One Care: MassHealth plus Medicare
MassHealth Demonstration to Integrate Care for Dual Eligibles
Implementation Council Meeting – MassHealth Update
March 28, 2014, 1:00 PM – 3:00 PM
One Ashburton Place, 21st Floor
Boston, MA

Slide 2: MassHealth and Implementation Council Planning Meeting 
•	MassHealth and Implementation Council chairs held a joint planning meeting on March 19, 2014
•	Topics discussed included:
o	2014 IC priorities
o	MassHealth’s planning timeline to maximize impact of IC input on decision processes
o	IC 2013 Annual Report
o	IC 2014 Work Plan
Slide 3: Total Enrollment
•	Effective March 1, total number of enrollees: 9,722
•	Total Enrollment by Plan
o	Commonwealth Care Alliance (CCA) – 6, 371
o	Fallon Total Care (FTC) – 2,549
o	Network Health – 802
o	Total: 9,722
•	Total number of opt-outs as of March 1: 17,701
o	Details regarding enrollment as of March 1 are posted in the Monthly Enrollment Report on the One Care website
o	April enrollment numbers expected in 2-3 weeks (will include Round 2 auto-enrollments)
Slide 4: Round Two Auto-Assignment
•	Number of people auto-assigned = Approx. 6,400
•	Assignment Approach 
o	Includes individuals from across the target population (rating categories C1, C2, C3)
o	In addition to primary care, MassHealth used data on where individuals accessed LTSS and behavioral health services to match individuals to a One Care plan
o	MassHealth worked closely with the One Care plans throughout the assignment process to understand their capacity to accept additional auto-assignment enrollments, and to maximize matches with their provider networks
•	Key Dates
o	January 24-27: 60-day notices mailed to enrollees
o	February 21: 30-day reminder notices mailed to enrollees
o	April 1: Coverage begins

Slide 5: Round Three Auto-Assignment
•	MassHealth and the One Care plans have begun discussions about round three auto-assignment, which will take effect July 1, 2014

•	At 3/19/14 planning meeting with Implementation Council representatives, MassHealth requested input regarding auto-assignment Round 3 by the end of March for consideration during the planning process
o	60-day notices will be mailed by April 28
o	30-day reminder notices will be mailed by May 28

Slide 6: LTS Coordinator
•	From continuing discussions with stakeholders and the Implementation Council, MassHealth is:
o	Refining a one-page description of the LTS Coordinator and the option for members to have one on their Care Team 
•	Draft incorporates language and feedback from LTS providers, community organizations, Implementation Council members, One Care plans, and EOHHS agencies
•	MassHealth anticipates finalizing the document for One Care plans to use by the end of April
o	MassHealth will develop a webinar on the LTS Coordinator role for providers, plans, LTS coordinators, community-based organizations, and others on the LTS Coordinator’s role in One Care

•	MassHealth will continue work with stakeholders to finalize the LTS Coordinator role document, develop key concepts for the webinar, and understand data around how the role is being implemented

•	Initial data is expected April/May

Slide 7: Mailing to Additional Members
•	In September 2013, MassHealth sent a One Care Enrollment Package to approximately 82,000 members and their guardians
•	From March 26-31, MassHealth is mailing another One Care Enrollment Package to 12,965 members and guardians:
o	Individuals who have become eligible for One Care since the September mail file was created
o	Others who appear eligible in MassHealth data, but were not mailed to in September
•	Enrollment packet is posted on the One Care website
•	MassHealth requests Implementation Council members’ participation in alerting their networks of this mailing

Slide 8: Mailing to Additional Members (cont’d)
•	The March 2014 mailing included a new “One Care Covers Prescription Drugs” insert with important information about Medicare Part D benefits in One Care

•	MassHealth developed the insert in response to feedback from members, advocates, and stakeholders about Medicare Part D coverage in One Care 

•	When members enroll in One Care, the One Care plan becomes their new Medicare Part D plan

Graphic of One Care poster containing text:
One Care Covers Prescription Drugs
MassHealth and Medicare are coming together to offer One Care, a new way to get your health care, services, and prescription drugs.  With One Care, you get all of your Medicare, MassHealth, and prescription drug benefits, including Medicare Part D, from a One Care plan.  Below is important information about getting your Medicare Part D benefits if you sign up for One Care. 
•	Your One Care plan would be your new Medicare Part D plan, and would also provide your other MassHealth and Medicare benefits.  You would still get your prescription drug benefits from your current Part D plan until your One Care coverage begins.  There would be no gap in your Part D coverage. 
•	There are NO COPAYMENTS for any prescription drugs in One Care. 
•	Each One Care plan may cover a different list of drugs.  This is sometimes called a formulary. Here’s how to find out if your drugs are covered. 
o	Call the One Care plans.  Contact information for the plans is in the Enrollment Guide that came with this insert. 
o	Visit the One Care plans’ websites and review their lists of covered medications.
o	Call MassHealth Customer Service at 1-800-841-2900 or TTY: 1-800-497-4648 (for people who are deaf, hard of hearing, or speech disabled). 
o	Call SHINE (Serving the Health Insurance Needs of Everyone) and speak with a trained counselor about your options. To schedule an appointment with a SHINE counselor, call 1-800-243-4636 or TTY: 1-800-872-0166 (for people who are deaf, hard of hearing, or speech disabled). 
•	If you are taking medications when you join One Care, you can get a temporary supply, even if the drugs are not on the plan’s list of covered medications. This will give you time to talk with your provider about making sure your medication needs are met. 

If you sign up for One Care, you will have one plan and one membership card.  You will also have one new way to live healthier, stay more active, and be more independent.  

One Care logo MassHealth+Medicare Bringing your care together
Please read the other materials in this packet to learn more about One Care. The information can help you decide if One Care is right for you. The materials also tell you how to enroll in a One Care plan. 

www.mass.gov/masshealth/onecare
Slide 9: Provider Engagement Strategy Update
•	Multi-prong strategy to continue to raise awareness of One Care among providers and to increase provider participation in One Care: 
o	Targeted Provider Awareness Campaign, Late Spring 2014 
•	Direct mail
•	Publicizing in trade and advocacy communication materials
•	Print advertising in trade publications
•	Participation and promotion at key meetings and conferences
o	Provider Learning Conference, June 2014
•	Conference theme:  Behavioral Health Integration and Primary Care 
•	MassHealth will present case studies and highlight examples of best practices in integrating delivery of care across medical, behavioral health, and long-term services and supports
Slide 10

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