A teen member with diabetes was having difficulty keeping their blood sugar at a healthy level.  A Member Connections representative from Coordinated Care, went to visit this member at their home following a hospital stay for a diabetic crisis. The staff member met with the patient and their mother to review some educational materials about diabetes and the directions established by our Case Manager. The mother was very thankful for our case management and for the Nurtur Disease coaching program for her child and said she wished we had been here as company 6 years ago when her child was diagnosed with Diabetes.

Coordinated Care is continuing to assist this family through Case Management. The family has been helped to sign up for a Safelink phone so they could reach case management, our 24-hour Nurse Line or their doctor anytime. The teen is doing much better in monitoring their blood sugar and taking insulin shots.

This is another example of how we help people get well, stay well and be well.

Dr. West, a graduate of the University of Washington School of Medicine, completed a residency in Family Medicine with the Providence St. Peter Residency Program. Dr. West has been practicing Family Medicine in Washington his entire career and will continue to see patients one day a week at Edmonds Family Medicine/Puget Sound Family Physicians where he has practiced for the last three years. Previously, Dr. West cared for patients at the Polyclinic/Ballard and Chief of Staff at Ballard Swedish Hospital.

Dr. West currently serves as co-chair of Government Affairs for the Washington Academy of Family Physicians and is on the Committee for Quality and Practice for the American Academy of Family Physicians.

Having a CEO and Chief Medical Officer who are local and experienced family physicians positions Coordinated Care strongly to fulfill its mission to empower patients to improve their health. “The focus on health and wellness and working with members to make positive choices to create better health for themselves, is part of what attracted me to Coordinated Care,” says Dr. West. “This health plan and its mission align with my core belief that effective preventive care starts with the critical relationship with a primary care physician. We will seek to connect every member to a health home and then incentivize and empower them to take charge of their own health, with support from our plan.”

For more information, please contact Sally Mildren, Director of Marketing at (253) 381-7704 or by email at smildren@centene.com.

• HEDIS information for Diabetes, EPSDT and Cardiac Care
• Start Smart for Babies program and 17P injections for high risk pregnancies
• Your credentialing rights
• and more!

• Diabetes
• Lowering your Cholesterol
• Incentives
• Planning ahead
• and more!

Young Pregnant Member Receives Support for Substance Abuse:A young pregnant member, who was having dental pain due to drug use, reached out for help. The staff at Coordinated Care was able to help the member obtain resources for getting dental care. In addition, the member was connected to a drug treatment center, assisted to sign up for WIC benefits and for Early Head Start Program to support her family. The member was signed up for a Safe Link phone so they could stay connected and supported while in the treatment center and is being supported to quit smoking with resources given to her by Coordinated Care. This member stated how excited she was to be with Coordinated Care and about the Start Smart for Baby program.

Case Management Helps an Entire Family:A member, who was 11 weeks pregnant, called the 24/7 Nurse Line with questions regarding her health. She was flagged for a follow up by case management to make sure she didn’t need additional support. The member, who has five other young children at home, has a history of pre-term labor and was not familiar with her plan benefits or the health support and education she could receive from Coordinated Care. The case manager helped the member come up with a plan of care and she was very excited to have someone follow her health during pregnancy, especially to provide coordination of care between her plan, her midwife and her Primary Care Provider (PCP). Her entire family of 7 is now with Coordinated Care.

Coordinated Care for Member Has Big Impact:A member from Yakima was diagnosed with cancer in 2000, which had since spread to other parts of her body. Because the cancer had spread, it was now causing vision problems for the member and during a call with Coordinated Care, the member said that she did not feel safe in her apartment due to the stairs that she had to climb up and down.

The member was also not receiving her chemotherapy medications and after calls to Home Health and her physician’s office, we sent a MemberConnections rep to visit the member and find out what the problem was with deliveries.

The rep identified that because of the secure entrance on the building, the deliveries were not being made because the drivers would not call the member to be allowed in the building. The rep helped get the medications set up for delivery to a nearby family member who can ensure that the member gets her medications on time.

The MemberConnections rep also identified the hazard of the stairs in the member’s apartment and assisted them with applying to the Housing Authority for a change. The member was very satisfied and grateful for the help.

Connecting Members to the Community:A member called with severe dental pain that was making it hard to sleep at night. The member said she had several teeth break. Coordinated Care connected the member to several dental clinics close to her home. Unfortunately, when the member went to the one dental clinic, she was told she would have to pay $50 co-pay and cancelled her appointment. When a case manager called to follow up with the member and heard she had cancelled her appointment, Coordinated Care called the dental clinic and helped them understand the Medicaid benefits for this member and discovered there would be no co-pay, no pay what so ever for the member! She was treated and feeling much better.

http://www.tvw.org/index.php?option=com_tvwplayer&eventID=2012070007

The Quality Adjustment is comprised of the following factors and based on health plan scores from the RFP:
     30% Care Management
     25% Access to Care and Provider Network
     25% Quality Assurance Performance Improvement (QAPI)
     20% Program Integrity

Headquartered in Tacoma, Coordinated Care was established in 2012 as a Medicaid Managed Care Organization to deliver innovative, quality health care in the state of Washington through local, regional and community-based resources. The company exists to improve the health of its beneficiaries through focused, compassionate and coordinated care and believes that quality health care is best delivered locally. Coordinated Care’s commitment is to provide empathy and understanding of its members and empower employees to go the extra mile to care for them. www.CoordinatedCareHealth.com.

“To lead its new venture in Washington state, Centene turned to Fathi, a Seattle physician with long experience caring for Medicaid patients. He came on board as Coordinated Care’s president and CEO in May. Up until his move to the executive suite, Fathi practiced family medicine in Seattle, including 12 years as a staff physician at Wallingford’s 45th Street Community Clinic. Immediately before joining Coordinated Care, he served as the medical director for Primary Care and Community Health for Swedish Health Services. In that role, Fathi was a leader in the development of the Swedish Community Health Clinic in Ballard, a “medical home model” pilot project that has received national attention.”

“We want to be able to create a system where providers are paid to do the right thing for the patient. We want to be able to make it possible for providers, when they have their hand on the door at the end of a visit, not to be thinking “I’ve got to get out of here and see my next patient” but instead to be asking themselves, “Have I done the right thing? Is my patient up-to-date on their immunizations and cancer screenings — is their diabetes and blood pressure well controlled?” That’s the kind of care a provider’s compensation we think should be based on, and I think that’s the model that we’re going to see more and more of nationwide.”

“What we do in managed care is coordinate the [patient's] care and help them navigate the system. We make sure they have primary care providers; we try to make sure they have smooth transitions to home after hospital discharge; and make sure they have good follow-up care so they don’t end up back in the hospital. If we see people going to the ER a lot, we try to reach out to them and find out what’s going on…We’re confident we will be able to do that, because managed care is our company’s core competency.”

What differentiates Coordinated Care from the other Medicaid managed companies in the market? I tell providers, “Look, we’re a company that’s run by a family doctor, who’s taken care of this population his whole career. We’re putting together a team that’s dedicated to the patient, and all our employees are directed by me, as CEO, to do the right thing for the patient all the time.”

Interview conducted and condensed by Michael McCarthy

For full article: http://www.bizjournals.com/seattle/print-edition/2012/10/19/health-care-questions-for-dr-jay.html

FOR IMMEDIATE RELEASE (September 5, 2012) Tacoma, WA.  Community Health Advocates from Salishan in Tacoma called Coordinated Care for help. “Many of the kids in this Tacoma community received backpacks filled with school supplies, but some were missed,” explained one staff member from Community Health Advocates at Salishan.

So Coordinated Care employees rose to the challenge and collected hundreds of dollars of supplies which were distributed on Sept. 4^th during a community event at Salishan. The donation was used to provide supplies for nearly one hundred more school-age kids and youth at the housing community.  “The size of the donation was wonderful and gave us the opportunity to provide supplies for youth and teens, who typically are missed during school drives,” explains a staff member.

But Coordinated Care shares more than just crayons with the Community Health Advocates at Salishan. They share a commitment to improving health of their members and the community. In fact, even prior to their launch in July, Coordinated Care provided a grant that was used to expand their community gardens at Salishan, helping to encourage healthy eating among their residents. 

Dr. Jay Fathi, a long time family physician caring for the underserved in the Puget Sound region, and CEO & President of Coordinated Care, believes that healthy choices now help lead to hope for a healthy future. “Ultimately, our missions are very similar. Both organizations are passionate about helping reduce barriers to better health and to helping our most vulnerable residents create a healthy lifestyle for themselves and their families,” says Fathi.  “That’s at the heart of our mission at Coordinated Care and we are proud to work with organizations like Community Health Advocates to meet the needs of our community.”

For more information, please contact Sally Mildren, Director of Marketing at (253) 442-1471 or by email at smildren@centene.com. Photos available.

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About Coordinated Care: 

Established to deliver quality healthcare in the state of Washington through local, regional and community-based resources, Coordinated Care  is a Managed Care Organization and subsidiary of Centene Corporation (Centene). Coordinated Care exists to improve the health of its beneficiaries through focused, compassionate and coordinated care. Our approach is based on the core belief that quality healthcare is best delivered locally.www.CoordinatedCareHealth.com

About Community Health Advocate Program/Salishan:

The Community Health Advocates Program is an innovative, grassroots approach to address the problems found in public housing and with low income and very low income individuals. It is another example of C.H.E.F.’s ongoing work to reduce the risk factors related to chronic disease, reduce barriers to better health and to help make healthy choices the easy choice for our most vulnerable residents.  Salishan is the Tacoma Housing Authority’s largest community and the most racially diverse public housing community in  Washington state. www.chef.org/healthequitypartners

“We are pleased and honored to be selected to offer coordinated healthcare services and programs to the people of Washington,” said Jesse Hunter, Executive Vice President of Corporate Development and Operating Group Chairman of Centene. “Centene’s core philosophy is to provide accessible, high-quality care at a lower cost, and we look forward to working together with the Health Care Authority to execute on this vision.”

According to HCA’s timetable, next steps will be to finalize contracts with the successful bidders by the end of February.  Services for enrollees are expected to commence in the third quarter of 2012.

“Washington will be the 15th state in which Centene operates health plans and is a continued example of Centene’s dedication to providing innovative health solutions at the local level for the members and states we serve”, said Michael F. Neidorff, Chairman and Chief Executive Officer of Centene.  ”We believe our strategic provider partnerships will help us deliver improved health outcomes for our members in a cost-effective manner.”  

Updates regarding this award will be provided when additional material information becomes available.  As a reminder, Centene’s 2011 fourth quarter and year-end financial results conference call will be held on February 7, 2012 at 8:30am (Eastern Time).

About Centene Corporation

Centene Corporation, a Fortune 500 company, is a leading multi-line healthcare enterprise that provides programs and related services to the rising number of under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children’s Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and long-term care, in addition to other state-sponsored programs, and Medicare (Special Needs Plans). Centene’s CeltiCare subsidiary offers states unique, “exchange based” and other cost-effective coverage solutions for low-income populations. The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health, life and health management, managed vision, telehealth services, and pharmacy benefits management. More information regarding Centene is available at www.centene.com.

The information provided in this press release contains forward-looking statements that relate to future events and future financial performance of Centene. Subsequent events and developments may cause the Company’s estimates to change. The Company disclaims any obligation to update this forward-looking financial information in the future. Readers are cautioned that matters subject to forward-looking statements involve known and unknown risks and uncertainties, including economic, regulatory, competitive and other factors that may cause Centene’s or its industry’s actual results, levels of activity, performance or achievements to be materially different from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. Actual results may differ from projections or estimates due to a variety of important factors, including Centene’s ability to accurately predict and effectively manage health benefits and other operating expenses, competition, membership and revenue projections, timing of regulatory contract approval, changes in healthcare practices, changes in federal or state laws or regulations, inflation, provider contract changes, new technologies, reduction in provider payments by governmental payors, major epidemics, disasters and numerous other factors affecting the delivery and cost of healthcare. The expiration, cancellation or suspension of Centene’s Medicaid Managed Care contracts by state governments would also negatively affect Centene.