Minnesota’s Demonstration to Integrate Care for Dual Eligibles

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The Minnesota Department of Human Services (DHS) is building on current state initiatives to improve performance of primary care and care coordination models for dual eligibles served in integrated Medicare and Medicaid Special Needs Plans and fee-for-service delivery systems. Dual eligibles refer to people who have benefits through Medicare and Medicaid (known in Minnesota as Medical Assistance).

Existing initiatives include integrated Medicare and Medicaid Special Needs Plan managed care programs such as Minnesota Senior Health Options (MSHO) and Special Needs BasicCare (SNBC), implementation of health care homes including the Medicare Advanced Primary Care Practice demonstration, and provider payment reform through the Integrated Health Partnerships. Proposed improvements include development of system-wide performance measures, risk adjustments, provider feedback systems and risk/gain sharing models specific to the dually eligible population.

Minnesota is working with the federal Centers for Medicare & Medicaid Services (CMS) to stabilize Medicare Advantage Special Needs Plans’ participation and to further integrate Medicare into these initiatives.

To access more information on this topic, please go to Public Meetings. These meetings will be held periodically to share information on the demonstration and get input from clients, stakeholders and other interested parties.

What’s New

Save the date for the Best Practice Care Coordination Conference, Monday, November 17, 2014.

Status update on the Dual Demo Project as of August 15, 2014

  • • On September 12, 2013, DHS and the Centers for Medicare and Medicaid Services (CMS) signed a Memorandum of Understanding (MOU) establishing a Demonstration to Align Administrative Functions for improvements in Beneficiary Experience (Demonstration).
  • • The demonstration began on September 13, 2013 and continues until December 31, 2016 and is designed to reduce costs associated with beneficiaries eligible for both Medicare and Medicaid, or dual eligibles.
  • • The demonstration’s Dual Demo Work Plan is also available for review.
  • • For historical information please go to Dual Demo Historical Information.
  • Status update on the Integrated Care System Partnerships (ICSPs) as of August 15, 2014

    DHS’ Health Care and Continuing Care Administrations requested public input on best practices for development of Integrated Care System Partnerships (ICSPs) between managed care organizations and primary, acute, long-term care and mental health providers serving seniors and people with disabilities under managed care programs. The ICSPs are especially for people with dual Medicare and Medicaid eligibility, including those enrolled in MSHO, Minnesota Senior Care Plus (MSC+) and SNBC.

  • • Per the 2013 contract, all health plans submitted ICSP proposals with identified quality measures by July 15, 2013. A total of 31 proposals were received and approved by DHS across eight health plans respectively. Of the 31 ICSP proposals,19 addressed the Senior population and 12 addressed the SNBC population.
  • • October 1, 2013: Health plans confirmed ICSP contracts were approved with identified partners.
  • • January 1, 2014: Implementation initiated for the initial 31 ICSPs.
  • • July 1, 2014: A total of 19 new ICSP proposals were received and approved for implementation in 2015.
  • • By September 30, 2014: Health plans will submit the 2014 third quarter Integrated Care System Partnership’s (ICSP) Summary of Performance Measures and Outcomes Report reflecting progress since implementation on January 1, 2014.
  • • Going into 2015: There are 50 ICSPs ready for implementation. Of the 50 ICSPs, 32 represent Seniors and 18 represent SNBC.

  • To access additional information please go to the October 3, 2013 Stakeholder Presentation and ICSPs Historical Information.

    Related information

    Minnesota DHS contacts

    For more information, contact:
    Sue Kvendru
    , Project Co-Director,Dual Demo Policy and Seniors MLTSS Programs Team Lead
    Deb Maruska
    , Project Co-Director,Grant/Data Management/Disability Programs Team Lead

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