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From silos to synergy.

Janet Treadwell1, Laurie Levermann, Gail Soffar

  • 1Texas Children's Health Plan, Houston 77021, USA.

Managed Care Interface
|November 29, 2007
PubMed
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Texas Children's Health Plan (TCHP) improved member-centric care through a redesigned care management approach. This enhanced collaboration boosted job satisfaction and supported preventive and chronic care delivery.

Area of Science:

  • Healthcare Management
  • Public Health
  • Pediatric Care

Background:

  • Texas Children's Health Plan (TCHP) sought to enhance member-centric care and the medical home model.
  • Existing care management processes required redesign to foster collaboration and synergy.

Purpose of the Study:

  • To redesign TCHP's care management approach for improved member support.
  • To integrate information and programs for collaborative member care.
  • To leverage synergy between staff, programming, and physician practices.

Main Methods:

  • Redesigned care management processes and structure.
  • Focused on connecting information and programs.
  • Promoted collaborative care delivery.

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Main Results:

  • Improved staff job satisfaction.
  • Achieved a positive change in the medical-loss ratio.
  • Developed innovations for preventive and chronic care service delivery.

Conclusions:

  • The redesigned care management approach successfully supported member-centric care.
  • Enhanced collaboration led to positive outcomes in job satisfaction and financial metrics.
  • Innovations were introduced to meet the evolving needs of TCHP membership.