Emerging Practices in Medicaid Primary Care Case Management Programs. Quality Activities


Case-study states have implemented a broad range of mechanisms to ensure high quality care for members. Therefore, their advice covers a wide range of issues.

  • Have a plan, from the start, for quality improvement processes.
  • Use multiple methods for obtaining beneficiary and provider feedback.
  • Include physicians on advisory committees so that messages and recommendations are more palatable to their peers and greater PCP buy-in for program policies can be obtained.
  • Provide a base for member outreach and education activities; conduct such activities on an ongoing basis.
  • Hands-on beneficiary education can promote appropriate emergency room use and facilitate access to timely preventive care.
  • Disease management programs are beneficial for the state, PCPs, and beneficiaries.

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