PP11       Title: A Health Plan Performance Improvement Project: Improving Adherence to New York State Asthma Guidelines Date: Thursday, June 19, 2008 Time: 12:00 PM - 04:00 PM Type: POSTER Level: ADVANCED Track: - Sponsor(s): - Speaker(s): Margaret "Peggy" Ann Leonard; Sheilah Kathleen McGlone Hudson Health Plan (HHP) in 2005 joined the New York State Collaborative for Asthma Care. The group was comprised of 12 Medicaid Managed Care Plans formed under the auspices of the Center for Health Care Strategies to address the delivery of asthma care in New York State. The effort also served as the Performance Improvement Project (PIP) for the managed care plans in New York State for 2005-2006.  HHP broadened their project to encompass member outreach as well. Working in collaboration with Dr. David Abramson of Columbia University, HHP adopted a randomized cluster design for the formal study in order to determine whether there is a relationship between types of asthma intervention and health outcomes for members. On the heels of the analysis, Thomas Wilson PhD, founder of Trajectory Healthcare, assisted with the data construction. This presentation will share strategies utilized to create a formal study designed to improve both provider management and patient self–management of asthma. The Plan had three specific aims it hoped to achieve after the interventions: to increase the use of controller medications by members aged 5-64 years with persistent asthma as defined by HEDIS; to reduce “bad days” - the combination of ER visits and inpatient days attributable to poor asthma control; and to ensure that asthma members had at least two PCP visits /year. Primary care medical groups were randomized into four study arms: usual and customary care; Provider outreach; Case Management; and Provider outreach and Case Management combined. Patient profiles and pharmacy alerts were developed and delivered to primary care practices in a standard report format. Physicians wanted to improve the health of their patients, and the Plan had administrative data that could help physicians to improve outcomes. The data analysis proved complicated. Based on controller medication use and “bad days’ results for the smaller subgroup, it appears that the population with persistent asthma was not only treated in better accordance with care guidelines before the beginnings of the study but has also received more attentive care from providers and benefited from case management during the study period. Objectives: Describe the three specific aims of the study which Hudson Health Plan hoped to achieve after one year of intervention.   Define the four arms of the study.   List three challenges encountered by the Nurse Case Manager during the operational phase of study.