CASE STUDIES - MCO

National Managed Care Organization looking to increase LDL screening and LDL goal attainment through chart based research and physician education interventions

Project Specifics:

• National MCO • Thirteen States • 9,738 charts reviewed • Administrative and pharmacy claims analysis

Goals:

• To statistically increase LDL screening and LDL benchmark goals as specified by HEDIS in the post cardiovascular events and diabetic patient population

TTM’s Process:

• Conduct baseline database analysis of medical and prescription claims • Conduct random sample selection • Review over 9,500 charts in 13 states evaluating risk factors and clinical performance measures • Analyze data and prepare aggregate and individual physician reports • Proprietary educational tools provide to physicians (ClinAdvisor©, ClinProfiler©, Clinfax©) • TTM clinical pharmacists met face-to-face with top 50 providers in each state • Member educational tools mailed to patient population

Impact & Outcome for TTM Client:

• LDL screening improved statistically in diabetic population • HEDIS LDL goal attainment of <130 mg/dL improved statistically in patients with diabetes • NCEP LDL goal attainment of <100 mg/dL improved statistically in post event and diabetes patient population • Nephropathy screening among patients with diabetes improved statistically