SDHF Roundtable Series Connecting Health and Housing | Presented by: Sabra Matovsky June A Health Plan Perspective

Molina Healthcare – Founded in

Molina Healthcare, Inc. Footprint includes 4 of the 5 biggest Medicaid Markets 3 Molina Health Plans Molina Medicaid Solutions Direct Delivery 1.Total enrollment relates to effective membership as of March 31, Puerto Rico commenced operations on April 1 st, 2015 and is not reflected in the total membership county 3M 1 members

Molina Healthcare of California 4 35 years serving Medi-Cal members Unique focus on government-sponsored programs – Medi-Cal – Medicare – Cal MediConnect (duals demo) – Marketplace (Covered California) 574,000 members across 6 counties 181,000 Medi-Cal in San Diego alone Top NCQA ranked Medi-Cal plan in all of our service areas Molina Service Area

Recent San Diego Initiatives = Health Plan Growth June Added Seniors and Persons with Disabilities (SPDs) to Medi-Cal Managed care (5,200 lives) January County’s Low Income Health Plan moved into Medi-Cal managed care (17,500) January Newly eligible Medi-Cal populations (mostly single adults) are now eligible for Medi-Cal managed care (37,500) January 2014 – State introduces a new Medi-Cal managed care mental health benefit for mild/moderate services (all Medi-Cal beneficiaries 181,000) April Coordinated Care Initiative launches. Most of the remaining fee-for-service Medi-Cal moved to managed care (4,200). Cal Medi-Connect integrating Medi-Cal and Long Term Supports and Services commences also (5,400). 5

Medicare Medicaid Plan (MMP) Demonstrations Cal Medi-Connect in San Diego 6 California (CalMediConnect) Molina is participating in 4 counties. San Diego, Riverside, San Bernardino started voluntary enrollment in April 2014, passive enrollment in May Los Angeles started passive and voluntary enrollment in July Illinois (MMAI) Molina is participating in 15 counties in the Central Region. Voluntary enrollment started in March Passive enrollment started in June Texas (Texas Dual Eligible Integration Project) Molina is participating in 5 large counties with significant duals Star+Plus membership. Voluntary enrollment started March Passive enrollment started April South Carolina (Healthy Connections Prime) The state initially set a statewide service area. Molina’s primary focus is 23 counties. Voluntary started Feb Passive to follow. Ohio (MyCare Ohio) Molina is in 3 regions (Southwest, Central and West Central), 13 counties. Voluntary enrollment started June Passive enrollment started January Michigan (Michigan Healthy Link) Molina is participating in the 2 largest counties (Wayne and Macomb). Voluntary enrollment started May Passive enrollment starts July Contracts awarded to MOH Demo states started Membership Data from CMS Monthly Report of MA Enrollment by State/County/Contract, January 2015

Medicare Medicaid Plan (MMP) Demonstrations Cal Medi-Connect in San Diego Health Risk Assessments-uses utilization history and medical- psycho-social evaluation to determine care management needs. Care Plans-member centric, multi-disciplinary teams-includes input from member, PCP, social worker, medical director, pharmacy, member’s caregiver, IHSS supervisor, etc. Care Manager-serves as primary contact for all member needs Long-term supports and services-coordinated by the health plan Health Plans responsible for non-psychiatric custodial care-members used to disenroll back to fee-for-service Medi-Cal. 7

Housing and Health Pilots- The Next Frontier Key Health Plan Decisions Target population-Large enough to demonstrate success, but small enough to be manageable. Lots of need in the Medi-Cal population pilots need to show success in order to continue. Scope- Pilots need to show cost savings, but whose cost? Medical costs vs. law enforcement, community cost? Who is willing to share risk of program success/challenges? May require re-designing how certain parties conduct business currently. Administration-With a lot of opportunities (local, statewide) which ones make sense? Need to look at return on investment of time and money vs. benefits and choose wisely. Multiple models add cost, is there a clear benefit to trying alternate models? Long-Term Benefits-Best opportunity to learn, build infrastructure, partnerships and shared understanding for the future. Can we use infrastructure, models and lessons learned from the pilot for future expansion to additional populations? 8