and Community Health Centers. J Community Health 36, 180–190 (2011). https://doi.org/10.1007/s10900-010-9296-8
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DOI: https://doi.org/10.1007/s10900-010-9296-8