title: Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012.
abstract: BACKGROUND
  Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation's largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities.
  
  
  METHODS
  The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics.
  
  
  RESULTS
  Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities.
  
  
  CONCLUSIONS
  Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services.
authors.affiliation: California Department of Health Care Services, 1501 Capitol Ave, Ste 71.6129, MS 0000, PO Box 997413, Sacramento, CA 95899-7413. Email: Desiree.Backman@dhcs.ca.gov. Dr Backman is also affiliated with the Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California.
authors.forename: Desiree R
authors.initials: DR
authors.lastname: Backman
authors.affiliation: California Department of Health Care Services, Sacramento, California; Brian M. Paciotti, Optum Data Management, Sacramento, California, and California Department of Health Care Services, Sacramento, California.
authors.forename: Neal D
authors.initials: ND
authors.lastname: Kohatsu
authors.affiliation: Optum Data Management, Sacramento, California, and California Department of Health Care Services, Sacramento, California.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Paciotti
authors.affiliation: California Department of Health Care Services, Sacramento, California; Brian M. Paciotti, Optum Data Management, Sacramento, California, and California Department of Health Care Services, Sacramento, California.
authors.forename: Jennifer V
authors.initials: JV
authors.lastname: Byrne
authors.affiliation: Institute for Population Health Improvement, University of California Davis Health System, and University of California Davis, School of Medicine and Betty Irene Moore School of Nursing, Sacramento, California.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Kizer
mesh_terms: D002140:California; D003430:Cross-Sectional Studies; D019468:Disease Management; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008329:Managed Care Programs / Q000145:classification* / Q000191:economics*; D008484:Medicaid / Q000191:economics*; D011203:Poverty; D013221:State Health Plans / Q000191:economics*; D011795:Surveys and Questionnaires; D014481:United States