Slide 1: Flexible Benefits
One Care Implementation Council Meeting
Commonwealth Care Alliance (CCA)
April 2024
Note: There is an image of an older adult man wearing a blue shirt with white stripes with his arm around an older adult women who is also wearing a blue shirt is on the first slide. 
Slide 2: Awareness around Flexible Benefits
Flexible Benefits: Items or services other than – or beyond the amount, duration, and scope of – covered services that would have clinical value to the member and keeps the member independent in the least restrictive setting.

Member Awareness
•	Member Handbook: Recommend members ask their Care Partner
•	Initial Welcome Call: Talk about needs and tailor recommendations to meet their needs
•	Care Partners: Deeply knowledgeable & looking for opportunities to offer to members
o	Other Team Members (like LTSCs, Community Clinicians, etc.) would route member needs to the Care Partner

Staff Training
•	Comprehensive, Ongoing Staff Training:
1.	Incorporated into workflows & resources
2.	Available on CCA’s Learning Platform
•	Standardized, Transparent Documentation:  Standard Operating Procedure & Medical Necessity Guidelines
•	Address in Case Conferences
•	Document on Care Plan
•	Explore other opportunities if the member is not eligible for flexible benefits

Note: the following footnote appears on this slide and all other slides going forward. “© 2024 Commonwealth Care Alliance® Confidential & Proprietary Information”
Slide 3: Ensuring Access to Flexible Benefits
Note: the following two items are shown on the left side of this slide with a bracket to the right of them showing that both are part of CCA monitoring.

Our systems are designed to track via:
Utilization Management Requests
Care Plan

CCA then monitors access & impact via:
1.	Ongoing assessment of member needs
•	Through Care Partners & members feedback
2.	Annual review using utilization data
•	To consider what benefits should be broadly 	available
•	To ensure flexible benefits are being utilized 	(demonstrating awareness and access)
3.	External reporting
•	Utilization report to MassHealth when requested (e.g., Care Management Focus Initiative)
o	Utilization reports are utilized as the fullest view of all requested flexible benefits.
Slide 4: Highlighting Examples of Flexible Benefits
Many our flexible benefits fall into the following categories:
•	Small appliances
•	Services to support a member during an out of home episode
•	Social connectedness
•	Additional LTSS services

Care Partners work with Members on individual unique needs, flexibly.