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

Slide 3: Total Enrollment

•	Effective June 1, total number of enrollees: 13,409
•	Total Enrollment by Plan
o	Commonwealth Care Alliance (CCA) – 7,846
o	Fallon Total Care (FTC) – 4,661
o	Network Health – 902
o	Total – 13,409
•	Total Enrollment by Rating Category
o	F1 – 18
o	C3B – 143
o	C3A – 2,150
o	C2B – 623
o	C2A – 3,001
o	C1 – 7,472
o	Unavailable* - 2
o	Total – 13,409
o	*Rating categories for two enrollments were unavailable at the time of this report.

Slide 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
•	Notes -  
o	60-day notices sent to ~9,300 people
o	30-day notices sent to ~7,000 people
o	People who made enrollment decisions (opted in earlier, changed plans, opted out) will not receive a 30-day notice.  Drop also accounts for undeliverable mail. 

Slide 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

Slide 6: LTS Coordinator: Training

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

Slide 7: LTS Coordinator: Member Education
•	A 1-page overview for members on the LTS Coordinator has been developed in collaboration with stakeholders
o	Will be translated into Spanish, and available in Braille, large print, and as an ASL vlog
o	Anticipate distributing final version to One Care plans, CBOs, the One Care Ombudsman, state agencies, and others in July
o	Current and future One Care enrollees will receive the document
o	MassHealth will also make the document available on the One Care website for people to refer to when making enrollment decisions

Slide 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

Slide 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
o	Comments were due June 20
o	Measures will be finalized in the near future

Slide 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
o	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
o	One Care plans: Provided overview of use and disclosure policies for BH information, and the processes to obtain member consent for disclosures
o	DMH and DPH:  Agency role is to provide support and ensure that plans are in compliance with BH privacy requirements   
•	Next steps: 
o	Continue discussion to ensure that members are educated, informed, and afforded an opportunity to determine how BH information is collected and used
o	Continue to review plan processes and collectively identify best practices / improvement initiatives

Slide 11: Provider Outreach
•	MassHealth is working with MORE Advertising to place full- and half-page advertisements in provider journals
o	Geographic targeting
o	Behavioral health and primary care provider targeting
•	Shared Learning Conference on Integration of Behavioral Health and Primary Care held in June
o	Case study approach
•	Behavioral health provider specific outreach:  MassHealth will meet with some high-volume diversionary service and outpatient providers
o	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 

Slide 12: Community Outreach
•	MassHealth is working with to implement additional outreach strategies
o	Video vignettes of One Care members
o	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
o	Implementation Council representatives 
o	EIP focus group and survey results

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

Slide 14: 
•	Visit us at www.mass.gov/masshealth/onecare 

•	Email us at OneCare@state.ma.us