Division of Health Care Finance

Slides:

Advertisements

Similar presentations

DDRS Health Homes Initiative: Meeting the Triple Aim through Care Coordination. Shane Spotts Director, Indiana Division of Rehabilitation Services May.

Advertisements

Public Educational Tour July 30-August 2, Agenda Introductions KanCare – State presentation MCO – presentations – Amerigroup: Andrea Allen, Marsha.

PALLIATIVE CARE WAIVER STAKEHOLDER MEETING California Department of Health Services Medi-Cal Policy Division 11/29/06.

Acquired Brain Injury Home & Community-Based Services Waivers

1115 WAIVER Utah Department of Health Division of Medicaid and Health Financing 1Chacon.

Housing and Health Care Programs and Financing that Integrate Health Care and Housing Housing California Institute April 15, 2014 John Shen Long-Term Care.

Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing 1 CCT & MDS 3.0 Section Q Return to the.

1 Wisconsin Partnership Program Steven J. Landkamer Program Manager Wisconsin Dept. of Health & Family Services July 14, 2004.

It’s All About MME Tasia Sinn September 18, 2014 Understanding Colorado’s New Medicare- Medicaid Enrollee (MME) Program.

1 Autism Commission Presentation January 24, 2011 Lisa McDowell, Director of Institutional, Residential & Day Services MassHealth Office of Long Term Care.

Health Homes for People with Chronic Conditions: A Discussion with Dr. Moser 10/24/2013Dr. Robert Moser Webinar.

Medicaid Managed Care: KanCare Request for Proposals House Social Services Budget Committee Topeka, Kansas January 11, 2012 Scott Brunner Senior Analyst.

San Diego LTCI Project Timothy C. Schwab M.D. CM/IO January 12, 2005.

Virginia’s Blueprint for the Integration of Acute and Long-Term Care Services The Second National Medicaid Congress Cindi B. Jones, Chief Deputy Director.

1 Empowering Patients & Consumers to Access and Effectively Use High-Value Care Marcia J. Nielsen, PhD, MPH Executive Director.

MassHealth Managed Care for Older Members and Members with Disabilities Lori Cavanaugh Director of Purchasing Strategy NASHP Annual Conference October.

KanCare Implementation Update Becky Ross Medicaid Initiatives Coordinator KDHE/Division of Health Care Finance Kansas Medical Society Webinar 9/6/2012.

Healthy Alaska Plan Alaska Medicaid Redesign Initiative North Star Council on Aging Senior Center presented by Denise.

Medicaid Managed Care Program for the Elderly and Persons with Disabilities Pamela Coleman Texas Health and Human Services Commission January 2003.

Section 1115 Waiver Implementation Plan Stakeholder Advisory Committee May 13, 2010.

“Reaching across Arizona to provide comprehensive quality health care for those in need” Our first care is your health care Arizona Health Care Cost Containment.

Maryland Medicaid’s Partnership in Improving Behavioral Health Services Susan Tucker Executive Director, Office of Health Services May 14, 2014.

Home and Community Based Services Waiver Integration Project Public Information & Listening Session.

Transition to Reform in Wisconsin Donna McDowell, Director Bureau of Aging & Disability Resources Department of Health Services D. McDowell1.

1 1 Michele Goody, Director Cross Agency Integration July 2014 Community First MassHealth Initiatives and Programs.

Patient Protection and Affordable Care Act The Greens: Elijah, Amber, Kayla, Patrick.

1115 Waiver Proposals California Children’s Services Program.

General Assistance – Unemployable Experience in WA state July 2010.

KanCare Renewal Stakeholder Feedback Forums May 24, 25 and 26, 2016; 1:00-3:00 and 5:30-7:30 pm Topeka, Kansas City, Wichita, Hays & Pittsburg, Kansas.

1 Drug Medi-Cal ODS Demonstration Waiver Small County Strategic Planning May 25, 2016.

Suzanne S. Gore Director, Policy and Research Virginia Department of Medical Assistance Services SNP Alliance Meeting October 10, 2013 Commonwealth Coordinated.

Older Americans Act Mental Health Provisions: Collaborative Strategies of AoA and SAMHSA American Public Health Association 2007 Annual Meeting November.

Community Based Care for Older Adults with Complex Needs: The PACE Program Matthew McNabney, MD Medical Director, Hopkins ElderPlus June 25, 2016.

Better Care Coordination for High-Need Beneficiaries: What Works, and for Whom? SNP Alliance Annual Leadership Forum A National Conversation on Integration.

Care Management for All

The Medicaid waiver program

Alaska Medicaid January 27, 2014

Debra Hurwitz, MBA, BSN, RN CTC-RI Co-director October 20, 2016

Meghan Davey, Medicaid Director

Can Managed Care Turn the Tide for Complex Populations?

Coordination of Care and Integrated Care New York State Perspective

Overview – Behavioral Health Care in Utah

Transition to Adult Services and Collaborating with Community Supports

Medicaid Delivery model Options for Nevada

Consumer protections in Medicare – Medicaid coordinated care models SNP Executive roundtable March 30, 2015 Lynda Flowers Senior Strategic Policy Advisor.

Medicaid Managed Long Term Services and Supports – Moving Forward

Department of Medical Assistance Services

Integrated Care Initiative

CALIFORNIA FOUNDATION FOR IDEPENDENT LIVING CENTERS STATEWIDE MEETING

Health Homes – Providing Care to Our Recipients

Pediatric Innovations in Medicaid Whole Child Model

Sco Senior Care Options Bringing Medicare and MassHealth Together.

House Social Services Budget Committee Meeting February 6, 2013 Overview of the Kansas Department for Aging And Disability Services Presented by: Shawn.

Division of ACF / Assisted Living Surveillance

Long Term Services and Supports (LTSS) Quality in KanCare

Behavioral Health Integration in Centennial Care

TBI Waiver Services Information

CMS ITU Outreach and Education Event May 17, 2018

NC Dual Eligibles Advisory Committee September 23, 2016

67th Annual HSFO Conference Louisville, KY

2019 Model of Care Training University of Maryland Medical Systems Health Plans, Inc. Proprietary and Confidential.

Trends & Transitions: Future for Long Term Care

Mark Trail, Managing Principal

West Virginia Medicaid Summit

Harvard Pilgrim Quality Programs

Student loan support to strengthen the health care workforce:

AIDS/HIV Brain Injury Children’s Mental Health Elderly

Helping People Achieve Healthier, More Independent Lives

86th Legislative Session Overview

Texas Council Managed Care Summit

Presentation transcript:

Division of Health Care Finance Michael Randol, Director

Discussion Topics KanCare Overview Features and Benefits Partnerships- KDHE, KDADS, MCO KanCare Going Forward

KanCare - Current KanCare 1115 Waiver Project In year 4 of a 5 year demonstration 95% of populations and services included Break down silos of care Improve quality/outcomes while bending cost curve down Provide integrated, coordinated care Increased emphasis on health, wellness, prevention, early detection and early intervention

KanCare Composition

KanCare Populations *HCBS Services includes Autism, Severe Emotional Disturbance, Technology Assisted, and Traumatic Brain Injury **Long Term Care includes Nursing Facilities, Money Follows the Person Frail Elderly and Physically Disabled, and the Physically Disabled and Frail Elderly Waivers

Key Features of KanCare Coordinating care for the whole person Clear accountability Improving health outcomes Consolidation of financing

Whole Person-Centered Care Coordination No reduction in current levels of Medicaid services and eligibility New services include: Heart and lung transplants for adults Weight-loss surgery Valued-added services In lieu of services Options counseling

Improving Outcomes Through the contracts with the managed care organizations (MCOs), we are focused on: Lessening reliance on institutional care Decreasing re-hospitalizations Managing chronic conditions Improving access to health services

Financing Consolidation Move almost the entirety of Medicaid into a capitated risk-based managed care system KanCare contractors will be rewarded for paying for preventive care that keeps people healthy

KanCare Benefits for Kansas Added new services and benefits (Bariatric surgery, heart and lung transplants and Value Added Services) 2013 through 2015 Total members getting value added services Total units of value added services provided Total value of value added services provided Combined three KanCare MCOs 520,515 1,722,637 $14,634,532

KanCare - Utilization Comparison

KanCare Cost Comparison

KDHE MCOs KDADS

KDHE Single State Medicaid Agency. Responsible to CMS for all Medicaid programs, policy and implementation decisions Manages FFS and Medical programs (non-Medicaid) Works collaboratively with KDADs Provides oversight of MCOs

KDADS Manages community based programs policy and eligibility (such as HCBS, Mental Health, and SUD) Licensing and credentialing for community programs Nursing facilities, and PACE Senior care act, Medicare programs Oversees state hospitals (OSH, Larned, Parsons and KNI)

MCOs Contracts with providers to ensure services are delivered to our members Manage provider network to ensure service provision (contracting and Credentialing) Coordinate care in community and transitions between in-patient services Provide health literacy and preventive services Assist in identifying and supporting members with special health care needs (complex health needs, disabilities, mental health or substance use treatment needs)

KanCare Renewal - Process Conduct Renewal Stakeholder Forums May 2016 Develop Draft Renewal Application June-July 2016 Post Application for Review and Tribal Consultation Aug.-Sept. 2016 Renewal Application Submitted to CMS November 2016 CMS Public Notice & Consultation With State Throughout 2017 CMS Decision & Special Terms and Conditions Issued By 12.31.17

KanCare – Potential Changes Continued improvement in coordination and integration of care Payment based on outcomes and value Waiver Integration

KanCare Website http://www.kancare.ks.gov/