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Busy Families: Have a Plan

Author : CareSource

Sep 11th, 2012 | by CareSource

By Jennifer Dozer - busy wife, mother and RN

The start of the school year often means the start of school-year stress for busy families. To families already overwhelmed with the usual chaos that comes from one or both parents working, adding homework, sports practices, and other activities into the mix can cause unwanted stress.

The American Academy of Pediatrics recommends that families establish a daily routine. Having a routine helps children feel safe, teaches self-discipline, and helps parents avoid the stress of rushed mornings and forgotten homework.

The internet is a treasure-trove of ideas for the organizationally-challenged. Popular blogs and social networking sites such as Pinterest are full of tips both for establishing personal routines that suit your family, and plotting out ways to organize your home.

Not sure where to get started? Here are a few tips:

  1. Establish a Command Center. A command center is a single place in your home- in your kitchen, office, or entryway- that meets your daily organizational needs. What should you keep in your command center? Homework folders, bills that need mailing, keys, phones, chore charts, calendars, and menu plans are typical command center must-haves. Papers that otherwise would get piled on tables should have a home here. There should be only one answer to the questions “Where is it?”, “When is it?”, “What am I supposed to do?”, and “What’s for dinner?” Go to the Command Center. 
  2. Make a Meal Plan. Having a plan ahead of time can help you avoid last-minute fast food runs and wasted time scrambling to figure out dinner. It can also help you save money!  If you find you don’t have much time for cooking on weeknights, consider spending a few hours on the weekend creating freezer meals, or becoming adept at using a slow cooker.   
  3. Keep a Family Calendar. Google makes it easy to keep a paper-free shared calendar online, and will automatically send a reminder email to your Gmail account. Setting up an account is free. If you have a smartphone, you can download the Gmail app, and get reminders directly to your phone! If you prefer to keep a calendar in your command center, you can often download and print free calendar pages for a family binder, or use a simple chalkboard or dry erase board. 
  4. Be Prepared. If you need something the next day, be sure to prepare it the night before. Make sure homework is done, papers have been signed, and lunches and book bags are packed. Need some healthy school lunch ideas? Try here
  5. Build Your Family Routine. Sit down and spend a few minutes thinking about what your family needs to accomplish before and after school, then devise a routine to help make it happen. Help your children gain some independence by delegating age appropriate tasks to them. You can post your family’s routines and chore charts in your command center or keep track of completed tasks in a family binder.

 

Follow CareSource on Pinterest to check out our boards. We’ve pinned plenty of tips to help get you started on a smooth transition to the school year. 

Helpful Pins 

Command Centers: 

 

Meal Planning: 

 

Family Calendar/Binder: 

 

Chore Charts: 

 

Family Routines:

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How May We Help You?

Author : CareSource

Oct 25th, 2011 | by CareSource

We celebrated National Customer Service Week October 16-22. It’s a week devoted to recognize the importance of customer service and to honor our employees who serve and support our members with the highest degree of care and professionalism. Two members of our senior management team had the opportunity to sit with our service reps and get a glimpse in to their world. Here is what they found.

True Service
By Jenny Michael, Director, Public Relations and Corporate Communications

A few weeks ago I received a request from one of my peers that piqued my interest. The director of service operations was asking her peers to take 30 minutes to sit with a customer service team member in honor of Customer Service Week. I welcomed the opportunity to get closer to the day-to-day mission of CareSource and especially to hear firsthand from our members. She thought that I was doing her a favor by accepting her request, but in reality I was the one who really benefited.

Member Compliment MagnetsI was paired with Jennifer, a customer service representative. Jennifer has been with CareSource for a little over a year, but already had  magnets on her cubicle full of member compliments. Jennifer graciously welcomed me as I pulled up a chair in her cubicle and put on my headset so I could listen in on her calls.

During the course of an hour I was able to listen to several calls and watch the science behind the art of customer service. Jennifer skillfully navigated between screens entering data, confirming mailing information and providing answers to the members’ questions.

One call in particular stuck with me. It was from a new mom who was calling to make sure her child was covered by CareSource. She had a flurry of activity going on in her home. Jennifer and I could hear the mom rustling papers, quieting her children and caring for her new baby’s needs while she confirmed her mailing address and received a list of doctors in her area.

JenniferThe caller kept using the word “awesome” to describe everything Jennifer did for her. It was obvious that the mother was truly grateful for the help that Jennifer was providing. She thanked Jennifer for every answer she gave. It quickly reminded me the true meaning of service and the important role our customer service team plays in serving the underserved. I would guess that this member wasn’t accustomed to receiving this level of attention and help.

Our customer service team is the voice of CareSource to our members. When members need help, they know there is someone just a phone call away ready to help them navigate the health system. That’s true service.


Our Front Door
By Jackie Smith, Vice President, CareSource University

Recently, I had the privilege of spending time with Brenda, a customer service representative.  I was amazed at the depth of knowledge our reps have and their ability to guide our members through challenging situations.  One of the calls Brenda took was very detailed and lengthy.  

Over the 45 minute call (yes, 45 minutes!), Brenda conveyed professionalism and a level of service that wowed not only the member but me as well.  Although the member had a number of needs that were, at times, rather difficult to discern, Brenda guided her through the conversation with excellent questions, provided helpful information and created an experience the member called, “very caring and helpful.”  She not only addressed the issues the member originally called about, but also identified other needs during the call – going above and beyond.

Our customer service reps are the “front door” to CareSource for many of our members.  They complete the most extensive position training in the company and need to know everything about our organization to provide the best customer experience.  The image they convey and caring service they provide is extraordinary. 

Congratulations to the entire service center team for living our mission every day – to make a difference in the lives of underserved people by improving their health care.

www.caresource.com

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Health Care Collaboration Produces Real Results for Children with Asthma

Author : OurHealthCareSource.com

OurHealthCareSource.com serves as an information source for those who are interested in helping shape a new system of health care delivery.

Nov 23rd, 2010 | by OurHealthCareSource.com

A health care home – or medical home – model works best when all parties that touch the health care system are involved. That means having a collaborative effort among providers, patients and insurance. The overriding goal of a health care home model is to keep patients healthier while reducing the cost of care. This is a model that we support, certainly. But more importantly, it’s a model we are putting to practice in a number of ways.

Our recent alignment with the Ohio chapter of the American Academy of Pediatrics (AAP) is an ideal example of how collaboration can lead to better outcomes and improved quality. The CareSource Foundation recently awarded a signature grant of $75,000 to the Ohio chapter of the AAP supporting an asthma quality improvement initiative. As a result of the CareSource grant, CareSource will widen its focus on asthma quality improvement opportunities for physician practices throughout Ohio.

Currently, CareSource works with 13 practices in Ohio in a Medical Home pilot where physicians and CareSource as working together to identify patients whose asthma may not be well controlled. These practices include community health centers, hospital-based systems and private practices. Together, we have formed a medical collaborative to address issues of asthmatic children from birth through 18 years old among other conditions addressed.
Goals of the grant are to decrease hospitalizations, identify treatment options and form strategic asthma control plans to improve health outcomes for all children.

Collaboration Equals Results
Through our association with the Ohio Chapter of AAP, and the medical home pediatric offices, we are striving to educate and change behaviors in asthmatic patients. This is done through a combination of hands-on coordination and helping the patient and his/her family be more aware of the condition, and how to deal with it. A CareSource case manager is assigned to each practice, and is responsible for helping the patient carry out the instructions/recommendations that the doctors communicate.

Specifically, our pilot medical home teams are doing the following:

  • Surveying patients and their families about asthma triggers
    Doctors start by documenting with the patient and his/her parent or guardian the triggers that cause an asthma episode. By understanding what causes the episode, the hope is that the patient and family seek ways to avoid those incidences. Also, by knowing what the triggers are, families can make changes to their living environments to remove anything that causes an asthma episode. Episodic documentation is also part of the ongoing relationship between doctor and patient as unforeseen triggers can often arise.
  • Consistent Care
    Children with asthma do better by seeking regular care for their condition. So as a service to our members, we work hard with providers and patients to make sure patients are being seen regularly. We encourage doctors to keep a breathing peak-flow record of the patient so changes in the condition can be recognized and addressed. We also encourage doctors to assess and review changes in lung function on a regular basis to more effectively care for the child.
  • Create an Action Plan
    Working with the doctor and patient, we collaborate on an asthma action plan that strives to keep the patient healthy and avoid unnecessary doctor or emergency room visits. The action plan includes consistent doctor visits, prescription instructions, lifestyle/behavioral actions, ongoing monitoring, etc.

And We’re Seeing Results
Ohio currently ranks seventh in pediatric asthma incidences with nearly 10 percent of children suffering from asthma. For children living in poverty and of certain races, that number nearly doubles. So it’s easy to see why it’s important that we as a health care community strive to address asthma within the Medicaid population. Although our pilot program is in its infancy, we are already seeing positive results.

Of the children that see pediatricians in the pilot area practices, there has been a 30% drop in emergency room visits (when comparing 2008 to 2009). The overall awareness of asthma within the communities where the pilot program is taking place has also been raised. And lastly, since we are championing this alongside the Ohio Chapter of the American Academy of Pediatrics, we are removing many of the barriers of access to care.
As time goes on, we expect these results to be even stronger. We also anticipate adding provider practices to the pilot program as our results continue to deliver positively.

Some Fast Facts About Children with Asthma

  • Ohio ranks seventh in pediatric asthma incidences with nearly 10 percent of children suffering from asthma
  • Pediatric asthma accounts for 14.7 million days of school missed by children nationally each year and workdays missed by parents who stay home to take care of their children
  • Acute asthma encounters can cost $400 per emergency department visit and $5,000 for inpatient care
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More Is Not Better – The Story of Fragmentation of Care

Author : Craig Thiele, M.D.

Chief Medical Officer, CareSource Over 16 years of clinical leadership experience with a strong background in case and disease management. Oversees clinical and quality initiatives at CareSource and manages medical policy, clinical care guidelines, utilization parameters, and quality assurance for its health plans.

Nov 4th, 2009 | by Craig Thiele, M.D.

It’s the Fragmentation, People

I heard a story that didn’t surprise me, but may surprise you, especially if you haven’t heard much about fragmentation of care. It was called “The Telltale Wombs of Lewiston, Maine,” on National Public Radio. At the start, the story seemed to be pointing a finger at doctors for providing services (especially surgeries) that their patients don’t really need, sometimes with negative results. This point of view has been around awhile, and frankly, does not do justice to a complex situation.
In the end, here’s what I heard that concerned me:

“(Dr.) Elliott Fisher…compared Medicare recipients with similar levels of sickness in areas throughout the whole United States. Fisher looked at places where elderly people used relatively few health care services and compared them with places where elderly people used a lot of health care services.

‘The patients in the high-spending regions were getting about 60 percent more care; 60 percent more days in the hospital; twice as many specialist visits,’ Fisher says. ‘And yet when we followed patients for up to five years, if you lived in one of these higher-intensity communities, your survival [rate] was certainly no better, and in many cases a little bit worse.

This is probably because of something called fragmentation of care. In high-use areas, it’s often the case that many different doctors play a role in the care of a patient; many specialists are responsible for overseeing only a small part of the person. This increases the amount of treatments, tests and hospitalizations that people get, and exposes people to more risk of harm from medical error and side effects.”

For most Americans, fragmentation of care is a difficult idea to accept: It’s hard to understand that more care isn’t necessarily better for you.

But study after study has borne out the truth of this completely anti-intuitive conclusion. In fact, Fisher and other researchers estimate that almost one-third of the care given in our country today is that kind of care — care that may not help.

In some studies, it is estimated that the United States spends more than $2 trillion on health care every year. If 10 percent of this care provided is unnecessary, this would cost $200 billion. Some estimate it may be as high as 30 percent, or roughly $600 billion.

What lesson should we take from this about health care reform overall? It seems to me that whatever the final form it takes, reform must confront and solve these issues, including fragmentation of care. Whether we go with “exchanges,” “co-ops,” a “public option,” Medicaid expansion, or a combination of all of them, attention must be paid to avoid fragmentation by coordinating care.

It seems too obvious to point out that non-profit insurers like CareSource have been improving outcomes and controlling costs through care coordination for years now. We certainly hope that Congress, in its wisdom, will put that experience to work.

Ask your health care reform questions here

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Pay for the Health Care We Want? What a Concept!

Author : Craig Thiele, M.D.

Chief Medical Officer, CareSource Over 16 years of clinical leadership experience with a strong background in case and disease management. Oversees clinical and quality initiatives at CareSource and manages medical policy, clinical care guidelines, utilization parameters, and quality assurance for its health plans.

Aug 18th, 2009 | by Craig Thiele, M.D.

“The Status Quo is Not an Option.”–Barack Obama

Most people agree with the President that the health care system has to change.  If we want people to be healthier and use health care efficiently, it’s just upside down to pay doctors primarily for treating people when they’re sick.  We need to turn this irrational arrangement on its head…but in a way that keeps doctors whole while they keep patients well.  We know what we want. All we have to do is get serious and pay for it.

CareSource Has a Solution that Works for Members and Providers
It’s not as if either our members or the physicians we work with are any happier with the status quo than the President is. But so far, no solution has worked well for everyone concerned—no one has found a way to balance access, quality, and cost.

In our role as care coordinators as well as payers, however, we at CareSource have realized we are ideally positioned to perform reconstructive surgery on the broken system, making effective doctor patient relationships financially possible, changing focus from treatment to outcome, and providing resources that help each medical practice become a true ‘health care home’ for its patients.  That’s why we’re piloting a bold new approach; it’s a big up-front investment, but it’s good for doctors and patients alike.  Ultimately, that’s good for us, too.

Here’s our 4-part plan:

One: help the patient trust that their doctor is truly there for them, and even more, empower them to take a responsible role in their own health.
When CareSource members meet their Primary Care Physician for the first time, they’ll get a simple written agreement—a “contract,” that they and the doctor both sign. The doctor will provide realistic, responsive access to quality care. The patient will follow instructions, check back with the doctor with questions and call that doctor first when an urgent situation arises. In addition to building the relationship, this approach has been shown to reduce no-shows by 50%.

Two: help the practice change its approach to primary care
It takes extra staff and hours to fit patients in as needed, to follow up on instructions and medications, to provide wellness education, to focus on outcomes rather than treatments. It takes extra time just to talk to patients as much as they need. Providers participating in this CareSource program have agreed to do all that and more for our members, because we are paying them extra fees for two years to cover the costs of a complex transition.

Three: change our own approach to care management!
Strange but true: we are actually changing our own practices to make things easier for providers and members alike. One of the most significant innovations is to assign case managers to the provider practice, rather than the individual patients So our providers will have a dedicated resource to help them connect the dots on the members’ care, reaching out to social services, carefully reviewing the records for difficult and chronic cases and to alert providers to any anomalies, redundancies or challenges that apply.  Our new Member Profiles will play a role here, too.

Four: transition to payment for outcomes
We’re giving our docs time to adjust and staff for this new way of doing things while they are still paid the old-fashioned way. But after that, they’ll be paid for outcomes. When well-child visits go up, or E.R. visits go down, when blood pressure, blood sugar or cholesterol are under control, doctors will earn more. So the incentives are for better care instead of just more.

Sounds Excellent:  But There’s a Problem
The CareSource restructuring of provider service and payments activates the best and highest use of each participant: physicians are empowered to provide the best possible care for their patients…and care management keeps the wheels turning and the process organized.  What could be better than that?

From the physicians’ point of view, actually, it could be lots better.  We are hardly the only plan they work with, but we are one of the few that pay for outcomes and support a transition—complicating the business of running a practice   We’ve done what we can to help the whole system change, by structuring it around national HEDIS standards, so other companies potentially could participate.

We’re making as good a start as possible on our own turf.  How to help the system change in similar directions is the great question of the current debate.

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