The purpose of this project is to: (1) design a managed care product that incorporates a new system for delivering more coordinated, appropriate care to employed persons and their dependents with chronic illness; and (2) evaluate its cost-effectiveness for employers/insurers. Under this project, managed care strategies will be designed for four or more chronic illnesses using specialists in the Johns Hopkins Hospital System in tandem with specialized nurse practitioners serving as the gatekeepers. These strategies will be packaged and marketed as a benefit option within the Johns Hopkins self-insured group health plan and as a Blue Cross/Blue Shield HMO product. An evaluation plan will be designed to compare utilization, costs, demographics, and risk selection for enrollees in the plan with those who have similar chronic illnesses but are not enrolled. The grantee will: (1) select four or more chronic illnesses to establish clinical criteria for management of care; (2) determine number of persons in target population who meet clinical criteria for inclusion and who are appropriately geographically distributed; (3) design marketing strategy; and (4) cost out rates.
Amount Awarded $195,770.00
Awarded on: 1/23/1992
Time frame: 4/1/1992 - 3/31/1993
Grant Number: 19665