Medicare-Medicaid Demonstration Project Meeting November 19, 2015

Agenda Welcome and Introductions DISCUSSION: ACC:MMP Team Memorandum on Service Coordination Plan Spring 2015 Site Visits DISCUSSION: 2016 State Audit REVIEW: Monthly Reports

ACC:MMP Team Memorandum Noted strength was the adoption of “electronic systems to support comprehensive care management, including incorporation of the SCP.” Areas for improvement: Using outdated version of SCP Missing required elements of the SCP Incomplete SCPs reported in monthly report to State Blank vs Not Applicable Missing Attachments Client Summary Client Goals Shared Care Coordination/Case Management Assessment Narrative

2016 State Audit RCCOs will receive HSAG Audit Review Tool by 11/23; Jo will forward this as well as any other written directions from the State, to all delegates working on the MMP Demonstration HSAG will review MME charts AND SCPs Sample size of 10 MMEs with an oversampling of 5 MMEs for each RCCO (which means 30 for CO Access) Sample will be pulled from monthly ACC:MMP Reports of Members reported to have had a completed SCP

REVIEW: Monthly Report Metrics Requested Metrics for Service Coordination Plan Report Delegated MMP Care Coordination Activities: 1.A new Service Coordination Plan was completed by Delegate. 2.A Service Coordination Plan was updated by Delegate. 3.Percentage (or number) of Clients discharged from a hospital, nursing facility, or other institutional setting who were contacted for care coordination by Delegate within three to seven (3-7) days following discharge. 4.Number and type of referrals Delegate provided for MMP Members.

MME Metrics, continued Care Coordination Challenges: 1.A list of MMP Members, including names and Client IDs, for whom Delegate or its subcontractor was not able to obtain accurate information for during the reporting period. 2.Delegate attempted to contact at least three (3) times, using two different contact methods, but did not receive a response during the reporting period. 3.The Member refused care coordination during the reporting period. 4.The Member was ineligible with reason for their ineligibility. 5.Other – any reason that does not fit within the list of potential challenges. MMP Protocols: Delegate shall include the number and types of providers (Single Entry Points, Community Center Boards, Behavioral Health Organizations, Skilled Nursing Facilities, hospitals, home health organizations, and hospice organizations) Delegate has contacted to comply with protocol requirements during the reporting period.

SCP Metrics – MMP Members COA_Delegate Metric Template Hospital Discharge Information: By RCCO Number of discharges from hospitals, nursing facilities, or other institutional settings in Reporting Period Number of discharge follow-ups within 3-7 days in reporting period Percentage of Discharges contacted within 3-7 days of discharge Member-specific list, by RCCO #, First/Last/Medicaid ID/Metric Reported/High Risk/Attempts 1-3