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SoonerCare Health Management Program.

jessievenegas Jessie Venegas — 11/01/2009

Other Organization

The SoonerCare Health Management Program (HMP) is an innovative and comprehensive disease management program designed to benefit members with chronic conditions as well as the provider. HMP members will be selected for the program using predictive modeling software. The software identifies SoonerCare Choice members who are at high risk for adverse outcomes and increased health care expenditures. Most of this risk will be driven by co-morbid conditions that increase the likelihood of a health care crisis. The predictive modeling software Identifies high-cost beneficiaries for its Health Management Program. The state first excludes dual-eligible, institutionalized, and home- and community-based waiver beneficiaries and then uses the software to identify the top 5,000 beneficiaries with chronic conditions with the highest predicted future costs.


Fragility, pluripathology/polipathology and/or complex chronic diseases

Goals Prevention:
Promotes adecuate understanding levels on the community about the importance of prevention
Goals Detection:
Promotes early intervention through primary health care measures , Provides registries and patients contact systems , Shows new evidence on the importance of early detection, including guidelines of effective practices
Goals Treatment:
Develop basic elements for an integrated health system , Provides support health policies to facilitate the planning and integration at locally and regionally , Strengthens cooperative local groups to provide integral services , Improving access to health services across the entire spectrum, from prevention to treatment , Ensures the best quality of health services , Emphasizes the care of pluri-pathological and fragile patients , Promotes electronic health information systems to improve the quality of care

None


1/01/2007

Progress

UNITED STATES OF AMERICA

Oklahoma

Oklahoma

Oklahoma

Oklahoma City, OK 73105
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