Administrative Memos

200109

FROM: Theodore O. Will, Chief Executive Officer
DATE: Jun 26, 2001
SUBJECT: Medicaid Project: Congestive Heart Failure
IPRO CONTACTS:

Charles Stimler, M.D., M.P.H., Clinical Coordinator, ext 634, Monte Malach, M.D., F.A.C.C., M.A.C.P., Medical Director/Clinical Coordinator, ext 634 and Barbara Shields, R.N., C.P.H.Q., Director

Enclosed please find a statewide report on "Medicaid Congestive Heart Failure - New York Statewide Report". A major goal of this quality improvement project is to increase utilization of angiotensin converting enzyme inhibitors (ACEI) in eligible Medicaid patients (those with left ventricular systolic dysfunction heart failure) without contraindications.

IPRO has been working with physicians, providers, and other health care personnel since 1996 to increase the rate of use of ACEI for patients with congestive heart failure (CHF). There has been an improvement over the years, and currently approximately 87% of the Medicaid patients with CHF appear to have appropriate use/non-use of ACEI. Among those patients who are not admitted on an ACEI, however, nearly a quarter (22.6%) of those eligible for ACEI are not started on one prior to hospital discharge.

Other findings indicate other opportunities to improve. The use of beta-blockers prior to admission (a marker for the extent of use in the community) now recommended for many patients with CHF, was at 23.9% which is lower than the rate in a comparable Medicare population.

Other results of interest to those caring for Medicaid patients with CHF are presented in the attached report. Please note also the enclosed "Summary Sheet" which presents a brief overview of the major results.