Expert Panel Task Force Foci & Potential Questions

Medical knowledgeand health care technology: Breast and cervical cancer

Medical research and health care technologies offernew possibilities for screening and referral for breast and cervicalcancer. Current knowledge and practicesand projections for the future must inform WHN policy.

· What services should be provided: breast screening, cervical screening,breast diagnostics, cervical diagnostics? …and to whom (age)? Should an annualvisit be required?

· What are the criteria for entering at the diagnostic level?

· What risk assessment should be used to trigger enrollment for women toenroll? Breast/cervical? What screening services should be offered to womenidentified at high risk?

· How should WHN stay informed about new technologies, procedures, andprotocols?

Medical knowledge and health care technology: Cardiovascular disease

Medical research and health care technologies offernew possibilities for screening and for CVD risk reduction and for lifestyleinterventions to reduce CVD risk.

· What services should be provided: Screening (ht, wt, BP, lipid panel,glucose), diagnostics, lifestyle interventions? Should an annual visit berequired?

· Is it possible to offer CVD services to all women enrolled in theprogram?.

· Who should conduct risk assessments?

· Which lifestyle interventions are likely to have the greatest impact onCVD risk? Nutrition, Physical Activity, Smoking

· What are the implications of recent developments in relevant medicalknowledge and technology for CVD screening and counseling?

Healthdisparities and barriers to health care access

WHN is a program to lessen disparities in healthbetween low income, uninsured women and others. Changes in WHN should help to improve program effectiveness for groupsthat differ by race and ethnicity, language, culture, immigration and refugeestatus.

· What disparities exist in terms of breast cancer, cervical cancer,cardiovascular disease?

· Which programmatic approaches would be most successful in reducinghealth disparities?

· How do economic and social resources, healthcare, and individualservice preferences vary with social group?

· What provider and service system characteristics create barriers tohealth care?

Health caredelivery systems

The WHN program operates within a complex andchanging organizational environment that includes public and private hospitals,community health centers, professional associations and advocacy groups.

· What organizational system models maximize WHN effectiveness?

· What laws and regulations must be taken into account in WHN operations?

· What information technology would improve WHN interface with the largerhealth care system?

Case management

Case Management is a mandate of the federallegislation that guides the WHN policies and protocols. Case managers currentlydeliver services through one of the program’s 26 contracted vendors. Case Managers often play many different WHNroles within the current contract structure.

· How should case management be conducted: Site specific, regional, statewide?…contracted by case? …telephonic/in-person? Etc.

· What qualifications are most appropriate for WHN case managers?

· What team structure is most conducive to effectively case managing WHNclients? Culture/language differences?

· What additional training should be available for case managers?

· Should case management be different for CVD/chronic disease cases?

Fiscalmanagement and WHN business operations

Cost and reimbursement considerations affect theinterest of health care providers in participating in WHN. Changing insurance policies and the economicsof health care must be factored into an effective strategy for the WHNprogram.

· What is the most effective operational structure to support thecomplexities of WHN billing/payment/database maintenance?

· Should WHN provide services to under-insured women? How can a vendorknow who is under-insured?

· How does the availability of free care pool funding shape provider andclient interest?

· How does funding for a selective set of services affect providerparticipation?

· Diagnostic payment is not available for CVD services, does this presenta problem for provider participation?

Education,outreach and enrollment

Effective client education, outreach and recruitmentare essential for the success of WHN.

· What is the most effective and efficient type of enrollment:Centralized, site specific, regional? Who will assist clients with enrollmentpaperwork and verification?

· Which outreach strategies are most cost-effective for recruiting WHNeligible women from culturally and linguistically diverse groups? How shouldoutreach be coordinated and evaluated?

· What are the most effective strategies for educating culturally andlinguistically diverse groups about screening, diagnostics, case management,preventative services and interventions?

· What is the most effective and efficient way that WHN canprovide/support educational opportunities for vendors, providers, clinicians,community based outreach staff, and DPH-WHN staff?