Health Programs and Campaigns

Members Empowered to Succeed (METS) is a Behavioral Health clinical program within Buckeye Health Plan that has been successfully supporting Ohio providers and members for two years.

METS takes a unique approach to member care focusing on the individualized needs to create a recovery roadmap that is personalized to the member. We partner with both the provider and the member to ensure the member achieves the ultimate level of recovery and resiliency. Our Clinical Liaisons are licensed clinicians that work directly with BH providers to identify the member’s treatment and supports needed for successful progress in treatment. Our Member Engagement Service Coordinators reach out telephonically to the member to identify needs and resources to meet the member’s behavioral health, social, and medical needs.

Benefitis and Outcomes of METS

• Integrated, whole health approach to member’s needs and care including behavioral
• Health, medical, therapeutic, pharmacy, and supplemental
• Cross-care team partnership to ensure coordination of care and collaborative
• problem solving
• Coordination of services and treatment between multiple providers
• Knowledge of covered services such as expanded benefits or new programs and how to access
• Access to various physicians and specialists to promote diversity among providers and treatment team

Please know that no release of information is required. PHI that is used or disclosed for purposes of treatment, payment, or healthcare operations is permitted by HIPAA Privacy Rules (45 CFR 164.506) and does not require consent or authorization from the member.

For questions, please contact Provider Services.

Partnering with Visiting Physicians Palliative Care, Buckeye is proud to share that we have created an exciting clinical program affectionately called Harmony Cares.

Harmony Cares provides support to members with chronic illnesses that may need assistance with managing their health within their home and assists with filling care gaps. However, it is not your typical palliative care program that is a precursor to hospice, but rather a program to assist members who would like to have an added level of support from a Nurse Practitioner in their home that works with their Primary Care Provider.

Services offered by the program:

• In home or Telemedicine visits
• Injectable medication to manage acute symptoms
• In-home mobile X-ray & ultrasound services
• In-home lab draws processed by VPA CAP accredited laboratory within 24 hours
• Post hospital visit within 48 hours of an acute admission
• Psychosocial assessment completed by a Licensed Clinical Social worker to address social needs
• Provide appropriate screening and assessments to close HEDIS gaps
• 24/7 patient support to assist with afterhours and weekend clinical questions or requests
• Real-time health information exchange alerts for inpatient admits/discharges or ER visits for members

Service Area

At this time, Buckeye is servicing Cuyahoga County, Lorain County, Lake County and other neighboring counties. If you have a patient/our member that you feel may benefit from having a visit from a Certified Nurse Practitioner through VPA please see the contact information below. Each patient is looked at individually and visits are based on the patient’s need.

Referral Considerations

Here are some things to consider when reviewing your patients for a possible referral. Members:

• With chronic conditions, including but not limited to, the following diagnosis i.e
  • Diabetes
  • COPD
  • Heart Failure
  • Chronic Pain
• That have frequent inpatient admissions or ER visits
• Who may not have a great understanding of their disease process and may require more education
• Wiith symptoms that are difficult to manage

If you believe your patient may benefit from this amazing program, please contact:

Luann Mobley, RN CM
Buckeye Health Plan
Harmony Cares Coordinator
330-690-0769

or

Call Visiting Physicians directly at 440-202-1635

Providers, Let’s Partner!

Buckeye Health Plan is looking to partner with participating providers to facilitate care gap closure events. Our recently introduced Buckeye HealthConnect van serves the state of Ohio and rotates from region to region. Buckeye is looking for provider partners to staff the mobile unit with clinical staff to provide clinical services. The van is designed to be multifunctional, allowing us to meet and address multiple member needs and close gaps in care. Examples may include backpack drives and flu vaccinations.

Our van features

• Size: 164” X 98”
• 2 Collapsible Desks
• First Aid Kit
• Fridge
• Sink
• Eye wash station
• Diagnostic Wall System
• Storage Cabinets
• Wifi
• Air conditioning & heat
• Generator
• Outlets
• Rear lift gate

 We Can Provide

• Mobile Clinic
• Drivers
• Member outreach
• Assistance with logistics planning
• Data and quality assessments and outcomes
• Supplies and materials

HEDIS Measures and Care Gap Closures

• Support Community Events
• Support Social Interventions
• Access to Preventive/Ambulatory Health Services
• Controlling High Blood Pressure
• Adult BMI Assessment
• Flu Vaccinations/HepB
• Diabetes Control
• Children and Adolescents' Access to Primary Care Practitioners
• Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
• Childhood Immunization Status
• Immunizations for Adolescents
• Colorectal Screening

Currently Scheduled Locations

• Columbus    August – October, 2021
• Cincinnati    November – February, 2021 to 2022
• Toledo         March – April, 2022
• Cleveland    May – July, 2022

Billing Information

• The service code for mobile unit is Place of Service 15
• Buckeye will reimburse for this service code for Buckeye members
• Although Buckeye will focus on identifying members with care gaps, there is not an expectation for outreach and services to only include Buckeye members. Providers can provide services to their patients and community members according to their administrative policies, billing and strategic initiatives.
• Providers will have access to outlets and wifi and can bring their laptops to connect to their EMR system

We are pleased with the response we’ve received from community and provider partners. Partnerships will be prioritized among the mobile unit initiatives, planning and operations. Requests must be made in advance and are subject to availability and capacity

Providers Request to Partner

Note: Please be aware that Buckeye reserves the right to deny requests based on schedule conflicts. All requests are reviewed and subject to alignment with our mission and guidelines and agreement to comply with terms and conditions. Submission of a request does not guarantee approval of request. The mobile unit cannot be used to support fundraisers or political activities

Did You Know: Your patients are likely to get a flu shot if you recommend it.

You can make a difference! Help your patients get their flu shot.

Take these steps to help protect them from the flu:

• Make a strong recommendation to your patients to get their flu shot. Research shows that patients are more likely to get a flu shot if their doctor recommends it.
• Follow-up is important! If your patient did not get the flu shot during their visit, there’s a chance they didn’t get it at all. Talk to your patients about where and when they’ll get their flu shot, and make a note to confirm during their next visit.
• Talk with your patient about any questions or concerns — and be sure to repeat your strong recommendation. Most people know the flu shot is important. They may just need your reminder!

Learn SHARE:

• Share reasons to get the flu shot based on their age or other risk factors.
• Highlight positive experiences with the flu shot to reinforce benefits. 
• Address concerns about the vaccine, including effectiveness, side effects, safety and misconceptions. Patients are less likely to push back than you may think.
• Remind patients that the flu shot not only protects them but also everyone around them.
• Explain that getting the flu can mean taking sick days from work or missing fun with family and friends.

For additional assistance, download this Talking Points (PDF) file.

All 5 Ohio Managed Care Plans (MCP) are proud to partner with the Ohio Department of Medicaid (ODM) to improve the health and well-being of all Ohio Medicaid members. Now, we’ve established a dedicated initiative to focus on improving the lives of our diabetic members through the Diabetes Self-Management Education (DSME) program covered by all MCPs.

What is DSME?

• Members receive instruction and counseling on:
  • Healthy eating habits
  • Weight management
  • Use of glucose meter
  • Insulin pen
  • Other tools
• The program utilizes Medicaid approved providers such as physicians, pharmacists, nutritionists or other trained health care providers throughout the state to assist providers and members. You can find one near you by accessing the list of DSME providers on our website. 
• This partnership has also made it easier for providers and members to order and receive diabetic supplies. We have agreed upon an easier prior authorization process for glucose meters and standard diabetic supply amounts. The hope of the agreement is members will be more willing to test their blood glucose, which in turn would lead to better glucose control, better health and well-being of the members and lower health care cost.
• Additionally, MCPs can supply support with member outreach for scheduling and home testing kits for members who are hard to reach or have barriers to receiving regular care at provider facilities.

For assistance with resources or more information on any of these services please contact your MCO representative at your convenience.

Diabetes Self-Management Education Program (PDF)

In August, Buckeye began a robust Dental campaign to members through mail, postcards and other methods. 

We created an Infographic for you to download for talking points or to share with your patients.

For your reference, we also want to share the Tip Card that was sent out

To see more details on our Dental campaign, please see our Dental page on the member website page.

Healthy Food Rx Partnership

In 2020, Buckeye partnered with Lower Lights Christian Healthcare Center, an FQHC located in urban Columbus, to provide a Healthy Food Rx program for adult Medicaid members who have chronic health conditions (uncontrolled diabetes, hypertension, obesity). The program is focused on providing participants with nutrition education and access to healthy food through Lower Lights’ Jubilee Market. The Food Rx program provides members with six months of curriculum, monthly check-ups with primary care providers and healthy groceries, recipes/cooking demonstrations and sampling.

Goals are to:

• Reduce health disparities resulting from poor access to healthy, affordable food; and lack of understanding about nutrition, and healthy food preparation.
• Improve health outcomes among members with uncontrolled diabetes, hypertension and obesity by increasing healthy, nutritious food in their diets.
• Increase awareness, understanding and adoption of healthy food purchasing, preparation and eating habits.

How Does the Partnership Work?

• Buckeye provided a grant in June 2020 to fund the Healthy Food Rx program with Lower Lights Christian Health Care Center
• The six-month program helps 21 Buckeye members develop healthy eating habits that will remain with them for years to come.
• Each month, medical and nutritional staff provide education and encouragement to members to make healthy choices.
• Members receive a $60 grocery prescription card each month to use at Lower Lights’ Jubilee Market and Cafe for fresh produce, grains, legumes and other healthy foods. In addition, they get help from a dietitian, receive a $15 monthly meal kit and easy-to-prepare recipes, as well as attend educational workshops, food tastings and cooking demonstrations.

Initial Program Outcomes through October 2020

• 21 active members participating
• Members reported significant weight loss
  • Seana D. lost 21 pounds in 3 months
  • Dixie H. lost 14 pounds in 3 months
• Members said that they enjoy the monthly meal kits that includes easy-to-make recipes and fresh ingredients.
• Members noted that monthly dietician appointments helped lower their intake of: 
  • Salt
  • Sugar
  • Processed foods
• Members Darren D. and Sam L. noted that they enjoyed cooking healthy recipes with their children and encouraging them to make healthier choices

A Video journal documents the progress and perceptions of participating members

Breast cancer is the second most common cause of cancer-related death for Ohio women. But when it’s detected early, most breast cancer can be treated successfully. As part of Buckeye Health Plan’s commitment to improving the health of the community, one person at a time, we’re encouraging all women age 45+ to protect themselves through regular mammograms.

Buckeye helps make it easier

We help our members with no-cost transportation to and from their mammogram — and this is an extra benefit that doesn’t count toward their annual transportation benefit. Plus, Buckeye members ages 50-74 can earn $75 in reward dollars just for getting their mammogram.

NOTE: Providers enrolled in our P4P program get rewarded, too! $10 for every patient who completes their mammogram.  If you are interested in enrolling in our P4P program call 866-296-8731 to find out more today!

Mammogram Infographic for Patients (PDF)