2016 Session

Budget Amendments - SB30 (Committee Approved)

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Medicaid Physician & Managed Care Liaison Comm. - Emergency Dept. Care Coordination Workgroup (language only)

Item 306 #2s

Item 306 #2s

Health and Human Resources
Department of Medical Assistance Services


Page 265, line 57, after "committee.", insert:

"The Committee shall establish an Emergency Department Care Coordination workgroup comprised of representatives from the Committee, including the Virginia College of Emergency Physicians, the Medical Society of Virginia, Virginia Hospital and Health care Association, the Virginia Academy of Family Physicians and the Virginia Association of Health Plans to achieve the following goals: (i) develop a plan for improved coordination of care across provider types for super utilizers; (ii) identify the fiscal impact of primary care provider incentives and of funding improved interoperability between hospital and provider systems; (iii) identify best practices for formalizing a statewide emergency department collaboration.  Such best practices to consider may include: (i) Washington State's "Seven Best Practices" in the emergency department; (ii) adoption of a system to electronically exchange patient information and more easily access the prescription monitoring program among emergency departments on a statewide basis, such as the EDIE system used in other states; (iii) development of a process to create care plans for super utilizers, including patients who are in the Medicaid Client Medical Management program, and (iv) establishment of regional care coordination teams comprised of emergency medicine physicians, hospital leaders, primary care physicians, representatives, substance abuse professionals and mental health service providers to develop and review care plans for identified super utilizers, electronically accessible to providers in the region's emergency department to help ensure consistent care to this population regardless of where they present for care."


(This amendment adds language directing the Medicaid Physician and Managed Care Liaison Committee to establish an Emergency Department Care Coordination work group and sets forth its representatives and tasks to improve coordination of care across provider types for "super utilizers" of services and identify best practices for collaborating on care across hospital and provider systems.)