Amid the changes brought about by the COVID-19 pandemic,
Medicare Advantage Special Needs Plans (SNPs) and others serving low-income
dually eligible members are looking at ways to promote the use of telehealth
and other technologies more broadly across their populations while continuing
efforts to improve integration of Medicare and Medicaid benefits.
Cheryl Phillips, M.D., president and CEO of The SNP Alliance,
says the association of SNPs and Medicare-Medicaid Plans (MMPs) expects the
Biden administration to support improvements to the delivery of long-term
services and supports and explore ways to support caregivers. "I think a
new administration will do some work in helping them better understand how MA
and particularly SNPs can be the best vehicle to align and serve high-risk,
high-cost individuals, particularly those who are dually eligible," she
says.
The SNP Alliance this year is focused on two main areas:
promoting quality measures for individuals with social risk factors that are
not captured by current quality measurement, and looking at how it can identify
Medicare-Medicaid integration strategies for states.
California was moving toward aligned enrollment with its
California Advancing and Innovating Medi-Cal (CalAIM) initiative but delayed
that effort because of the pandemic.
According to an updated CalAIM proposal posted by the Dept. of
Health Care Services on Jan. 8, the state intends to require all full- and
partial-benefit dual eligibles to be in a managed care plan by January 2023,
when it will transition Cal MediConnect members currently served by the
Coordinated Care Initiative (CCI) duals demo to aligned D-SNPs and managed care
plans operated by the same organization as their CMC product.
Yet the proposal does not include any requirements to operate
Fully Integrated Dual-Eligible Special Needs Plans (FIDE-SNPs), points out SCAN
Health Plan Senior Vice President of Healthcare Services Eve Gelb. SCAN is the
only FIDE-SNP in California.
When CCI was implemented, it created some statutory limits on
where FIDE-SNPs could operate, and SCAN is hoping to work with the department
to eliminate those caps and allow the growth of FIDE-SNPs in non-CCI counties,
adds Gelb.
Meanwhile, Boston-based Commonwealth Care Alliance (CCA) expects
the rapid adoption of telehealth to continue. "The use of telehealth and
other technologies like video visits, remote patient monitoring, AI-powered
symptom checkers…will become an integral component of care delivery models
post-COVID," predicts Chris Palmieri, president and CEO of CCA.
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