Dual Eligible Special Needs Plan Model of Care. SNP Model of Care. The SNP (Special Needs Plan) Model of Care is the architecture for care management policy, procedures, and operational systems for members with both Medicare and Medicaid otherwise known as Dual Members.
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Dual EligibleSpecial Needs PlanModel of Care
The interdisciplinary care team includes at a minimum a:
Individualized Care Plans are developed as a guide for care delivery in conjunction with the member/caregiver, primary care provider, appropriate specialists and other key community or institutional professionals. Care Plans include, but not limited to:
Fidelis Care maintains an interactive website through which members, providers and the public can receive information on Fidelis Care health plans, network providers, current health care initiatives and advice to maintain a healthy lifestyle
Fidelis Care will also communicate with its members and providers:
The quality committee structure of Fidelis Care is designed to ensure that all activities pertaining to performance and the health outcomes of the SNP members, the quality of service delivery and appropriate utilization management are evaluated at multiple levels throughout the organization.
The SNP Model of Care is evaluated annually making any necessary and appropriate changes. The evaluation includes review of the eleven elements which comprise the MOC including:
Fidelis establishes clinical programs to assure that members with exceptional needs (i.e., the frail, near end-of-life, dementia needing supervision, etc.) receive recommended preventive care as well as the appropriate care for acute and chronic illnesses. These programs include activities to: