North Carolina’s Dual Eligible Beneficiary Integrated Delivery Model

Slides:

Advertisements

Similar presentations

Culturally and Linguistically Appropriate Services And Clinical Trials (EDICTs CLAS-ACT) Armin D Weinberg Baylor College of Medicine.

Advertisements

New America Forum April 12, 2010 New America Forum: A First Look at Implementing Health Reform The Delivery System Challenge State Implementation Issues.

Medicaid Division of Medicaid and Long-Term Care Department of Health and Human Services Managed Long-Term Services and Supports.

The Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration Jody Blatt Senior Research Analyst Project Officer, MAPCP Demonstration Medicare Demonstrations.

DSRIP & Bronx Partners for Healthy Communities: An Overview

Medicaid Health Homes Presented by: Jayde Bumanglag, Quinne Custino & Sean Mackintosh.

Michelle Apodaca, J.D. Stacy E. Wilson, J.D. April 20, 2012 Medicaid Section 1115 Waiver Overview.

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

11 Opportunities to Improve Care for Persons with Disabilities: The Community Living Initiative IMPLEMENTING NATIONAL HEALTH REFORM IN A DIFFICULT ECONOMIC.

New York State Workforce Investment Board Healthcare Workforce Development Subcommittee Planning Grant Overview.

Community Care of North Carolina 2012 Overview. Medicaid challenges  Lowering reimbursement reduces access and increases ER usage/costs  Reducing eligibility.

1 Michigan’s Long-Term Care Conference Hilton Detroit, Troy March 23-24, 2006 Michigan Nursing Facility Transition Initiative.

Section 1115 Medicaid Waiver Renewal Workforce Development Expert Stakeholder Workgroup Framing Our Discussion Anastasia Dodson Department of Health Care.

Patient Centered Medical Homes Marcia Hamilton SW722 Fall, 2014.

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

Overview Community Care of North Carolina. Our Vision and Key Principles  Develop a better healthcare system for NC starting with public payers  Strong.

SustiNet Board of Directors Recap of Board Decisions Summary of Survey Reponses on “Additional Questions” December 15, 2010.

Affordable Care Act Aging Network Opportunities Judy Baker Regional Director Health and Human Services October 18, 2010.

Primary Care and Behavioral Health 2/4/2011 CIBHA.

Title text here Health Homes: The 4 th Long-Term Care Policy Summit September 5, 2012 Wendy Fox-Grage AARP Public Policy Institute.

Section 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions Mike Hall, Director Division of Integrated Health Systems Disabled.

VISIONING SESSION May 29, NWD Planning Grant  One year planning grant, started October 1, 2014; draft plan by September 30, 2015; final plan by.

Stephanie Hull MGA Conference Chief, Long Term Services and Supports June 7, 2012 Maryland Department of Aging.

Balancing Incentive Program and Community First Choice Eric Saber Health Policy Analyst Maryland Department of Health and Mental Hygiene.

The Indiana Family and Social Services Administration Section 2703 Health Homes July 13,2012.

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

DataBrief: Did you know… DataBrief Series ● September 2010 ● No. 1 Characteristics of Dual Eligibles 33% of dual eligibles suffer from diabetes, stroke,

Michigan Department of Community Health Director Olga Dazzo Michigan’s Plan for Integrated Care National Academy for State Health Policy Kansas City, Missouri.

Community Care of North Carolina 2011 Overview March 15 th, 2011.

“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.

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

MA Reform Waiver David Godfrey Medicaid Director Minnesota Department of Human Services December 5, 2011.

Open Public Meeting February 28, pm – 5 pm 1 Ashburton Place, Boston MassHealth Demonstration to Integrate Care for Dual Eligibles.

Practice Transformation Initiative AlignmentCCPNHHNPTN Practice Transformation Network is a 4-year CMS sponsored program that prepares NC and SC providers.

Putting people first, with the goal of helping all Michiganders lead healthier and more productive lives, no matter their stage in life. 1.

Promoting Health Information Technology Linda Magno Director, Medicare Demonstrations Group.

Roadmap to Change: Updating Maine’s Response to the Olmstead Decision Project Overview.

Welcome! 1 To hear the audio portion of this presentation, please call: 1 (877) When prompted, enter participant code: # We will begin shortly!

Johns Hopkins Bloomberg School of Public Health Medicare Beneficiaries with Serious Physical or Cognitive Limitations (PCI) Karen Davis Roger C. Lipitz.

The Medicaid waiver program

All-Payer Model Update

Renee Markus Hodin, JD Director, Integrated Care Advocacy Project

Can Managed Care Turn the Tide for Complex Populations?

Update on CMS Financial Alignment Initiative and State Integration Efforts Inside and Outside Demonstration Authority Lindsay Barnette Medicare-Medicaid.

The Maryland Experience Cynthia H. Woodcock

Human Services Delivery Systems and Organizations

DY7 and beyond A new DSRIP structure …..

MLTSS Delivery System SubMAAC

Health Homes – Providing Care to Our Recipients

SNP Alliance Executive Roundtable March 19, 2012 Suzanne Gore, JD, MSW

Department of Health and Human Services Stakeholder Engagement

Supporting the Leadership of State, Territorial and Local Jurisdictions in Integrated HIV Prevention and Care Planning An Update from the Centers for.

Integrated Care Initiative

North Carolina’s Dual Eligible Beneficiary Integrated Delivery Model

Rural Health Network Development Program Funding Opportunity Released By: U.S. Department of Health and Human Services Health Resources and Services Administration.

Region 15 Regional Healthcare Partnership 38th Public Meeting

Health Homes – Providing Care to Our Recipients

Sco Senior Care Options Bringing Medicare and MassHealth Together.

Greater Columbia ACH Board of Directors 4/19/17

Cascade Pacific Action Alliance

Synopsis of CCNC Initiatives

Older American Act Amendments of 2006

Characteristics of Dual Eligibles

67th Annual HSFO Conference Louisville, KY

All-Payer Model Update

The Care Transitions Network

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

Community Collaboration A Community Promotora Model

Student loan support to strengthen the health care workforce:

Learning Collaborative

Presentation transcript:

North Carolina’s Dual Eligible Beneficiary Integrated Delivery Model Overview April 16, 2012

Integrated Delivery Model Goals Improve responsiveness to beneficiary goals, Improve care quality, and Achieve shared savings

Strategic Framework Development Process Why: Design a model to integrate Medicare and Medicaid services and supports to dual eligible beneficiaries Who: 180 + volunteers including beneficiaries and more than 50 agencies & organizations What: Define what works well, what needs improvement

Acknowledges Individual differences in quality of life goals, Wisdom of preventive services/quality care, Need for flexibility to meet individual beneficiary goals to accommodate variation in the availability of natural supports and community resources

Building on Strengths Existing statewide medical home and population management strategy Community Care of North Carolina (CCNC) has 14 regional Networks In top 10 percent nationally on quality of diabetes, asthma, and heart disease care

Beneficiary Centered Medical Homes Work with beneficiaries as they define and refine their goals Physician led medical home teams to assist in the achievement of goals

Phase 1 Development Medical homes for dual eligible nursing home and adult care home residents Independent assessment & functional need-based process for resource allocation Beneficiary and other stakeholders Work Groups to: Continue to refine the model, Guide implementation & evaluation and Design & implement community education

Community Education & Dialog Topics Medical home and model quality monitoring Beneficiary goal setting and team dynamics Importance of advance directives to specify personal preferences for instances when unable to express preferences yourself about physical health care and/or mental health care

Phase 2 – With Shared Savings Realign financial and regulatory incentives to: Build capacity & expand service and support options Establish new working relationships and information sharing, and Encourage broader use of actionable data

Proposal Review Process March - April NC Public Comment and Editing Period May 2 May - June Federal Public Comment and Review Period July - August CMS/NC Memorandum of Understanding Developed NC Proposal Submitted to CMS

Implementation Time Line Fall 2012 CMS/NC Negotiate Agreements Readiness Review Notifications 2013 Phase 1 – 18 months ACH/NH Residents Develop Independent Assessment & $$ Allocation Process Community Education/Dialog Phase 2 est. Mid -2014 & 2015 Shared Savings Become Available Information Sharing & Capacity Incentives Assess & Allocation Process Implemented/ More Flexible Use of Funds