L.A. Care Health Plan currently offers an asthma disease management program called “ L.A. Cares About Asthma” to our Healthy Families, Healthy Kids, and Medi-Cal members directly enrolled with L.A. Care. 

Your L.A. Care members in these programs that are identified with asthma according to our data are automatically enrolled into this program.  Participation is voluntary, and patients may opt out at any time.  Program participants are identified and stratified by severity levels monthly and receive health education materials on a regular basis.  High risk members are eligible to receive a phone call or home visit by our asthma care manager. 

Your practice can use these disease management services by referring your L.A. Care Healthy Families, Healthy Kids, and Medi-Cal (directly enrolled with L.A. Care) patients with asthma into the program and by reviewing the clinical reports that are mailed to your office on a quarterly basis. 

In support of our commitment to improve outcomes for all of our members identified and diagnosed with asthma, you will receive the following reports if you have L.A. Care members with asthma:

1.      Asthma Registry Report - designed to provide an aggregate report of patient-specific data across all of L.A. Care’s product lines

2.      Asthma Care Reminder - designed to support our asthma disease management program for our Healthy Families, Healthy Kids, and Medi-Cal (directly enrolled with L.A. Care) members

1.     The Asthma Registry Report includes the following information based on the previous 12 months of available data:

·         Provider’s total L.A. Care membership by product line, including Medi-Cal, Healthy Families and Healthy Kids

·         Provider’s total membership diagnosed with asthma

·         ER visit rate for your patients with asthma with the L.A. Care network-wide average

·         Hospitalization rate for your patients with asthma with the L.A. Care network-wide average

In addition, the report includes patient-specific data, including the risk stratification level assigned based on the available data.  The risk stratification is designed to indicate if the patient is likely to be at a high, moderate, or low risk of having uncontrolled asthma.  Please note that this risk assignment is not necessarily aligned with the clinical severity classification you have determined for your patients according to their symptom frequency pattern.  This patient-specific data allows you to quickly glance at the report and identify those patients that may need to be called in to assess for control (e.g., patients with one or more ER visits in the reporting period).

2.  The Asthma Care Reminder -- sent only to physicians with assigned L.A. Care Healthy Families, Healthy Kids, Community Health Plan (CHP) Medi-Cal, and L.A. Care Medi-Cal (directly enrolled with L.A. Care) members with asthma -- is designed as a full-page report with information on one patient per page and contains the following:

·         History of asthma-related office, ER, and hospital visits

·         Medication history for all prescriptions filled, regardless of prescribing physician, as an L.A. Care member benefit, (i.e., purchased using their L.A. Care member I.D. card) along with the calculated controller-to-reliever ratio

·         L.A. Care’s target controller-to-reliever ratio

·         Risk stratification level

·         Feedback section to facilitate communication with L.A. Care.

The controller-to-reliever ratio is one way to assess the appropriateness of asthma medication management.  While it is not a perfect measure, it does provide a relative measure of the extent to which patients are using controller and rescue medications.  A low controller-to-reliever ratio implies a patient is less likely to be in good control due to the relatively high rate of use of rescue medications (e.g., albuterol).

We have designed these reports for your use if you believe it can add value to your practice.  Our hope is that you will consider using it as a case management tool.  It may assist you in identifying those patients that might benefit from a focused office visit to address educational needs or barriers to effective asthma control.  It may also be utilized as a teaching tool to facilitate communication with your patients. This report can then be filed in your patient’s medical record should you choose to adopt it.  We have also provided a convenient feedback section at the bottom of the form which you can use to refer patients into our asthma disease management program. 

L.A. Care also offers a diabetes disease management program "L.A. Cares About Diabetes" for Healthy Families, Healthy Kids, Medi-Cal (directly enrolled with L.A. Care) and Medicare members.  Members can receive enhanced health education, telephonic coaching from a nurse, and information on social services to help them manage their conditions.  L.A. Care has contracted with Healthways, a disease management vendor to provide this service.  Physicians can call (866) 756-2048 to refer members with diabetes who are enrolled in direct lines of business.  Eligibility criteria will apply.

For more information about disease management, please contact Phinney Ahn at (213) 694-1250 x4379.

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