III

Lovelace Community Health Plan

Change:

Lovelace held lunch trainings at each of the four provider sites.  All 25 providers

were trained across the sites.  Lovelace's Medical Director discussed New Mexico's

low referral rates and provided information about how to implement the ASQ tool

and how Lovelace would help providers navigate the FIT referral process.  The follow 

ing system changes were implemented to improve screening and referral practices:

The receptionist hands out the ASQ tool to the caregiver to be filled out in the

waiting room prior to selected (six , 12 , 18 , and 24 month) well visits as well as

whenever the caregiver or provider has a concern.

The provider reviews the questionnaire with the caregiver during the well visit exam.

Through a  fax back program  office staff bundle all score sheets indicating rea 

son for follow up evaluation and fax them to Lovelace weekly.

Health plan Outbound Caller contacts the caregivers of children who are eligible

for a FIT evaluation and helps the caregiver set up an appointment.

The Outbound Caller contacts FIT and provides them with the scoring sheet. 

The Outbound Caller follows up with the caregiver after the appointment to

ensure that the child has been evaluated.

If the family misses an appointment, it is referred to case management for further

intervention.

Results:

Lovelace purchased the ASQ screening tool and manual and made copies for each

of their pilot sites.  Through hands on training, providers learned how standardized

screening could easily be incorporated in well child care visits.  Providers responded

positively and continue to use the ASQ screener with all of their patients.

The fax back program proved to be difficult for providers over time and Lovelace

had a low fax response rate.  This was due to providers dealing with multiple payor

sources and serving several non Lovelace members.  The provider site staff found it

inefficient to cull out only Lovelace member ASQs.  As a result, Lovelace introduced

the idea to the New Mexico Department of Health and Human Services (DHHS).  By

implementing the fax back program at a state level, providers would be able to

send all score sheets indicating reason for follow up to a single place.  Lovelace

developed a list of local FIT providers and covered services specific to each pilot

site.  Providers have found this to be very useful in helping families navigate the

referral process.

MEMBER OUTREACH 

Lovelace set a goal to reach out to members through develop 

ment of member education materials and the development of

 Well Visit Round Up  days at the four pilot sites.   Building on

Lovelace's existing Healthy Trails Program, the health plan creat 

ed a mascot, Hank the Healthy Trails Horse.  On monthly Well 

Visit Round Up days, Hank the Horse visits the waiting rooms at

the four pilot sites, armed with health education materials and

parental resources on developmental topics such as toilet train 

ing, nutrition, and language and literacy development.

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