CDPHP has offered case management services to our Medicaid Health and Recovery Plan (HARP) members since 2016. These are members who are identified as having significant behavioral and medical health needs. Our HARP case management team works to connect these members to providers and services in an effort to improve their health outcomes.
2019 has brought about some significant changes in the way CDPHP supports our highest-need Medicaid HARP members. The NYS Department of Health (DOH) Performance Opportunity Project (POP) is an incentive-based model offering intensive case management to a specific subset of the Medicaid HARP population.
Medicaid HARP members are identified as POP-eligible after a series of four emergency room visits or inpatient hospitalizations in a 12-month period. HARP case managers engage these members in the health care setting and identify current gaps in care and/or support. After discharge, POP members are followed closely by CDPHP case managers and/or community agencies working in tandem with our team. Using DOH guidelines, the support team plans a series of “milestone” visits with the member in the months following discharge.
This model allows CDPHP to have an immediate and direct impact on connecting our members to the supports they need. A POP plan may include establishing the member with new providers, appointment reminders, assistance with Medicaid transportation, medication reviews, referrals to appropriate agencies, and ongoing support from a consistent source.
To learn more about the POP, contact the CDPHP behavioral health access center at (518) 641-3600.