Slide 1:  One Care Implementation Council Meeting
Executive Office of Health & Human Services
MassHealth Demonstration to Integrate Care for Dual Eligibles
October 12, 2021, 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
Slide 2:  MassHealth Updates

•	Topics being covered….
o	MassHealth COVID-19 Vaccination Updates
o	MassHealth COVID-19 Vaccination Comparison Rates
o	Integrate Care COVID-19 Guidance Updates
o	One Care Procurement Updates
Slide 3:  MassHealth COVID-19 Vaccination Updates
•	MassHealth COVID-19 Vaccination Incentive Payments
o	In Spring 2021, MassHealth created incentive payments for plans to increase vaccination rates for their members. For One Care, incentives would be paid to plans that fully vaccinated at least 80% of their members in the 20 cities/towns identified by the State as disproportionately impacted by COVID-19 by June 30, 2021.
o	MassHealth has been repeatedly at the forefront in the nation on making sure reimbursement for our healthcare partners for vaccination is high and high enough to incentivize prioritization of that work.
o	MassHealth is now reimbursing providers for vaccine counseling codes to provide incentive to address vaccine hesitancy “in the moment.” 
•	Department of Public Health and State driven efforts;
o	Efforts to target minority communities that have seen higher rates of infection,
o	Mobile vaccine clinics provided by the State and Providers Systems, and
o	The in-home vaccination program.
Slide 4: MassHealth COVID-19 Vaccination Updates cont.
•	No Wrong Door for Vaccinations
o	MassHealth wants vaccinations to be readily accessible to all members regardless of who administers the vaccination 
•	Additional Vaccinations* for Individuals who are: 
o	Immunocompromised
o	Ages 65 and older
o	Ages 18-64 and at increased risk for severe COVID-19 due to underlying medical conditions
o	Ages 18-64 and at increased risk for COVID-19 because of occupational or institutional settings
•	MassHealth will turn on all the necessary operational and payment components for third dose vaccinations, update tracking, and continue to push on plans to prioritize vaccination and communication with members

*Currently available only to individuals who received Pfizer vaccinations, but MassHealth will update this guidance based on any upcoming federal approvals.
Slide 5: MassHealth COVID-19 Vaccination Comparison Rates
Note: the following statistics are shown in a bar chart and a table on this slide.

One Care Members Comparison to FFS Equivalent:  Received At Least One Dose of COVID-19 Vaccination*

FFS-Duals:  Adult
Total Members	106,917
At least one dose	70,791
% of Total	66%

COMMONWEALTH CARE ALLIANCE
Total Members	28,868
At least one dose	19,597
% of Total	68%

TUFTS HEALTH UNIFY
Total Members	3,244
At least one dose	2,046
% of Total	63%

*data pulled from 8/18/2021 MassHealth Vaccination dashboard
Slide 6: MassHealth COVID-19 Vaccination Comparison Rates Cont.
One Care Members Comparison to FFS Equivalent:  Received Full Dose of COVID-19 Vaccination*

FFS-Duals:  Adult
Total Members	106,917
Fully Vaccinated	65,534
% of Total	61%

COMMONWEALTH CARE ALLIANCE
Total Members	28,868
Fully Vaccinated	18,013
% of Total	62%

TUFTS HEALTH UNIFY
Total Members	3,244
Fully Vaccinated	1,885
% of Total	58%

*data pulled from 8/18/2021 MassHealth Vaccination dashboard
Slide 7: Integrated Care COVID-19 Guidance Updates
•	MCE Bulletin for One Care, PACE, and SCO – expect to be effective late October/early November 2021
o	Certain activities, including Telehealth, will continue through the federal Public Health Emergency (PHE)
o	For members who haven’t been seen in-person in the last year, Plans must attempt to engage in-person with those members to evaluate for changes in status, and must develop criteria to prioritize these members
o	Assessments will return to in-person interactions as the default, with telehealth (preferably video) available for members who prefer not to be in-person
o	Removes limitations from performing care management in-person
o	Plans must address PPE needs for assessments and care management, and support members in accessing PPE for in-home and community-based services
o	Telehealth alternatives must meet the members’ accessibility and communication needs, and the mode of engagement (audio, video, etc.) must be documented in the member’s record
o	Plans are encouraged to continue providing meal preparation, grocery delivery, and other supports to help members access food
o	Plans must help enrollees access available federal, state, and community resources and assistance programs, including for food, housing, financial, heating, and other types of assistance
Slide 8: One Care Procurement Updates
•	The procurement for One Care plans is on track for implementation for January 2022.
•	New Three-way Contract for 2022 to implement procurement under the current demo terms has been executed with the three selected entities: CCA, Tufts, and United
o	Effective for 1/1/22; effectively replaces current Contract; expect to operate for 1 year under current Demo, which was extended through 12/31/22
•	Starting this month, members can request enrollment for January 1, 2022 
•	The Integrated Care Team would like to extend our sincerest gratitude to the Implementation Council Consumer Reviewers for all the hard work they have done to get us to this point.
Slide 9: One Care 2022 Service Areas
•	While the One Care service area overall will be the same as in 2021 (all mainland counties, which accounts for 12 of 14 Massachusetts counties), members will have additional plan choices in several counties.
•	Eligible members will have a choice of two or more One Care Plans in 9 of 14 Massachusetts Counties.
•	Commonwealth Care Alliance will be available in the following 12 counties: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester.
•	Tufts Unify will be available in the following 6 counties: Bristol*, Middlesex, Norfolk*, Plymouth*, Suffolk, and Worcester.
•	UnitedHealthcare Community Plan will be available in the following 9 counties: Bristol, Essex (partial county), Franklin, Hampden, Hampshire, Middlesex, Plymouth, Suffolk, and Worcester.

* Tufts Service Area Expansion effective January 1, 2022
Slide 10: One Care MassHealth + Medicare
Bringing your care together
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