Health Literacy in Managed Care Prevention Programs. MetroPlus Health Plan. MetroPlus Health Plan
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1 Health Literacy in Managed Care Prevention Programs MetroPlus Health Plan Arnold Saperstein, MD President & CEO MetroPlus Health Plan September 15, 2009
2 MetroPlus Background MetroPlus began operations in 1985 MetroPlus is a wholly owned subsidiary of the NYC Health and Hospitals Corporation (HHC), the largest municipal hospital system in the U.S., serving 1.3 million New Yorkers 11 acute care hospitals, 4 skilled nursing facilities, 6 large diagnostic and treatment centers and over 80 community based clinics HHC and MetroPlus serve the same low-income, innercity population 2
3 MetroPlus Products MetroPlus offers Medicaid, Family Health Plus and Child Health Plus Medicaid HIV Special Needs Program (SNP), called Partnership in Care, for people with HIV/AIDS MetroPlus Gold for HHC employees and their dependents Medicare for Dual Eligibles and HIV SNP; full Medicare product in January 2010 MetroPlus operates in Manhattan, Brooklyn, Queens and the Bronx; four of the five New York City counties 3
4 MetroPlus Membership Membership grew 100K in the last two years Products Medicaid Family Health Plus Child Health Plus HIV Special Needs Plan Medicare MetroPlus Gold TOTAL Members Sept ,384 34,608 19,403 3,099 2,069 2, ,477 4
5 MetroPlus Provider Network MetroPlus hospitals 11 HHC hospitals Hospitals of Continuum Health Partners, Long Island College, Lutheran Medical Center, Maimonides Medical Center, Mount Sinai Hospitals, NYU, NY Eye and Ear Infirmary, Peninsula, SUNY Downstate Primary and specialty care through over 12,000 HHC and community providers Primary Care Providers: 2,614 (158 HIV PCPs) OB/GYN: 774 Other Specialists: 8,573 5
6 Quality Driven Organization Rated #1 in quality for 3 of the last 4 years, based on indicators chosen by the NY State Department of Health Published in Consumer s Guide to Medicaid Managed Care Chronic Disease Pay-for-Performance (P4P) Rewards improvements in Asthma and Diabetes outcomes; began in 2005 Quality Assurance Reporting Requirements (QARR) awards Annual quality measures reported to the NYSDOH, based on NCQA HEDIS measures; began in 1998 Medical Provider Performance Pool (MPPP) Quarterly profiles reward improvements in the process of care, based on 14 claims-based indicators; began in
7 Why MetroPlus Considers Health Literacy Important Health literacy affects MetroPlus members ability to: Navigate the healthcare system, including the ability to locate providers, enroll and renew coverage Share personal and other health information Engage in self-care and chronic disease management programs Adopt health-promoting behaviors, such as a healthy diet and the right amount of exercise We believe that improved health literacy will improve members health outcomes and quality of life and will lower healthcare costs 7
8 MetroPlus Members Are At Risk For Limited Health Literacy Limited or no English proficiency in at least 30% of our member population Limited education Low income population Older adults 8
9 MetroPlus Members Speak Over 65 Different Languages 72% English 20% Spanish (70K) 2.2% Bengali (8K) 1.2% Chinese (4K).8% French/Haitian Creole (2.7K).7% Urdu (2.6K) 60 other languages and dialects, each less than 0.5% of our member population 9
10 How MetroPlus Serves Members Who Don t t Speak English Customer Services Live customer services available in 13 languages from Monday Saturday, 8 am 8 pm Automated phone line available in five languages (English, Spanish, Chinese, Russian and Haitian Creole) More languages supported through Pacific Interpreters Language cards available on site for members to point to their language Website in English and two additional languages Spanish and Chinese 10
11 How MetroPlus Serves Members Who Don t t Speak English Member newsletters published in four languages in addition to English and sent to all member households Spanish, Chinese, Bengali, Haitian Creole All member materials including marketing and health education information published in multiple languages and available both in print and on the plan website MetroPlus staff reviews translations before publication as a quality check of the certified external translation company Over 70 languages spoken by MetroPlus diverse work force 11
12 How MetroPlus Helps Members with Limited Health Literacy Offer Care Management programs for members with chronic diseases Behavioral Health Asthma Plus Diabetes CARE MetroMom Complex/Transplant HIV/SNP (Partnership in Care) Every program has multilingual staff and materials published in multiple languages Conduct health screening for all Medicare members, includes health literacy topics 12
13 How MetroPlus Helps Members with Limited Health Literacy Provide multilingual patient navigators at HHC hospitals Help patients evaluate treatment options, obtain referrals and apply for assistance Use simple, plain language, 4th grade reading level In brochures, newsletters, health information, member handbook and other materials 13
14 Other MetroPlus Initiatives to Address Limited Health Literacy Established MetroPlus Member Advisory Committee to solicit feedback and advice from members Expanded the customer satisfaction survey to improve feedback from English and Spanish speakers Utilize the NCQA CAHPS survey which is only available in English and Spanish Provided survey vendor with language flags for the sample population Spanish speaking members were sent the Spanish survey rather then requiring members to call and request a Spanish survey (usual protocol) Excellent response rate 42% 14
15 Other MetroPlus Initiatives to Address Limited Health Literacy Work with HHC on initiatives to address health literacy Actively participate on the HHC Equity Council where one major focus is to encourage initiatives to ensure high quality care for all, overcoming language and comprehension as a barrier Analyzed our quality data by primary language to identify potential disease or language specific variance in the quality of care Partner with civic and faith-based organizations to ensure that the health information that members receive is accurate, current and reliable 15
16 How MetroPlus Will Continue To Address Limited Health Literacy Continue the programs that we have established Create and identify quality health education materials written at varying literacy levels, in various formats and in multiple languages Further analyze the impact of language and literacy barriers on the clinical outcomes of our member population Direct members to trusted health education web sites that have the potential of enhancing the health literacy of our membership 16
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