Eight Michigan health plans from across the state submitted 24 ground-breaking programs to the Michigan Association of Health Plans Foundation Pinnacle Awards, leading the health care industry with innovative programs to improve patient health care, lower costs and increase services to Michigan citizens.
The winners were presented at a reception on Tuesday, September 28th, 2021 at the Radisson Hotel in Lansing. Health Alliance Plan captured two awards and Priority Health, MeridianHealth, McLaren Health Plan, UnitedHealthCare and Upper Peninsula Health Plan all received one as well and Molina received an honorable mention.
MAHP shares the winning programs among members, helping them adopt best practices throughout the state’s health plans. This year’s winners address issues from COVID-19 mitigation efforts to food insecurity to addressing social determinants of health that trigger asthma.
“I’m pleased to see the innovation and continual improvement processes used by MAHP members to address key issues aimed at improving the health of their members and their communities,” said Dominick Pallone, executive director of MAHP. “It’s truly an honor to recognize these achievements and watch many be adopted around the state and nation.”
Health plans submit new programs to a judging panel comprised of health care experts and lawmakers. The panel reviewed submissions in depth before selecting winners in various categories for commercial health insurers and Medicaid health plans. Full details on each winner are available at www.mahp.org.
Following are brief descriptions of winning programs:
“Health Alliance Plan COVID-19 Vaccination Project”
After the start of the pandemic in 2020, Health Alliance Plan (HAP) made it their mission to educate their members about COVID-19 while also simultaneously preparing for COVID-19 mitigation efforts. HAP is on track to reach their goal of 70% of members receiving the COVID-19 vaccine by October 1st, 2021, and more than 78,000 doses of the vaccine have been administered at HAP Troy, serving nearby communities and the Henry Ford Health System.
2021 Chronic Disease Management: Government Programs: Medicare
“HAP Improves Osteoporosis Management in Women”
HAP’s Osteoporosis Management in Women (OMW) program measures the number of women ages 67-85 who have had a fracture and received appropriate treatment within six months of their initial injury. Their program started in 2016 and have since enhanced it so more women can get important treatment. 70% of HAP’s eligible members are expected to receive treatment in 2021, which is a 52% increase from 2017. HAP is also expected to receive a five-star CMS quality rating in 2022.
2021 Community Outreach: Single Plan
McLaren FIRST is a comprehensive program that addresses food insecurity across the state. The program provides families with transportation to local food pantries, delivery of a two-week food supply directly to their doorstep and identification of social determinants of health that are the root cause of their food insecurity challenges. By addressing hunger across their communities, McLaren is playing a role in improving the overall health of their members.
2021 Clinical Service Improvement: Government Programs
“Connecting with Pregnant Moms through CHWs”
Meridian’s maternity program targets low and moderate risk members for case management during their pregnancy and postpartum period. 1,429 members were successfully enrolled with Community Health Workers (CHWs) for ongoing case management, and the enrolled members were then contacted 2,685 times by their assigned CHW for ongoing support. The Meridian CHWs educated members on the importance of prenatal and postpartum care, and had an emphasis on educating members on support available across their communities, like the Maternal Infant Health Program.
2021 Chronic Disease Management: Government Programs: Medicaid
“Asthma Environmental Housing Project”
Priority Health partnered with community organizations to provide in-home visits dedicated to health education and social determinants of health that are known to trigger asthma. Priority’s Medicaid Asthma Environmental Housing Program reduced emergency department visits by 61.4 percent and decreased annual medical spending by $675,274. Households received tailored asthma education, an asthma management plan, community health worker support, and housing repairs where possible.
2021 Business Operational Performance: Government Programs
“Proactive Provider Outreach”
UnitedHealthCare’s Proactive Provider Outreach is an initiative that targets specific claims in new day/original submission and evaluates internal systems. The main goals of the initiative include speeding up cashflow for providers, mitigating inappropriate denials, improving provider relationships and reducing rework and denial rates for providers. By evaluating their internal processes, UnitedHealthcare can identify any gaps in provider billing behaviors and send instant resolution and education.
2021 Community Outreach: Collaborative
“Marquette County Community Resource Fair and Forum”
UPHP led a two-part event in 2019, which included a forum for community-based organizations (CBOs) and health care providers to connect and learn about each other’s offerings, followed by a large-scale community resource fair that provided a practical opportunity to connect individuals with resources to meet their daily needs. The event was heavily attended and well-received by all.
2021 Integration: Medicaid
“Molina-Hegira Behavioral Health Collaboration”
Molina Healthcare and Hegira collaborated to create an emergency department (ED) diversion program for Medicare members presenting with acute behavioral health conditions at hospitals across Wayne County. The Community Outreach for Psychiatric Emergencies program (COPE) is a 24-hour service with a purpose of keeping members safe through crisis intervention and support as an alternative to hospitalization. Since its creation, 29 percent of members were successfully diverted from emergency departments.