« The Dual Agenda: February 19, 2015 Issue

State Highlights

California

The California Department of Health Care Services (DHCS) released new data on Health Risk Assessment (HRA) completion rates in the Cal MediConnect program. The data released is for HRAs completed within 90 days of enrollment during Quarters 2 and 3 (April – September 2014).Seventy-eight percent of the HRAs were completed within the 90 day timeframe. HRA is a survey tool that assesses an enrollee’s current health risk and identifies further assessment needs and is used as a basis to develop the enrollee’s individual care plan. Plans are required to conduct the HRA within 45 days for beneficiaries that have high risk, and 90 days for low-risk beneficiaries.

In other news, the latest enrollment numbers show that 123,079 beneficiaries were enrolled in the Cal MediConnect program as of February 1, with 178,701 beneficiaries opting-out of the program.

Massachusetts

MassHealth, the state’s Medicaid program, released the December and January One Care enrollment reports. As of January 1, the total number of enrollees is 17,867. The total number of opt-outs, as of January 1, is 26,593. The state will host the next open meeting regarding the One Care program on February 27.

Michigan

On February 3, the Michigan Department of Community Health (MDCH) announced the start of enrollment for MI Health Link, the state’s dual eligible demonstration project. MI Health Link will be active in four regions of the state and will launch in two phases. Phase 1 includes the entire Upper Peninsula and eight counties in southwest Michigan. Phase 2 includes Wayne and Macomb counties.

Ohio

The Medicare-Medicaid Coordination Office posted a provider outreach letter geared towards Medicare providers in Ohio to inform them about the MyCare Ohio dual demonstration project.

In other news, the latest budget proposal by Ohio Governor Kasich proposes to eliminate independent home health providers. Under the proposal, the independent providers would still be paid through 2016, but by 2019 would have to be paid through home health agencies. The elimination of this vital role will significantly impact consumers, including those in the MyCare Ohio duals demonstration. The Ohio Consumer Voices for Integrated Care (OCVIC) coalition members are working collaboratively with other consumer advocacy organizations and coalitions to oppose this provision and ensure that consumers are protected.

Rhode Island

Martha Watson, Advanced Nurse Practice Manager at Miriam Hospital and Geriatric Provider Advocate for the Rhode Island Voices for Better Health project, recently conducted the first of three training sessions with a group of nurse case managers on falls prevention for the older adult population at the Neighborhood Health Plan of Rhode Island (NHPRI). NHPRI is currently serving the long-term care needs of dual eligibles, and is expected to be part of Rhode Island’s forthcoming duals demonstration project. Other relevant resources that were shared at this training are: Falls Change Package and Falls Summary Guide.

South Carolina

The Medicare-Medicaid Coordination Office posted frequently asked questions for providers participating in the South Carolina dual eligible demonstration project, called Healthy Connection Prime.

Texas

The Medicare Medicaid Coordination Office posted frequently asked questions for providers participating in the Texas dual eligible demonstration project.