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San Diego Long Term Care Integration Project

San Diego Long Term Care Integration Project. LTCIP Planning Committee October 11, 2006. Strategies Developed to Support “Vision”. Aging & Disability Resource Center Physician Strategy Healthy San Diego Plus. California Endowment Proposal San Diego Team.

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San Diego Long Term Care Integration Project

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  1. San Diego Long Term Care Integration Project LTCIP Planning Committee October 11, 2006

  2. Strategies Developed to Support “Vision” • Aging & Disability Resource Center • Physician Strategy • Healthy San Diego Plus

  3. California Endowment ProposalSan Diego Team Resources to build a local social network of chronic care innovators across sectors, setting, and funding by: • Community development of “team dynamic” through joint provider education • Enhancement of available IT communication supports for docs, office staff, ancillary and community providers, consumers, caregivers

  4. Key Elements of San Diego Team • Work with the UCSD Geriatric Education Center to: • Influence geriatric training • Improve coordination between disciplines • Promote national policy improvements • Listen to doctors and other providers to develop additional policy improvements within LTCIP

  5. Healthy San Diego Plus (HSD+) • Medi-Cal Aged, Blind, and Disabled offered voluntary enrollment in LTC Integrated Plan • Models of care integrated across funding & the health and social services continuum: • Health Plans to contract with State and CMS through RFP with local pre-qualification • HSD+ Health Plans to develop program details with consultant resources

  6. Medicare Special Needs Plans (SNPs) Allows a SNP to restrict enrollment for certain categories of special needs individuals • Institutional Beneficiaries (in or expected to reside >90 days; Community NHC) • Dually Eligible (subsets of duals OK now with State partner) • Beneficiaries with Severe and Disabling Chronic Conditions (untested to be evaluated on case by case; e.g. disease specific) SNP Lumpers vs. Splitters!

  7. CMS Guidance to Integrating Medicare/Medicaid • How to coordinate marketing of Medicare and Medicaid to duals. • How to do streamlined MC enrollment of duals. • How to do MC quality integration for duals. • How to support State targeted SNP enrollments. • Clarity in bidding process to enable State savings. • Model SNP/State/CMS integrated relationship • Improved quality measures for SNP populations

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