Over five years ago, California implemented the Medi-Cal Managed Care Program. Medi-Cal beneficiaries, who traditionally were served by a Fee-For- Service system, were transitioned into managed care plans. The program’s goal was to improve the health status of Medi-Cal beneficiaries by providing a medical home and continuity of care. Through this framework, the orientation of health care shifted from episodic treatment of illness to a preventive primary care and early treatment intervention. Health Net, an IPA model HMO, under contract with the California Department of Health Services’ Medi-Cal Managed Care Division, has implemented this system of care in seven counties.
Preventive health receives the most attention during the prenatal and early childhood periods. As the population continues to age, adult preventive health is gaining importance. Adolescence is overlooked when it comes to preventive health. Like other adolescent behaviors, poor health behaviors are seen as a passing phase and are often ignored. The impact these behaviors can have on one’s future health is underestimated.
Based on its 1999 Health Evaluation Data Information Set (HEDIS) report, Health Net found that adolescent well care visits were an area of concern that needed addressing. A multi-faceted intervention plan was developed that incorporated the active collaboration and coordination of both internal and external stakeholders. This session will offer insights and applicable experience concerning the development of strategies to address adolescent preventive services. The lessons learned will illustrate the importance of the health plan’s innovative collaboration with community agencies that serve adolescents.
Learning Objectives: 1. Understand the challenges of providing adolescent preventive services especially within the Medi-Cal Managed Care setting. 2. Identify three of the leading health problems that disproportionately affect adolescents. Identify three leading health problems affecting adolescents. 3. Articulate the collaborative strategy Health Net used to outreach and serve the adolescent population within its Medi-Cal Managed Care Program
Keywords: Adolescent Health, Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.