Updates from CareOregon |
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CareOregon expansion
Building relationships on the Oregon coastThe transition to managed care has begun for Oregon Health Plan members in Tillamook and Lincoln counties. In January, CareOregon became one of the managed care organizations to offer services to these residents of the north coast. As of early April, CareOregon had 43 new members in Tillamook County and 680 in Lincoln County, says Jim Carlough, CareOregon’s senior manager of provider services. The Oregon Department of Medical Assistance Programs (DMAP) is transitioning all OHP members in these two counties to managed care by location, and expects to conclude the transition in the most populous ZIP codes by the end of May. The reception of CareOregon among providers has been good, Jim says, and the outreach will continue. (See a list of new CareOregon network affiliates.) “We’re looking forward to continuing to build relationships with providers and clinics that serve our members in these counties,” Jim says. Especially beneficial to patients with the most need—those who have complex medical conditions—are the services that can be provided by CareOregon’s CareSupport Program, Jim says. The nurses, behavioral health specialists and others on the CareSupport teams work with members and their providers to assure a better chance of compliance with the treatment plans that can fend off acute episodes. Jim asks that providers with Medicaid members who live in Tillamook and Lincoln counties, including providers located in neighboring counties, and who have not yet talked to a CareOregon network relations associate should feel free to initiate the contact. (A list of network relations associates and their contact information is available here.) He also wants to remind coastal providers who are planning to join the CareOregon network to be sure to return their contracts to CareOregon so that there will be no gap in access when the majority of Oregon Health Plan members switch to MCOs, including CareOregon, this spring. |
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Pharmacy Up-to-date formularies are available onlineCareOregon Pharmacy Department encourages providers to stay up to date with the most recent CareOregon OHP (Medicaid) and CareOregon Advantage (Medicare) formularies on the CareOregon web site. The formularies are available as printable PDF files. It is advisable to check the “Pharmacy Formulary Updates” section at this web site frequently since changes occur throughout the year. Web-site updates are posted by the 15th of the month (the effective date is indicated in the lower left corner of the document). The most recent updates are: You will find other valuable resources in this section including:
If you would like to have a copy of our prior authorization criteria for medication, please contact the CareOregon Customer Service Department at 503-416-4100 or 1-800-224-4840, Monday through Friday, 8 a.m. to 5 p.m. TTY/TDD users should call 1-800-735-2900. |
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Alerts
Please verify your clinic’s e-mailsCareOregon is confirming clinics’ e-mail addresses to ensure that we can contact you with system alerts and other critical information. Please send the e-mail address or addresses that you want CareOregon to use when contacting your clinic to careoregonalerts@careoregon.org. Be sure to include a name and job tile for each e-mail. CareOregon’s electronic provider alert system is designed to get critical information to providers quickly. These alerts can include pharmacy updates, unexpected system issues, workplace closures and unavoidable remittance delays. The messages are segmented by billers, officer managers (and one backup) and one clinician contact per clinic. To opt out of receiving the critical alerts, update an e-mail address or change the contact names for your clinic, please e-mail providercommunication@careoregon.org. Type “opt out,” “new e-mail” or “new contact name” in the subject line. |
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This quarter in CareLink
Member newsletter: Focus on asthma plans and cervical cancer screeningCareOregon’s member newsletter, CareLink, for Spring 2010 features articles on the expansion of health care for Oregonians (see related story in this issue of CareNews), advice on how to get the best results from medication by consulting with pharmacists, free guides to Oregon State Parks activities and where to get assistance with tax preparation. It also includes advice on cervical cancer screening and asthma action plans and medications. “We want to be a resource for both members and their providers to have the best chance at preventing disease and controlling chronic conditions,” says Ann Blume, RN, BSN, CPHQ, CareOregon’s quality improvement manager. The online version of CareLink includes links members can use to access directly the cervical cancer screening information in the Member Handbook for Oregon Health Plan Standard and the Member Handbook for Oregon Health Plan Plus. For asthma management, resources are available from CareOregon and other organizations to help providers and their patients work together.  CareAsthma Member Profile“We send the CareAsthma Member Profile report to providers every quarter,” Ann says. The report alerts providers of patients who may be experiencing problems controlling their asthma, and gives general information about the patients’ asthma-related health care utilization. The department wants this report to be useful for providers. “We want provider feedback on the format of the report,” Ann says. “We’d like to know how providers are using it in their practice.” Providers who have suggestions or comments about the report can e-mail them directly to Ann. Other asthma care resources“I have found a great resource from the Children’s Health Fund,” says Denise Johnson, CareOregon health education coordinator. The guide is valuable for families as well as providers. It’s downloadable in both English and Spanish. The state of Oregon also has an online resource bank for asthma education. The resource bank includes guides for developing an asthma action plan. According to National Asthma Education and Prevention Program (NAEPP) Guidelines, people with persistent asthma should have an action plan that summarizes their doctor’s instructions to help them manage their asthma. Doctors fill in directions for medication, peak flow numbers, asthma triggers and what to do in case of an asthma attack or an emergency. Copies of the plan should be kept at home, the doctor’s office and school or work. The Asthma Action Plan can be reached from the online resource bank. Downloadable PDFs are also available directly here: Color
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Smart Choices, Healthy Lives
Medford-area schools step up for healthy living
Medford—Four elementary schools in the Medford area took a big step toward fitness in March. Rather, the schools’ students took hundreds of thousands of steps toward fitness. As part of CareOregon’s participation with television station KOBI-TV’s Smart Choices, Healthy Lives campaign, CareOregon Health Education Coordinator Denise Johnson and Communications Manager Jeanie Lunsford traveled with members of the KOBI team to meet with fifth and sixth graders at four schools. Smart Choices, Healthy Lives is a three-year initiative designed to help increase activity and improve nutrition throughout Southern Oregon. Denise showed students how to get a lot of exercise in a short time, using a program called 10 Minute Recess. The students all received pedometers and step diaries and tracked their steps through the month of March. KOBI and CareOregon returned at the end of the month to announce the results. Ten thousand, even 15,000 steps a day and more were typical for the students. Videos of the KOBI reports are posted on the station’s web site. You can reach them here:
Other comments on Smart Choices, Healthy Lives and the elementary school step program: |
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Prenatal health
Text messages harnessed to promote healthy babiesCareOregon is one of many outreach partners in the largest national mobile health initiative to date: text4baby. Multnomah County Health Department is also a participating partner in this free mobile information service launched on February 4, 2010. Text4baby provides health education messages to the cell phones of expecting mothers and mothers of children under the age of one. There is no cost for the text. The messages are HIPAA compliant and have no commercial advertisements. The messages are written at a fourth-grade reading level and focus on a variety of topics. The weekly message may include information about immunization, nutrition, influenza, prenatal care, emotional wellbeing, drugs and alcohol avoidance, labor and delivery, tobacco cessation, breastfeeding, mental health, prevention of birth defects, oral health, car-seat safety, exercise and fitness, developmental milestones, safe sleep, family violence and more. The messages are one-way, so mothers can’t text back. But the messages will include phone numbers to call for additional information. Text4baby messages were developed by the National Healthy Mothers, Healthy Babies Coalition in collaboration with many leading agencies in the field of maternal and child health, most notably the Centers for Disease Control and Prevention and the National Institute of Child Health and Human Development. Content reviewers included OB/Gyns, nurse-midwives, pediatricians, nutritionists and lactation consultants. Thanks to the support of CTIA–The Wireless Foundation and participating wireless service providers the service is free even to cell phone users who do not have text messaging plans. The messages from text4baby also will not be counted toward text message plans with monthly limits on the number of texts. Most cell phone providers are providing the service, including these: Alltel, Assurance Wireless, AT&T, Bluegrass Cellular, Boost Mobile, Cellular South, Cellcom, Centennial Cellular, Cincinnati Bell, Cricket, Metro PCS, N-Telos, Sprint, Nextel, T-Mobile, U.S. Cellular, Verizon Wireless and Virgin Mobile USA. To sign up, expectant and new mothers can go to www.text4baby.org/index.html or just text Baby (for English) or Bebe (for Spanish) to 511411.
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