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Conclusion

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Conclusion

To date, there is no broad evidence base to support the assumption that disease management improves health outcomes and can reduce the cost of care for populations with multiple chronic illnesses. Most of the evidence currently available about DM is for diabetes, asthma, congestive health failure, and chronic obstructive pulmonary disease &nda
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Disease Management for HIV/AIDS

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Disease Management for HIV/AIDS

Antiretroviral treatment has extended the lifespan of people with HIV infection, and more people become infected with HIV than die from the disease each year. Since the mid-1990s, the age-adjusted HIV death rate has declined by more than 70 percent (Kaiser Family Foundation, 2008). As more people with HIV infection live longer, the demand for HIV
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Medicaid Disease Management

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Medicaid Disease Management

A 2003 study of three Medicaid DM programs (for all chronic conditions, not HIV-specific DM) indicated that the states’ varied program designs produced short-term net savings and improved outcomes in their patient populations (Gillespie & Rossiter, 2003). Because of the variability in the programs reviewed and the range of chronic co
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Disease Management for Complex Medical Conditions

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Disease Management for Complex Medical Conditions

In January 2008, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) convened an expert panel to discuss outcomes measurement issues related to DM for populations with chronic conditions. The panel included researchers and clinicians, and the discussion noted that the inconsistency in methodologies used to evaluate DM prog
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Disease Management: Findings from the Literature

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Disease Management: Findings from the Literature

Mixed results from studies of disease management programs in general indicate there is no conclusive evidence of the impact of the programs on cost-effectiveness and health outcomes. According to the Congressional Budget Office’s 2004 analysis of disease management studies for several chronic diseases, there is insufficient evidence to c
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Background

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Background

The prevalence of chronic disease in the U.S. is a significant public health issue. About 133 million people, almost half of all Americans, have at least one chronic health condition – for example, heart disease, asthma, or diabetes. The Centers for Disease Control and Prevention (CDC) estimates that chronic diseases account for 70% of a
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Introduction

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Introduction

Disease management (DM) refers to a system of coordinated health care interventions and communications to help patients self-manage their chronic diseases and prevent complications from these health conditions. DM has been touted by vendors as an effective tool to reduce health care costs. Some DM vendors have claimed that disease management progr
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Executive Summary

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Executive Summary

Disease management (DM) is a system of coordinated health care interventions and communications to help patients self-manage their chronic diseases and prevent complications from these health conditions.
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Disease Management and Medicaid Waiver Services

Disease Management and Medicaid Waiver Services for HIV/AIDS Patients

This paper examines the limited evidence to date on the impact of disease management (DM) for low-income populations enrolled in public insurance programs, and explores issues concerning the effectiveness of DM targeted to people living with HIV/AIDS.
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The Importance of Quality Implementation for

The Importance of Quality Implementation for Research, Practice, and Policy

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Key Implementation Considerations for Executing

Key Implementation Considerations for Executing Evidence-Based Programs: Project Overview

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Core Intervention Components: Identifying and

Core Intervention Components: Identifying and Operationalizing What Makes Programs Work

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Oklahoma Marriage Initiative (OMI): The Promise

Oklahoma Marriage Initiative (OMI): The Promise and Challenge of Using Volunteers to Provide Community-Based Marriage Education

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National Study of Child Protective Services

National Study of Child Protective Services Systems and Reform Efforts: Review of State CPS Policy - Appendix C

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Endnote

Emerging Practices in Medicaid Primary Care Case Management Programs. Endnote

1.  In general, "TANF" refers to other poverty-related populations in addition to TANF beneficiaries. However, Alabama makes a distinction between SOBRA women and SOBRA children; SOBRA children are mandatorily enrolled, while SOBRA adults are not eligible.
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Appendix C

Emerging Practices in Medicaid Primary Care Case Management Programs. Appendix C

Case Study States' Enrollment Policies   Alabama Florida Iowa Maine North Carolina Oklahoma Texas Virginia Patient 1 st
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Appendix B: North Carolina ACCESS II & III

Emerging Practices in Medicaid Primary Care Case Management Programs. Appendix B: North Carolina Access II & III Core Elements of the Asthma Disease Management Program

Build Capacity for Routine Assessment of Asthma
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Appendix A: Case Study States' Contacts

Emerging Practices in Medicaid Primary Care Case Management Programs. Appendix A: Case Study States' Contacts

Charlene J. Benson Director, Medicaid Care Management Oklahoma Health Care Authority 4545 North Lincoln Suite 124 Oklahoma City, OK 73105 405-522-7366 bensonc@ohca.state.ok.us Scott F. Cannady Managed Care Unit Supervisor Department of Medical Assistance Services P.O. Box 537 Richmond, VA 23204 804-786-5445 SCannady@dmas.
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Appendices

Emerging Practices in Medicaid Primary Care Case Management Programs. Appendices

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Conclusions

Emerging Practices in Medicaid Primary Care Case Management Programs. Conclusions

As Medicaid managed care has evolved during the past decade, states have balanced the development of their PCCM programs with the growth and/or decline of risk-based managed care. Each state has taken a slightly different approach, depending in part on the state's particular managed care environment. Some states developed PCCM as a stepping stone

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Form Approved OMB# 0990-0379 Exp. Date 9/30/2020