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Medical Providers

More than 2,100 providers in 34 counties in central and southeast Ohio Medicaid regions participate in Partners For Kids. With assistance from those providers, Partners For Kids programs have led to steady or improving measures of quality care and patient outcomes.

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Our Quality Improvement Coaching Program has supported 33 practices’ QI initiatives, potentially reaching 90,000+ children

Since the program’s inception in 2014

Our Quality Improvement Coaching Program has trained 170+ providers and office staff in QI methodology

Since the program’s inception in 2014

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Programs and Benefits
Our member benefits offer the support and assistance you need to focus on the people who matter most - your patients.

By joining our practice network, you will receive the following benefits:
Physician Reimbursement

By joining Partners For Kids, you will receive a premium over Medicaid rates for each adjudicated claim.

Provider Incentive Program

Our incentive program makes quarterly payments based on quality measures, including:

  • A bonus for each patient who achieves pre-established quality outcomes, including well-child visits.
  • A share in the cost savings that result from a focus on prescribing patterns for select drug categories. Our staff pharmacists can assist with prescribing guidelines.

Primary Care Incentive Program

Pharmacy Consultations and Education Support

Partners For Kids Pharmacy provides pharmacy services to achieve the best medication-related outcomes for all of our patients. Our pharmacists help you make sure that patients have access to the medications they need by providing on-site education and online resources on clinically-effective medications covered by the Medicaid Managed Care Plans.

Quality Improvement Coaching

We offer free, quality improvement coaching. Our experts work directly with your office to provide on-site support and assist practices in achieving improved outcomes. Practices select from a list of issues to make their focus. That list includes:

  • Asthma
  • Behavioral health
  • Healthy children (well care visits)
  • Emergency department avoidance
  • Fluoride varnish
  • Reproductive health

View the specific projects below.

A Partners For Kids quality improvement specialist will come on-site to help guide the projects. The team and the quality improvement specialist will meet regularly to share ideas for change and test changes. The improvement process at the practice is then supported through participation in a learning network where diverse practices share best practices. Through this evidence-based approach, practices participating in similar programs have experienced success in increasing delivery rates of preventive services and improving relationships, communication, and efficiency among staff and providers. By participating in a quality improvement project, you may be eligible to receive Maintenance of Certification (MOC) Part IV credit.

 

 

Preventive Care Portfolio
Healthy Children ≥6 well visits by 15 months of age

Annual well visits for children 3-6 years old

Annual well visits for adolescents (12-21 years)

Body Mass Index (BMI) documentation and coding for children 3-17 years

Oral Health Fluoride varnish application for children up to 6 years of age
Reproductive Health Reproductive health assessments for adolescents

Contraception prescribing among 15-19-year-old females

Disease Management Portfolio
Asthma Reduce asthma-related Emergency Department visits and hospitalizations

Asthma Medication Ratio (AMR)

Asthma management (control assessed at every visit, schedule follow up appointments every 6 months, and asthma action plans updated annually)

Emergency Department Use Reduction Reduce utilization of the emergency department when the patient could have received appropriate and more sustainable care from their primary care provider or at an urgent care setting
Behavioral Health Portfolio
Attention Deficit Hyperactivity Disorder ADHD screening and follow up

Appropriate prescribing of ADHD medications

Depression Universal screening of adolescents for depression

Primary care management of depression in adolescent patients

Suicide Prevention* Screening adolescents for suicide intentions

Referral and management of at-risk adolescent patients

Antipsychotic

Prescribing*

Reduction in prescribing multiple concurrent antipsychotic medications

*Projects in development

Patient Outreach

To help you improve well-check compliance and earn incentive dollars, we provide free staffing to contact your patients who have not been seen recently and schedule them for a well-child appointment. Our staff can work in your office to:

  • Schedule patients or work closely with your schedulers, depending on your preference
  • Send an outreach letter to families with children due for their well-child services. Using your practice’s letterhead and stationery, we will print letters on your behalf; or, if you prefer to handle the mailing, we can reimburse your practice for postage expense.
Care Navigation

Care coordinators assist your patients with medical complexity and their families to navigate uneventfully, efficiently and as effectively as possible through the health care system. Examples of how we help families include:

  • Ensuring family/child links with provider referrals
  • Assisting with prior authorization/denial assistance
  • Reminding about annual well check/immunization
  • Following-up post-utilization with Emergency Department or inpatient admissions
  • Assisting with identifying/linking with providers for DME supplies, home health care
  • Ensuring families have access to managed care plan transportation benefits
  • Ensuring family understands and has ability to follow provider treatment recommendations
  • Connecting with social and community resources

Our care coordinators serve children who live in one of 34 Partners For Kids’ delegated counties and are diagnosed with complex medical or behavioral health conditions. Children must be enrolled in Medicaid through Molina Healthcare, Buckeye Health Plan or UnitedHealthcare Community Plan.

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Delegated Credentialing

We provide credentialing for all five Medicaid managed-care plans and most of the large commercial plans.

Claims Issue Resolution

Our staff is ready to assist you with resolving claims issues with the five Medicaid Managed Care Plans.

Continuing Education

You will receive cutting-edge education and updates about the Partners For Kids community through our monthly e-newsletter, webinars and website. Physicians can also achieve CME credit through Partners For Kids.

Electronic Medical Record Implementation

Working with information technology experts within Nationwide Children’s, we can assist in implementing a new eClinicalWorks EMR and a related Health Information Exchange. Thirty percent of the implementation fee is subsidized.

PROJECT ECHO

Project ECHO (Extension for Community Healthcare Outcomes) is a collaborative medical education and care management model that empowers clinicians to provide better care to more people: right where they live.

Learn More