Quality improvement initiatives
ODS has designed and implemented a number of quality improvement initiatives for members, employer groups, providers and ODS employees. ODS created these initiatives to improve member health, enhance our members’ care and service experiences, and reduce cost.
ODS Healthcare Services offers programs and services to members at all stages of life and health. To measure our progress, we use results from the Healthcare Effectiveness Data and Information Set (HEDIS®)* and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. We also review our medical and pharmacy claims data.
- Health coaching
- Diabetes screening reminder mailing
- Childhood immunizations
- Flu and pneumonia vaccine reminder
- Adult health screenings
- Medication adherence
- Tobacco cessation program
- Oral health
Health coaching
ODS health coaching offers one-on-one member support from a health coach. Our overall goal is to help ODS members improve their health and quality of life. Care programs are designed to help members prevent chronic conditions and self-manage current conditions to keep them from getting worse.
Participants work with a health coach by phone or email. They also receive member-specific reminder mailings, worksheets, workbooks and online support tools. Health coaches help participants become confident in managing their health.
Any ODS member can enroll in one of nine care programs:
- Cardiac Care
- Depression Care
- Diabetes Care
- Lifestyle Coaching
- Maternity Care
- Medication Therapy Management
- Respiratory Care
- Spine & Joint Care
- Weight Care
These programs emphasize regular screenings and management of chronic conditions. For example, a participant with diabetes learns the importance of having regular eye exams and hemoglobin A1c testing. Other participants are encouraged to take medications, such as those for high blood pressure, correctly.
ODS uses member surveys and clinical outcomes to measures the success of health coaching programs. In 2010, survey scores showed overall improvement in member involvement in their healthcare. Clinical outcomes were also better for members who engaged in health coaching than those who were not part of the coaching program.
Each year, ODS evaluates our care programs and decides whether to continue or start new programs. Based on the 2010 review, ODS staff will explore expanding our Maternity Care program to include general women’s health.
Learn more about our Healthcare Services.
Diabetes screening reminder mailing
ODS sends reminder mailings to our members with diabetes. We do this to help them receive better preventive screenings and services. Our goal is to increase LDL-C screenings, dilated eye exams, hemoglobin A1c screenings and nephropathy screenings.
We send monthly reminders for diabetes-related screenings. These letters explained why screenings are important, how often members should have screenings, and information about preventive measures. These members also receive a dental cleaning reminder if they did not have a cleaning in the past year. ODS sends medication mailings as well. These include information about medications for high blood pressure and to protect kidneys.
It’s also important to keep providers up to date on our members’ care. We send providers information about our members’ needs for screenings and medications.
In 2010, ODS improved all HEDIS measures related to diabetes preventive screenings. We also met or exceeded the regional and national means for these measures.
Childhood immunizations
ODS sends a newsletter to parents of 5-month-old children. Our goal is to improve member health by educating families about vaccines. We describe the importance of immunization, risks of not immunizing and common myths. We also include daycare and school exclusion dates.
In addition, we send reminders to families of 20-month-olds in need of specific vaccines. We identify these children using medical claims and data from the Oregon Alert Registry. The Oregon Alert Registry is a statewide database that keeps immunization records accurate and up to date. It collects data from healthcare providers and links them into one patient record.
ODS improved in eight HEDIS measures related to childhood immunization. ODS meets or exceeds the regional and national means for these measures.
Flu and pneumonia vaccine reminder
All ODS medical members receive a flu vaccine reminder. We also promote an annual flu shot and the once-in-a-lifetime pneumonia vaccine online on myODS. Our goal is to increase the rate of flu and pneumonia vaccinations among ODS members.
We measure the percentage of members who received the flu and pneumonia vaccines using the ODS Medicare Advantage CAHPS survey. The ODS rate of pneumonia vaccination increased from 2009 to 2010 and exceed the national mean.
Adult health screenings
ODS has created a reminder birthday card that includes important age- and gender-specific preventive screenings. We want to encourage ODS members to receive screenings, such as cervical cancer, breast cancer and colorectal cancer screenings.
We send this personalized birthday card to men over 50, women 18-39, and women over 40. It includes reminders about age and gender-specific cancer screenings, immunizations, breast exams, blood pressure and cholesterol readings, and adult immunizations.
ODS exceeded HEDIS regional and national means in measures related to breast, cervical and colorectal cancer screenings.
Medication adherence
ODS wanted to increase the rates of members taking medications correctly for depression, cardiac health and asthma. We sent members information about the importance of taking their medication as directed. We also sent their providers copies of member materials, adherence information and a letter encouraging them to discuss medication adherence with their patients. The materials also include information about ODS care programs and other ways we offer support.
Our goal was to reduce the number of members who did not refill medication at least 80 percent of the time. In 2010, the data specifications changed. Therefore, we can’t compare our progress in 2010 to previous years. However, our data does show that adherence is better for members engaged in health coaching than those who are not.
Tobacco cessation program
Quit for Life is an ODS program that helps members quit using tobacco. This program is free to many ODS members* and offers the following:
- One-on-one phone-based support from a Quit Coach
- Toll-free phone access to Quit for Life coaches
- Recommendations for medications, such as bupropion or Chantix
- Free delivery of nicotine replacement products, such as the patch or gum
- A Quit Guide to help participants stay on track between calls
- Interactive web tools to keep members engaged with other participants
The Quit for Life program can help members quit tobacco for good. For more details, call 866-784-8454 or visit www.quitnow.net.
*Not all ODS members are eligible for Free & Clear benefits.
For members not eligible for Quit for Life, ODS promotes the Oregon Quit Line and National Quit Line. Each of these includes the following resources:
- Phone or web-based support from a quit coach
- Workbook with additional support
- Access to a web coach, online community and other resources
- Nicotine replacement therapy, such as patches or gum
- Information about local resources
ODS sends a monthly mailing to members identified as tobacco users. Members are referred to the tobacco cessation program by mailing, provider referral and health coach referral. The goal of this outreach is to increase enrollment in the tobacco cessation program and decrease the use of tobacco. In 2010, we sent 4,695 mailings to providers and members encouraging them to use or refer to tobacco cessation programs. This is a significant increase from 2,646 in 2009. ODS is unable to accurately measure the number of tobacco users in the member population and the number of those who have quit based on the current data available.
Oral health
ODS encourages good oral health in a number of ways. While oral health is important for everyone, it is especially important for pregnant women, children and diabetics. The goal is to increase dental cleaning by five percent annually.
We send educational material to pregnant members about the importance of oral hygiene during pregnancy. An Oregon Health Plan (OHP) version is available to OHP members in both English and Spanish.
ODS commercial members with dental coverage who are pregnant or have diabetes also receive extra support. They receive an additional dental cleaning as part of their dental benefit. We provide instructions on how to redeem the additional cleaning.
We also send reminders to members who have been diagnosed with diabetes and have not had a dental cleaning in the past year.
Parents or caregivers of children aged six months to 17 years with the OHP dental benefit receive an English or Spanish brochure about the importance of oral health for children. The brochure contains tips on good oral hygiene with a timeline for recommended dental care for infants.
ODS is in the process of determining a measurement for the oral health programs.
*HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
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