¶ … responsibilities as it relates to implementation of the MIPCD project. All four study arms should be described. Disease Area

Implementation Steps

Barriers and Solutions

Diabetes Management

Diabetes is linked to cardiovascular mortality, neuropathy, stroke, amputation, periodontal disease, kidney failure, and blindness.

Attending a session with an endocrinologist or primary care appointment or filling medications for diabetes is required.

The number of deaths from chronic illnesses in the State of New York is slightly more than the U.S. average, principally on account of a greater number of deaths from heart disease. The characteristics of chronic illness include complex causality, long latency, various risk factors, functional disability/impairment, prolonged illness, and improbability of cure, in some instances.

They deeply impact the affected person's physical, mental and emotional well-being, and are linked to substantial economic costs.

Timely chronic illness detection and cure, in addition to a focus on self-management on the part of the patient and disease management on the part of healthcare providers, for preventing debilitation and expensive disease complications.

Process measures have significance in the diabetes management context. Primary care appointments and self-management training of diabetics together make up a comprehensive evidence-based intervention that effectively leads to better control of blood glucose levels. For aiding diabetics in overcoming a key financial obstacle of participating and remaining enrolled in this program, Medicaid beneficiaries in New York State can avail themselves for the above services at minimal or no cost (i.e., as a co-pay). Benefits of Medicaid encompass primary care appointments and training in self-management for diabetics. These services may be utilized by chronic diabetics for promoting maintenance.

The division of diabetes management will comprise covered benefits of Medicaid, including diabetes medication and primary care appointments. Only adult recipients of Medicaid (i.e., those aged from 18 to 64 years) are entitled to inclusion under the division of diabetes management.

Hypertension Management

Filling antihypertensive prescriptions or attending appointments for primary care management of blood-pressure.

High levels of blood pressure constitute a key cardiovascular disease risk factor. It is the principal cause for deaths of both women and men hailing from all races, within treatment regimens.

Numerous process measures play a significant role in facilitating better control of blood pressure levels in patients. Primary care appointments, non-pharmacological treatment recommendation (reduced dietary sodium consumption, weight loss, potassium supplementation,...

It is JNC-7-recommended using superior clinical evidence (JNC 7 implies Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure).
The best treatment for hypertension (from an economic and health perspective) is by means of medications to reduce blood pressure levels, and support for behavior modification. 79% of hypertension patients in New York State self-report consuming blood pressure medicine. With proper adherence to treatment regimen, nearly 92% of these individuals can successfully control blood pressure levels. But just 60% of Medicaid enrollees in the state have been successful in controlling their blood pressure, partly because of non-adherence to prescribed treatment schedules.

A 10-mm-mercury reduction in systolic pressure, or its maintenance.

The plan will identify those suffering from hypertension. It will work with healthcare providers, interns, practice directors, etc., for enrolling Medicaid recipients who are eligible and monitoring patient attendance at appointments with primary care practitioners, blood pressure level readings, and prescription fills. Every individual plan will provide electronic files to the Department on a monthly basis via Health Commerce System secure transfer of files, describing participant activity. Hypertension solutions have four incentive plans.

-Participants (process) may receive 50 dollars for filling Antihypertensive prescriptions or being present at primary care hypertension-related appointments.

-Participants (outcomes) acquire 50 dollars every time a blood pressure check in any primary care setting gives a result of 10mm-Hg less than their previous measurement or a reading that lies below the target specified by JNC-8.

- Participants (outcomes and process) receive 25 dollars for filling antihypertensive prescriptions or being present at primary care hypertension-related appointments and 25 dollars every time a blood pressure check is done in any primary care setting, giving a result of 10mm-Hg less than their previous measurement or a reading that lies below the target specified by JNC-8.

Smoking cessation

Process measures include counseling for smoking cessation and therapy for tobacco-dependence (such as Zyban, Chantix, nicotine replacement treatment, etc.), both of which represent comprehensive evidence-based interventions leading to decreased number of tobacco users. They are strongly recommended, with powerful evidence by America's Preventive Services Task Force. Process participants receive 50 dollars for taking part or being present in counseling sessions for smoking cessation (at…