The structure and content of telephonic scripts found useful in a Medicaid Chronic Disease Management Program.
In 2003, the Indiana Office of Medicaid Policy and Planning launched the Indiana Chronic Disease Management Program (ICDMP), a programme intended to improve the health and healthcare utilization of 15,000 Aged, Blind and Disabled Medicaid members living with diabetes and/or congestive heart failure in Indiana. Within ICDMP, programme components derived from the Chronic Care Model and education based on an integrated theoretical framework were utilized to create a telephonic care management intervention that was delivered by trained, non-clinical Care Managers (CMs) working under the supervision of a Registered Nurse. CMs utilized computer-assisted health education scripts to address clinically important topics, including medication adherence, diet, exercise and prevention of disease-specific complications. Employing reflective listening techniques, barriers to optimal self-management were assessed and members were encouraged to engage in health-improving actions. ICDMP evaluation results suggest that this low-intensity telephonic intervention shifted utilization and lowered costs. We discuss this patient-centred method for motivating behaviour change, the theoretical constructs underlying the scripts and the branched-logic format that makes them suitable to use as a computer-based application. Our aim is to share these public-domain materials with other programmes.
Roth
Alexis M
AM
Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. almroth@iupui.edu
Ackermann
Ronald T
RT
Downs
Stephen M
SM
Downs
Anne M
AM
Zillich
Alan J
AJ
Holmes
Ann M
AM
Katz
Barry P
BP
Murray
Michael D
MD
Inui
Thomas S
TS
D000368:Aged; D002908:Chronic Disease / Q000628:therapy*; D006233:Persons with Disabilities; D019468:Disease Management; D006285:Health Planning; D006291:Health Policy; D006296:Health Services / Q000706:statistics & numerical data; D006298:Health Services Administration; D006801:Humans; D007196:Indiana; D008484:Medicaid; D033262:Narration; D016730:Program Development; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D014481:United States; D016903:Drug Monitoring