NHP/Brightwood Program Evaluation

Background

In May, 2001 the Neighborhood Health Plan (NHP) and Brightwood Community Health Center in Springfield, MA began an innovative program to change the way health care services are delivered to Brightwood's MassHealth enrollees. The new program was designed to address the needs of approximately 400 long term unemployed and 800 SSI disabled enrollees, and was also expected to identify and serve an unknown number of TANF enrollees with chronic health care needs.

NHP made a major investment in on-site primary care, care coordination, and behavioral health resources at Brightwood that went beyond the existing primary care or behavioral health capitation payment. The additional primary care and behavioral health staff targeted their services to the Medicaid NHP enrollees with chronic and complex health and psychosocial conditions. Risk assessments were conducted of all NHP enrollees, and individuals were triaged to the appropriate care managers.

Demonstration and Evaluation Hypothesis

The underlying hypothesis of this demonstration is that a managed care organization has the ability to use capitation payment to finance the health center's transformation of a fragmented care delivery system to provide cost effective care that meets the needs of members with complex disabilities and illness. Components of this evaluation include:

  1. Structural evaluation (Staffing patterns, Provider roles, Service integration, Financing, Utilization Management and Outreach)
  2. Process evaluation (Model implementation, Culture and community, Risk assessment process, Outreach and enrollment process, Obstacles and challenges)
  3. Outcomes evaluation (Provider experience, Enrollee experience, and Pre- and post- enrollment cost and utilization) Outcomes are published in: Bachman, S., Tobias, C., Master, R., Scavron, J., Tierney, K. (2008). A managed care model for Latino adults with chronic illness and disability: Results of the Brightwood health center intervention. Journal of Disability Policy Studies.

Project Staff: Carol Tobias, Sara Bachman, Viviana Abuchar and Serena Rajabiun.

Brightwood Evaluation Report

Brightwood Results Powerpoint Presentation