MED. Medicaid Evidence-based Decisions Project. At the Center for Evidence-based Policy 2017
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1 Medicaid Evidence-based Decisions Project At the Center for Evidence-based Policy 2017
2 states Alabama Alaska Arkansas Colorado ABOUT MED The Medicaid Evidence-based Decisions Project The Medicaid Evidence-based Decisions Project (MED) is a collaboration of 18 state agencies, housed at the Center for Evidencebased Policy at Oregon Health & Science University. MED produces reports, and other tools, to help state policymakers make the best, evidence-based decisions for improving health outcomes. The reports provide valuable evidence about effective treatments as well as information about harmful or unnecessary services. MED participants have access to policy and evidence resources that support sound decision-making with unbiased analyses of complex issues. Louisiana Michigan Minnesota Missouri New York North Carolina Ohio Oregon Rhode Island Tennessee Texas Washington West Virginia Wisconsin RESULTS The return on investment is high The MED project is designed to meet the needs of policymakers by providing participants with information that is timely, accurate, unbiased, and actionable. MED participants have used the collaboration s research to improve their programs in a variety of ways, including: ALABAMA Alabama utilized a MED analysis of DME expenses that led to policy changes related to home IV services resulting in cost avoidance of $1 million annually. MINNESOTA Minnesota has created a process to control the growth of high tech imaging (HTI) use stabilizing at 41 procedures per 1,000 enrollees, well below the trend rate previously experienced (47/1,000). MISSOURI Missouri now requires prior authorization of CT and MRI imaging of the chest, lower back, head, and neck, resulting in savings of over $9.3 million during a two-year period. WASHINGTON Washington no longer covers arthroscopic debridement and lavage of the knee for osteoarthritis, resulting in an estimated savings of $400,000 within the first year of the policy.
3 BENEFITS Participation in MED includes many benefits EVIDENCE & POLICY REPORTS The MED project produces evidence-based answers to welldefined questions, providing MED participants with access to proprietary reports on a variety of policy and evidence issues. These reports utilize robust research strategies to appropriately cover clinical, policy, and financial issues. COLLABORATION & DISSEMINATION OF BEST PRACTICES The MED Project is bolstered by the collective knowledge and expertise of its participants. In addition to bimonthly conference calls, participants meet in-person biannually. These unique forums allow MED participants and other key staff to share ideas, and collaboratively address common issues. In addition to its regular meetings, workgroups addressing current challenges on priority issues for states convene regularly. The workgroups review evidence and policies as well as share current state practices. There are currently seven workgroups meeting to address: Durable Medical Equipment Genetic Testing Managed Care Non-Emergency Medical Transportation Opioids Oral Health MED/DERP RAPID RESPONSE TO STATE- SPECIFIC NEEDS MED participants have access to MED s Participant Request Service, which allows participants to request brief reviews of the evidence on emerging state issues, at any time. The MED team will quickly search for evidence and produce a report on the specified topic. Participant Requests can take a variety of forms, including expert librarian search, brief evidence summary, policy brief, or review of information provided by a vendor. INFORMATION RESOURCES In addition to MED reports and products, participants have access to several proprietary information sources, including: MED Clearinghouse A web-based compilation of MED reports, federal, state and private payer policies, news, and discussion forum available to participants through a secure website Weekly Newsletter MED staff scan a wide breadth of journals and publications and provide concise analyses of relevant and timely information in a weekly electronic newsletter MED benefits
4 reports as of January 2017 REPORTS Selected topics completed or in progress since January 2016 ADHD Diagnosis in Adults: Tools and Clinical Evidence Allergy Testing Association of Metavir Fibrosis Scores and Clinical Outcomes Best Practices in Residential SUD Treatment ESPDT Implementation: Increasing Participation and Screening Rates Evaluation of the AASLD/IDSA Hepatitis C Guidance Home Care Services and Utilization Management for Appropriate Use of Factor Replacement Therapy in Patients with Hemophilia Case Management Services Cervical Cancer Screening for Women and Methods to Improve Screening for Women with Disabilities Community Health Workers and Substance Use Disorder* Complex Care Interventions to Address Social Determinants of Health Continuous Glucose Monitoring for Individuals with Type 1 and Type 2 Diabetes Demographic Trends in Utilization of Nursing Homes and Home and Community-based Services* Drug Courts and Medicaid* Effectiveness and Safety of Longterm Use of Carisoprodol Effectiveness and Safety of OBERATM and ReShape for Weight Loss Effectiveness and Safety of Vagal Nerve Block Therapy for Weight Loss Effectiveness of Dynamic Standing Wheelchairs Effectiveness of Power Standing Wheelchairs Identifying and Addressing Social Determinants of Health in Medicaid Populations Incarceration and Poor-health and Economic Outcomes Following Release Individuals with a Dual Diagnosis of an Intellectual/Developmental Disability and Harmful Sexual Behavior Long-term Use of Vivitrol to Prevent Relapse to Opioid Use Disorder Magnetic Resonance Imaging for Monitoring Progression of Multiple Sclerosis Medicaid and Specialty Drugs: Current Policy Options Medicaid Managed Care Quality & Coverage Policies Medicaid Managed long-term Services and Supports for Children: Quality, Oversight, and Accountability Medicaid Pricing for Non-invasive Prenatal Screening for Aneuploidy Medication Therapy Management* Mental Health Rehabilitation Payer Policies Summary
5 Neonatal Intensive Care Unit: Back Transfers Neonatal Policies in Concurrent Inpatient Utilization Review Non-physician Providers and Locum Tenens Coverage in Medicaid Opportunities for Aligning with ONC Standards for Collecting Social Determinants Data in EMRs* Orkambi (Lumacaftor/ivacaftor) for Cystic Fibrosis: How is Treatment Response Defined? Perinatal Depression: Linking Patients to Care Pharmacogenetic Tests for Psychotropic Drugs Pharmacotherapy for Multiple Sclerosis Related Fatigue Pediatric Outpatient Long-term Care Services Coordination Processes for Updating Medicaid Coverage Policies and Provider Manuals Psychiatric Readmissions in Children* Sedation and Anesthesia for Dental Procedures Skin Substitutes for Chronic Wounds: Payer Policies State Best Practices to Address Inappropriate and Over-prescribing of Opioids State Mental Health Incentive Programs under Medicaid Managed Care State Policies and Evidence on Concurrent Inpatient Utilization Review State Policies to Cover Behavioral and Developmental Treatments of Autism Spectrum Disorder State Strategies for Identifying, Selecting, and Incentivizing Quality Measure Performance in Managed Care Strategies to Improve Postpartum Care Visits Using the CHIP Unborn Child Coverage Option Telehealth in Urban/Suburban Settings for Direct Service to Patients* Text Messaging Interventions for Patients with Chronic Diseases Treating Acute Pain among Patients Receiving Treatment for an Opioid Use Disorder Use of Nitrous Oxide at Birth Centers Use of Ultrasound to Diagnose Hemarthrosis and Monitor Joint Health in Hemophilia Value of Perinatal Back and Lateral Transfers Weight-based Dosing Strategies for Factor Replacement Therapy in Hemophilia A and B State Medicaid Medical Necessity Standards and the Role of Evidence * Report in progress FOR MORE INFORMATION CONTACT SUSAN AROMAA aromaa@ohsu.edu DEBBIE DION dion@ohsu.edu
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