Slide 1: One Care:  Implementation Council Meeting
Executive Office of Health & Human Services
MassHealth Demonstration to Integrate Care for Dual Eligibles
November 10, 2020, 10:00 AM – 12:00 PM
Virtual Meeting via Zoom
Slide 2: One Care Three-way Contract – Care Coordination (Section 2.5.3.)
•	The One Care Plan shall:
o	Offer Care Coordination to all Enrollees – 
•	Through a Care Coordinator (provider-based clinician or other trained professional) OR a Clinical Care Manager for medical/BH services
•	Through an LTS Coordinator for LTSS
o	Establish written qualifications for a Care Coordinator
o	Be responsible for appropriate training for the Care Coordinator and verifying that the training or any certifications remain current 
o	Have policies in place to address non-compliance with training by the Care Coordinators 
•	The Care Coordinator shall be responsible for the following:
o	Act as the single point of contact for a Member to the One Care Plan and the ICT;
o	Serve as a point-person to obtain or share information about a Member with other ICT members or with Providers as needed; 
o	Participate in Comprehensive Assessments for care planning;
o	Facilitating and supporting bi-directional communication with Providers who are responsible for the Member’s services; and
o	Monitoring the provision of services, including outcomes, assessing appropriate changes or additions to services, and making necessary referrals, as needed, for the Member
Slide 3: One Care Integrated Care Team (Section 2.5.2.4)
•	Plans must also recruit, select, train, manage, and employ or contract with appropriate and qualified personnel, including PCPs, Behavioral Health Clinicians, and Care Coordinators, and contract with LTS Coordinators, and maintain staffing levels necessary to perform their responsibilities under the Contract; 
o	Document that all members have participated in the required trainings;
•	Person-centered planning processes,
•	Cultural competence,
•	Accessibility and accommodations,
•	Independent living and recovery, and 
•	Wellness principles 
o	Ensure that the ICT is accessible to the Member, including by providing alternatives to office visits, including, as appropriate, home visits, email, and telephone contact.
Slide 4: One Care Plan - Readiness Review Highlights for Assessments and Care Coordination
•	MassHealth will be providing Technical Assistance (TA) to selected entities as part of Readiness Review for 2022 contract readiness. 
•	Readiness Reviews and TA will include a focus on these key areas.
•	MassHealth is also looking at near-term options for closer reviews to ensure care coordination currently meets contractual requirements.

Note: the following three items are shown on the left side of the slide in front of a triangle illustrating the three points of the review.

Evaluating for Best Practices in Care Coordination
Assessment and Integrated Care Planning Technical Assistance 
Alignment of these core principals 
Slide 5: Service Area Expansion
•	MassHealth and CMS have approved One Care service area expansions for Commonwealth Care Alliance’s One Care plan for 2021
•	Commonwealth Care Alliance will expand coverage to Berkshire County
o	Residents of Berkshire County have not had access to a One Care plan
o	We will be sending a “Welcome” mailing to all eligible residents in Berkshire County letting them know that One Care has arrived in their region
o	First effective enrollment date: January 1, 2021
•	Commonwealth Care Alliance will also expand to fully cover Plymouth County
o	Effective January 1, 2021, all residents of Plymouth County will have access to a One Care Plan
o	We will be sending a “Welcome” mailing to all eligible residents in Plymouth County that CCA is available to provide One Care throughout the county
Slide 6: Service Area Expansion continued
•	With these expansions, One Care will be universally available on the mainland of Massachusetts and there will not be partial counties in One Care.

•	Towns shaded Blue represent areas where both CCA and Tufts are available
•	Towns shaded Purple represent areas where CCA is available
•	Towns shaded Grey do not currently have One Care coverage

Note: this slide includes a map of Massachusetts showing areas of the state where Commonwealth Care Alliance (CCA) and Tufts Health Plan (Tufts) offers One Care coverage. The Blue area, where both CCA and Tufts are available, includes Middlesex, Suffolk and Worcester counties. The Purple area, where only CCA offers One Care coverage, includes Barnstable, Bristol, Essex, Franklin, Hampden, Hampshire, Norfolk, and Plymouth counties. The Grey area, where the One Care coverage is not currently available, includes Dukes and Nantucket counties.

Slide 7: One Care
MassHealth+Medicare
Bringing your care together

VISIT US ONLINE
www.mass.gov/one-care

EMAIL US 
OneCare@state.ma.us