CMO Corner: Lawrence Magras, MD, MBA, FHM, FAAPL

Care Management – Patient Activation Measure (PAM)

The HUSKY Health Care Management program has incorporated the Patient Activation Measure (PAM); an evidence-based survey to measure a member’s activation by assessing knowledge, skill, and confidence in managing one’s health... read more

The PAM is comprised of 10 scored declarative statements where an individual indicates how much they agree or disagree with each statement. The outcome of a completed PAM survey score aligns with one of four levels of patient activation with PAM Level 1 being the lowest level of activation and PAM Level 4 being the highest level of activation. Care Management staff utilize the member’s PAM level to tailor a person-centered team care plan focusing on assisting the member in becoming more activated in their health and healthcare. Numerous studies have demonstrated that increasing activation is key to ensuring positive health outcomes and improved patient self-management.1 Interventions within the team care plan will be unique to the member’s needs and may include: coaching to support further understanding of their health condition; developing an informed therapeutic relationship with their provider(s); action planning; care coordination to address gaps in access to needed care; approaches to engaging in proactive care versus reactive care; sustaining needed lifestyle changes; and consistent medication taking. The member’s PAM level and team care plan are shared with their providers, with the member’s consent.

1 Heath, S. (2020). Patient Engagement Strategies for Improving Patient Activation. Retrieved from Patient Engagement HIT: https://patientengagementhit.com/features/patient-engagement-strategies-for-improving-patient-activation

Technology

Eligibility Information

The Automated Eligibility Verification System (AEVS) provides a comprehensive source of Connecticut Department of Social Services (DSS) client eligibility information to all CMAP-enrolled providers to verify member eligibility, such as third-party insurance, Medicare coverage, waiver program eligibility, and Medicare-covered services information. . . read more

The System also provides self-service features for CMAP-enrolled providers such as client eligibility verification and downloading of pertinent forms.

To access the AEVS, please visit the DSS CMAP website. Under the provider menu, log in to the CMAP secure site. Providers can also call the CMAP Automated Voice Response System (AVRS) at 1.800.842.8440 and select the self-service menu option. The AVRS is available 24 hours a day, 7 days a week (except for maintenance) and allows CMAP-enrolled providers to verify member eligibility.

Benefits

HUSKY Health Program Benefit Grids

Benefit grids are available on the HUSKY Health website, and they provide information on HUSKY Health program benefits and authorization requirements that can be accessed at any time. . . read more

For your convenience, detailed benefit grids have been developed by provider type and medical program for the following:

Acupuncture Laboratory
Ambulatory Surgery Clinic Limited Eligibility Benefits
BHP Medical Clinics
Chiropractor Naturopath
Chronic Disease Hospital and Long-Term Care Outpatient Hospital
DHP Physician
Dialysis Clinic Podiatry
DME Radiology
Family Planning Rehabilitation Clinic
Home Health Therapy
Hospice Transportation
Inpatient Hospital Vision

To access HUSKY Health Program Benefit Grids, go to portal.ct.gov/husky and click on “Information for Providers,” followed by “Medical Management,” and “Benefit Grids.”

COVID-19 Public Health Emergency Updates

Update Us So We Can Update You

DSS has prepared tools to help HUSKY Health members stay informed about important information and steps they need to take to maintain their coverage when the COVID-19 Public Health Emergency (PHE) ends. . . read more

To avoid claims payment interruptions and an adverse impact to your revenue stream, please encourage the HUSKY Health members you serve to update their contact information so they can receive important communications about their benefits.

HUSKY Health members can visit https://portal.ct.gov/UpdateUsDSS to update their contact information. To access additional tools to share with HUSKY Health members, go to https://portal.ct.gov/phe?language=en_US and click on “Tools For Benefit Partners.”

Health Equity

Improving health and healthcare requires a focus on equity – equity of access, treatments, and outcomes. Healthcare providers are in a unique position to work with our HUSKY Health members to increase opportunities for them to be healthier – especially those who have the greatest obstacles.

HUSKY Health is committed to increasing access and improving the quality of care for underserved populations across Connecticut. Community Health Network of Connecticut, Inc.® (CHNCT) offers resources on many useful topics. Go to portal.ct.gov/husky, click “Information for Providers,” followed by “Reports & Resources,” and “Health Equity” to see what is available.