2012 Askew Award Winners

Recipient: Susan Brownlee

Project Title: Healthier at Home/Nurse Line: A Cost-Benefit Analysis

Project Description: A vendor is currently under contract with the Employee Insurance Program (EIP) to provide a printed self-healthcare guide (a handbook) and a toll-free Nurse Line service to State Health Plan (SHP) Savings Plan subscribers. The handbook and Nurse Line are provided at no additional charge to those enrolled in the Savings Plan, but are part of the overall costs associated with this health plan and paid by EIP to the contracted provider each month, based on the number of subscribers enrolled in the plan.  At the beginning of the project, the hypothesis was that the cost to the program was greater than the savings generated to the plan and the subscribers. However, through extensive data analysis, it was determined that in fact the savings to the insurance plan and the subscribers was over $1.2 million. It was determined that additional marketing efforts may result in greater savings to both the Plan and to its enrollees. Estimated cost savings for Plan enrollees is substantial; four times that for the Plan. Greater utilization of the Handbook and Nurse Line could mean significant savings to a greater number of enrollees, at no additional cost to the Plan, other than by actual enrollment numbers.

 

Recipient: Laurel Eddins

Project Title: Monitoring the Impact of Medicaid Savings Initiatives and Program Reductions
for South Carolina Department of Health and Human Services

Project Description: In state fiscal year 2011, the South Carolina Department of Health and Human Services (SCDHHS) was facing a budget deficit. The agency had to request additional funding from the legislature to continue the Medicaid program. As a result of the request, SCDHHS was granted an additional $222,452,086 million in state general funds. The funding saved the Medicaid program in fiscal year 2011, but not without increased scrutiny. Provisos were submitted into law that increased the reporting the agency was required to perform in state fiscal year 2012. Proviso 21.48 imposed new requirements upon the agency to increase reporting to a quarterly basis and expand existing transparency reporting to include county level statistics on providers, beneficiaries and expenditures at multiple levels. Several challenges of complying with the proviso included the time period and turn around requirements, the ability to report on the savings of each cost savings measure implemented, the level of detail specified, the breakout of provider sub-specialists, and the understanding what service level utilization trends were expected. The largest issue that had to be addressed by the agency was the fact that there was no mechanism in place to track savings at the granular level required by the proviso. However, the agency was able to create a reliable reporting process. By December 30th, the agency had complied with all the requirements of proviso 21.48 and the new process had been created, implemented, tested, and posted.