Sandeep Wadhwa, MD, MBA Vice President, Care Management Services McKesson Health Solutions Chair, Go

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Sandeep Wadhwa, MD, MBAVice President, Care
Management Services McKesson Health
SolutionsChair, Government Affairs
CommitteeDisease Management Association of
America
New Opportunities for Disease Management and Care
Coordination Programs in Medicaid

• Prepared for The National Medicaid Congress, June
  6, 2006

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Cross-country tour of DM trends
Provider-centric Medical home Nurse advice link
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Rural populations have unique needs
Oregon, Montana, Pennsylvania Underserved
Populations
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RN helps Oregon member follow doctors plan

• 6 million in avoided costs isonly part of the
  story." Barney Speight, State Medicaid Director,
  Oregon
• Rest of the story
• Severe bronchitis causes Flynns Christmas Eve
  asthma attack
• Nurse helps her follow through on doctors action
  plan. It kept me from panicking, which in itself
  is enough.

Bonnie Flynn participates in the Oregon DM
program. Tualatin (Ore.) Times photo.
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Montana takes strong approach

• Must call a nurse first
• Triage is disease management conduit
• Team Care
• High users of ED get medical home
• Must call RN before seeing PCP
• Clients will continue to get the professional
  care they need, as well as training to help them
  learn that its not necessary to visit the
  emergency room to treat a cold. Mary Angela
  Collins, Medicaid Managed Care Bureau Chief,
  Montana

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Providers central to Pennsylvania program

• Pay-for-Participation
• Primary care case management
• 169,000 children and 95,000 Medicaid
  beneficiaries
• 42 rural counties

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Discussion and questions

• Thank you.
• Sandeep Wadhwa, MD, MBA
• sandeep.wadhwa_at_mckesson.com
• Vice President, Care Management Services,
  McKesson Health Solutions
• Chair, Government Affairs Committee and Board
  Member, Disease Management Association of America