LQN is a Force Multiplier

Dr. Katie Queen is one of the few physicians in the country board certified in both Pediatrics and Obesity Medicine. By establishing the first Louisiana Childhood Obesity ECHO through LQN, she is able to extend her unique expertise to other clinicians across the state, caring for the most severe cases of pediatric obesity. Dr. Queen conducts live lectures and case consultations to expand treatment capacity throughout the state, including high-need rural communities.

Bridging the Gap: Addressing Social Determinants of Health

Social determinants of health greatly impact Medicaid patients' well-being and the program's efficiency and cost. Factors such as income levels, education gaps, housing instability, food insecurity, and transportation barriers can worsen health disparities and raise chronic illness rates.

By establishing alternative resources, coordinating local support resources, and improving communication with the patient community, LQN hospitals are directing patients to more appropriate care, both improving outcomes and lowering Medicaid costs.

"Every day, we see patients who are caught in a cycle of emergency room visits, not because they want to be there, but because they have nowhere else to turn,” said Cassie Twist, a social worker at Our Lady of the Lake Hospital in Baton Rouge.

"We had one patient who was frequently expelled from dialysis centers for aggressive behavior, had no permanent home, and did not have access to regular meals. As a result, he was frequently in the ED for treatment. I had more than 90 interactions with him.”

“Through our holistic approach, we not only secured his medical care but also addressed his housing and nutritional needs. We even helped him find a home with a supportive environment and better access to dialysis treatment and primary care.”

Months after settling into his new home, the patient reached out to Cassie to express his gratitude. “His simple holiday greeting was a profound affirmation of our work, a reminder that when we treat the whole person, not just the symptoms, we can truly change lives."

Reducing Return Visits to the Hospital

One solution to reduce hospital readmissions is to give patients the tools they need to follow their treatment plans and make it easier to access the medications prescribed to them. LQN has promoted the innovative “Meds to Beds” program throughout its member hospitals to ensure patients have all their medications prior to discharge. By reducing or eliminating all the extra steps a patient may need to take to access prescribed medicines, Meds to Beds improves adherence to their prescribed treatment and reduces the risk of medical complications, which may lead to readmission.

Jason Lindsey of North Oaks Hospital’s Case Management Department said “Many of these patients cannot access the medicines prescribed to them, either because they can’t get to the pharmacy, are confused as to what they need to take, or don’t want to spend more money on a new prescription, so they may just take the medicine they might already have at home.”

The Med to Beds program goes beyond just helping the patient. As Jason explains, getting the discharging teams to utilize the program is an important key to success. This includes simplifying the administrative process to get the right medicines directly to patients.

“By collaborating with nursing and pharmacy leaders, we’ve educated providers and developed streamlined processes, reducing the administrative burden and allowing healthcare professionals to focus more on patient care rather than paperwork.”

These improvements have led to a significant reduction in readmissions, positively impacting patient health outcomes and enhancing the overall efficiency of healthcare delivery.

LQN Put Theory into Practice, Cutting Costs and Eliminating Risks

Dr. Jeffrey Elder smiled down at the treatment plan. He realized at that moment that LQN’s efforts to reduce Low Value Care had become ingrained in practices at University Medical Center New Orleans. He was huddling with physicians about how to treat a patient with chronic sinusitis, and the conversation followed LQN’s script to a tee. And it is a conversation happening at hospitals throughout Louisiana because of LQN, explained Dr. Elder.

“Everyone wants to eliminate low value care in theory, but it takes a lot to get physicians to change their practice habits. LQN has put theory into practice. We created the structure to look at the data and educate frontline care providers. Now they’re lowering risks to patients while lowering costs to Medicaid, not only at UMC but also at every hospital in the LQN.”

Extending the Expertise of Louisiana’s Busiest Birthing Hospital

Woman's Hospital in Baton Rouge, an LQN member, holds a remarkable distinction as the top deliverer of babies in the state. Renowned for its commitment to maternal and infant health, the hospital serves as a beacon of excellence, championing better outcomes for mothers and newborns. Through LQN, Woman's Hospital shares invaluable wisdom, guidance, and tools to aid fellow network members in implementing stronger protocols and enhancing care standards.

Recognizing the power of communication, LQN emphasizes storytelling as a catalyst for change. Woman’s Hospital experts share best practices and guide others through Grand Round Presentations and by helping to identify necessary improvements and training opportunities. These collaborative efforts exemplify the core values of LQN, fostering a culture of shared learning and continuous improvement to ensure that every mother and infant receives the highest quality of care.

A Network Exclusively Dedicated to Quality

The MCIP program is available to all Medicaid Managed Care Organizations (MCOs) and Louisiana hospitals that are participating through two distinct networks. Louisiana Quality Network (LQN) is one of those networks.

The Most Trusted Names in Healthcare on a Collective Mission

The LQN banner represents a consortium of 12 healthcare systems and hospitals across Louisiana and five MCOs that came together to participate in the MCIP program. The Louisiana State University Health Sciences Center - New Orleans administers the program for the Network.

As providers of about half the state’s Medicaid services, LQN is improving the quality and delivery of medical care while creating cost-saving efficiencies.

Quantifiable Metrics that Make a Real Difference in Health and Efficiency

LQN focuses on measurable improvements and outcomes in the four Approved Incentive Arrangements (AIAs) over a five-year period (2019-23). These four AIAs were selected because they are seen as creating the greatest impact on improved healthcare, patient outcomes, and program efficiencies.

Within this set of AIAs are some 40 specific milestones each year that build on one another, allowing for continuous improvement over the course of the program and beyond.

Keeping Moms and Babies Healthy

“A patient arrived at our Emergency Department with a headache and high blood pressure just a week after giving birth. We followed the protocols put in place through the MCIP program and discovered a hemorrhage. Without these quality protocols, the new mom would likely have been discharged without detecting the hemorrhage. Because of the MCIP program, we prevented a possibly life-threatening situation and avoided the need for a more costly healthcare response.”

– Dr. Maria Buenaflor

Our Lady of the Angels Hospital, Bogalusa

Ending Costly Low Value Care

“On my last clinical shift, I explained to my patient that the CT scan they were asking for would not give us the information we needed and in addition would expose them to radiation the equivalent of 100 chest x-rays all at one time. My patient very much appreciated the explanation and our care. They went home more knowledgeable about their illness and what to do in the future. And we saved on the cost of the test, which would have been well over $1,000.”

- Jay Kaplan, M.D., FACEP

Medical Director of Care Transformation, LCMC Health

Keeping Patients Healthy & Out of the Hospital

“Patients are often confused, anxious, and overwhelmed after discharge from the Emergency Department. Aligned with the goals of the MCIP program, we’re helping patients navigate the complicated healthcare system, arming them with the knowledge they need to manage their follow-up instructions safely at home and help ease their concerns. This helps patients connect to the most appropriate point of care and allows our Emergency Departments to focus on the patients most in need.”

– Lisa McGowan, RN

LCMC Care Manager

Empowering People to Manage Their Care

In Tangipahoa Parish, LQN member North Oaks Health System is already seeing a reduction in avoidable healthcare services. Aligned with the MCIP program, the hospital is taking proactive steps to help patients, like Mr. Abbott, stay healthy. They call to check on him, to make sure he’s taking his medication, and to remind him about upcoming appointments. They’re also quarterbacking his team of care providers to improve efficiencies and outcomes, and they even arrange transportation to ensure Mr. Abbott can make it to treatments.

Ensuring ERs are for Emergencies

In Baton Rouge, LQN member Our Lady of the Lake Regional Medical Center created a “Navigation Program” in the Emergency Department. Diane Reidy, the Senior Director for Care Management, explains that people who lack financial resources or insurance traditionally have used ERs as their primary healthcare resources, because they knew they were places where they could get care. She’s quick to point out that many such patients were financially stable until a major accident or illness wiped out their finances.

Aligned with the goals of the MCIP program, the medical center is helping patients “navigate” toward more appropriate care, and they’re seeing a steep decline in unnecessary ER visits.

“Medicaid does not help with getting access to care unless someone helps people understand how to use it,” said Reidy. “The ER is care for your ‘right now’ problem; it is not designed to take care of you over a long term.”

That’s where Emily Stevens, the Social Services Manager, and her team comes in. When a frequent ER patient arrives, social workers intervene to identify patients’ issues and facilitate an overall smooth process to address them – right from the ER. The results: a steep decline in costly, unnecessary Emergency Department visits and a notable improvement in healthcare outcomes for patients.