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MassHealth Demonstration to Integrate Care for Dual Eligibles. One Care: MassHealth plus Medicare. MassHealth Updates to the Implementation Council May 30, 2014,1:00 PM – 3:00 PM One Ashburton Place, 21 st Floor Boston, MA. Agenda for MassHealth Updates. Enrollment Status
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One Care: MassHealth plus Medicare
MassHealth Updates to the Implementation Council
May 30, 2014,1:00 PM – 3:00 PM
One Ashburton Place, 21st Floor
*Rating categories for three enrollments were unavailable at the time of this report.
MassHealth is collaborating with LTS Coordinator providers, advocates, Implementation Council members, One Care plans, and other state agencies to ensure that we have an effective Independent Living and Long Term Services and Support (LTS) Coordinator role in One Care
Out of these discussions, MassHealth and stakeholders identified the need for:
A standard overview document describing the LTS Coordinator role for members
Data on member access to and use of LTS Coordinators
Training opportunities for LTS Coordinator providers and plan staff
LTS Coordinator overview document
Developed in collaboration with stakeholders
Will be translated into Spanish, and available in Braille, large print, and as an ASL vlog
Anticipate distributing final version to One Care plans, CBOs, the One Care Ombudsman, state agencies, and others in July
Current and future One Care enrollees will receive the document
MassHealth will also make the document available on the One Care website for people to refer to when making enrollment decisions
LTS Coordinator utilization data
Data collection from One Care plans on member referrals to and refusals of LTS Coordinators has begun
MassHealth continues to work with the plans and CMS to ensure standardization and consistency in reporting
Preliminary data for the Oct.-Dec. 2013 period have been shared with the EIP
1,752 with identified LTSS needs; of this group:
563 (32%) referred
558 (32%) refused referral
1,121 (64%) either referred or refused referral to an LTS Coordinator
Data is very preliminary, and was collected retroactively; may not completely capture actual performance
The data establish a baseline for ongoing improvement efforts
MassHealth and UMass Medical School are working with stakeholders to develop training on the LTS Coordinator role for LTS Coordinators, One Care plan staff, and providers
MassHealth has shared an initial outline for a webinar with stakeholders and is seeking additional input on content, format, presenters, etc.
Additional trainings and other formats (e.g. online modules, in-person sessions) may be developed to meet the needs of different audiences
Action Steps and Status, cont’d
MassHealth recognizes the critical role the Implementation Council plays in One Care and will continue to collaborate with the Council to respond to issues including:
Information and data reported through the EIP workgroup and the One Care Ombudsman
Strategies for engaging providers
Methods for One Care plans to find and engage hard to reach populations
Outreach strategies to target and engage underserved populations
Understanding and improving accessibility
Email us at OneCare@state.ma.us