Utilization of Children with Special Health Care Needs (CSHCN) Screener© by O'ahu's pediatricians.

O'ahu's primary care physicians are in the process of implementing the Patient-Centered Medical Home (PCMH) model. The Medical Home Task Force recommends the implementation of the Children with Special Health Care Needs (CSHCN) Screener© as one of the two quality improvement programs that must be completed by each participating physician. This study sought to find how many pediatricians practice population health management and to determine barriers for incorporating population health management and care registries into practices. An online survey of 55 pediatricians in Hawai'i was conducted between January 10, 2012 and March 10, 2012. The survey contained questions regarding knowledge and use of population health management and investigated the utilization rate of the Screener©. This survey provides baseline data on the implementation of this recommended screener, and informs the process that will be necessary to ensure maximal adoption of recommendations. Sixty percent of the survey participants have not incorporated population health management into their routine practice. Twenty three percent did not have knowledge of population health management and 85% did not use a chronic disease registry. As of August 2011, 95% had not screened their patients with the Screener©. Reasons included not having heard of the Screener© and never having considered using a systematic process to ask patients to assess their health. Based on results, there are important educational goals that need to be accomplished in order for Hawai'i's physicians to transform their practices into effective PCMHs. Physicians will likely need instructional and monetary support to effectively change their practices into PCMHs.

Community recommendations on outreach activities for QUEST-expanded: Medicaid managed care for the aged, blind, and disabled population.

The Hawai'i Medicaid Program intends to transition its Aged, Blind, and Disabled population from a fee-for-service to a managed care model. To determine the best outreach strategies for this transition, focus groups of beneficiaries were held throughout Hawai'i. Beneficiaries want information in simple language, to be told about the change by someone knowledgeable whom they trust, and to have services that address their individual needs. A model for the transition, including these strategies, is described.