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Acumentra Health, under a new contract with the Oregon Department of Human Services, Division of Medical Assistance Programs (DMAP), will help the state facilitate efforts to integrate the delivery of medical, mental health, chemical dependency, and dental care services for Oregon Health Plan (OHP) enrollees. Acumentra Health serves as the External Quality Review Organization for DMAP and for the Addictions and Mental Health Division (AMH). “Along with many health professionals across Oregon, we recognize the need for closer linkage and integration of physical and behavioral health care,” stated Jon Mitchell, FACHE, president and chief executive officer of Acumentra Health. “Acumentra Health will work closely with DMAP, AMH, and health plans to support quality improvement projects that promote integrated care.” Behavioral health issues often co-occur with a medical illness such as heart disease, cancer, or diabetes. Research shows that treating behavioral health conditions can reduce overall healthcare costs. As recommended by the Institute of Medicine, healthcare providers and payer systems across the nation are pursuing strategies to integrate services. Strategies range from full clinical, administrative, and financial integration to care coordination, co-location of providers, and use of evidence-based practices for screening and sharing of patient information. Under the new technical assistance contract, Acumentra Health will identify models and practices to serve as evidence-based guidelines for the managed care health plans that serve OHP enrollees. The organization will train the health plans to conduct performance improvement projects (PIPs) that use integrated care models to improve enrollees’ health outcomes. This program complements the state’s broader efforts to improve the coordination of care. DMAP and AMH oversee the managed care health plans that provide medical, dental, mental health, and substance abuse treatment for OHP enrollees. The health plans take part in collaborative PIPs that integrate physical and behavioral health care and dental care. Acumentra Health’s quality review work for DMAP and AMH includes evaluating the PIPs that managed care plans conduct as required by their contracts with the agencies. Initially, Acumentra Health will review the clinical literature to help the health plans identify potential study questions, performance measures, and change strategies. During 2008, Acumentra Health will conduct separate PIP training sessions for the health plans in various locations. The training sessions will provide instruction on the quality improvement process and will guide the health plans in customized project planning. Acumentra Health will provide ongoing technical assistance to each health plan to increase the likelihood that each plan will meet or exceed the federal requirements for conducting PIPs. Acumentra Health is a nonprofit organization dedicated to improving the quality and effectiveness of health care. Established in 1984, Acumentra Health’s work spans the continuum of care, reaching all ages and economic levels, and all delivery settings. Acumentra Health contracts with Oregon and Washington to provide External Quality Review (EQR) of managed care health services provided to Medicaid enrollees, as well as with Medicare to support effective, evidence-based health care for Medicare beneficiaries in Oregon along with overseeing the state’s Medicare Beneficiary Protection Program. In addition, Acumentra Health contracts with state agencies, public health organizations and coalitions, health plans, hospitals, physicians and others to conduct healthcare quality assurance and quality improvement projects. As a leader in healthcare quality, Acumentra Health provides expertise in areas such as performance measurement and improvement, surveys, utilization management, healthcare data analysis, chronic disease management, peer review, and electronic health records.
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For more information visit www.acumentra.org.
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