MassHealth Demonstration to Integrate Care for Dual Eligibles

1. MassHealth Demonstration to Integrate Care for Dual Eligibles One Care: MassHealth plus Medicare MassHealth Updates to the Implementation Council June 27, 2014,1:00 PM – 3:00 PM One Ashburton Place, 21st Floor Boston, MA

2. Agenda for MassHealth Updates • Enrollment • Auto-Assignment • LTS Coordinator Role • Quality Monitoring and Outcomes Measurement • Behavioral Health Privacy • Provider Outreach • Community Outreach • Demographic Data 2 2 2 2 2 2

3. Total Enrollment • Effective June 1, total number of enrollees: 13,409 3 *Rating categories for two enrollments were unavailable at the time of this report.

4. Auto-Assignment • Round 3 auto-assignments take effect July 1 • 60-day notices sent to about 9,300 people • Final number of auto-assignments that take effect will be smaller, due to individual decisions (opt in early, select different plan, opt out), and undeliverable notices • July 1 monthly enrollment report will include updated statistics 4

5. LTS Coordinator: Utilization Data In April/May, MassHealth presented data on member referrals to and refusals of LTS Coordinators for 2013 to the Implementation Council and EIP Workgroup MassHealth continues to work with the plans and CMS to ensure standardization and consistency in reporting We expect to report on a quarterly basis to capture a meaningful volume of longitudinal data EIP Workgroup will include LTS Coordinator utilization data trends in quarterly One Care indicator dashboard reports 5

6. MassHealth and UMass Medical School are developing a training webinar on the LTS Coordinator role for LTS Coordinators, One Care plan staff, and providers Responding to stakeholders’ request for a uniform, consistent training curriculum Stakeholders provided input on webinar content and discussed developing additional trainings and alternative formats to meet the needs of different audiences Webinar will be recorded and posted to the One Care learning website LTS Coordinator: Training 6

7. A 1-page overview for members on the LTS Coordinator has been 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: Member Education 7

8. Quality Monitoring and Outcomes Measurement • MassHealth presented on quality management to EIP workgroup in June. The group discussed: • Domains • Timeline • Context for quality metrics • Inaugural meeting of the Quality workgroup to be held this summer • The Quality workgroup will: • Review quality and outcome measures • Identify initiatives and/or metrics for ongoing collaboration • Develop and implement timelines and work plans for joint MassHealth/Implementation Council quality monitoring activities

9. Quality Monitoring and Outcomes Measurement (cont’d) • MassHealth is aware that stakeholders are interested in quality and monitoring activities that include reviewing data on plan expenditures for community-based LTSS, versus medical services and facility-based LTSS • Withhold measures: CMS issued a request for comments on state-specific withhold measures by June 20 • Comments were due June 20 • Measures will be finalized in the near future

10. Behavioral Health Privacy • MassHealth convened a discussion with DMH, DPH, Mental Health Legal Advisors Committee (MHLAC), Implementation Council representatives, and the One Care plans to discuss BH privacy concerns • MHLAC: Sought to better understand One Care plan processes to safeguard and protect BH information, and ensure it would not be used to stigmatize members • One Care plans: Provided overview of use and disclosure policies for BHinformation, and the processes to obtain member consent for disclosures • DMH and DPH:  Agency role is to provide support and ensure that plans are in compliance with BH privacy requirements    • Next steps: • Continue discussion to ensure that members are educated, informed, and afforded an opportunity to determine how BH information is collected and used • Continue to review plan processes and collectively identify best practices / improvement initiatives

11. Provider Outreach • MassHealth is working with MORE Advertising to place full- and half-page advertisements in provider journals • Geographic targeting • Behavioral health and primary care provider targeting • Shared Learning Conference on Integration of Behavioral Health and Primary Care held in June • Case study approach • Behavioral health provider specific outreach: MassHealth will meet with some high-volume diversionary service and outpatient providers • Topics for discussion: • Overview of One Care • Health plan interactions/ relationships • Volume of One Care members served • Brainstorm ways to outreach and serve members who are homeless and unreachable/hard-to-reach

12. Community Outreach • MassHealth is working with to implement additional outreach strategies • Video vignettes of One Care members • Informal conversations about One Care with enrollees and potential enrollees at community organizations such as • Independent Living Centers • Recovery Learning Communities • Homeless services agencies • Held outreach event at Boston HealthCare for the Homeless • Additional events planned for Pine Street Inn/Rosie's Place and facilities in other geographic locations • ARCs • Also exploring the possibility of targeted outside-the-home paid media (e.g., community newspapers, transit, radio) • One Care website redesign to incorporate feedback from • Implementation Council representatives • EIP focus group and survey results

13. Demographic Data • Implementation Council has recommended adding sexual orientation and gender identity to assessments • MassHealth engaging the One Care plans to identify barriers to collecting, documenting, and retrieving data • Will explore existing system and practices at Fenway Health Center and other practices 13

14. Visit us at www.mass.gov/masshealth/onecare Email us at OneCare@state.ma.us