Third Thursday Webinar

November 16, 2017

Jennifer Burnett Kevin Hancock Randy Nolen OFFICE OF LONG-TERM LIVING DEPARTMENT OF HUMAN SERVICES

WELCOME TO THE THIRD THURSDAY WEBINAR

Communication Access Real-time Transcription (CART) is available by clicking here:

• https://archivereporting.1capapp.com • Username/password: OLL

2

https://archivereporting.1capapp.com/

GoToWEBINAR HOUSEKEEPING: WHAT ATTENDEES SEE

3

PresenterPresentation NotesBefore we get started, I’d like to go over a few items so you know how to participate in today’s event.

We've taken a screen shot of an example of the Attendee interface. You should see something that looks like this on your own computer desktop in the upper-right corner.

To the left is the GoToWebinar Viewer where you will see the presentation.

To the right is the GoToWebinar control panel where you can ask questions and select audio mode. If the Control Panel is closed and you just see the slim red rectangle, click on the red arrow to expand.

You’re listening in using your computer's speaker system by default. If you would prefer to join over the phone, just select “Telephone” in the Audio pane and the dial-in information will be displayed.

You will be placed in listen only mode to hear the webinar presenters.

You will have the opportunity to submit text questions to today’s presenter by typing your questions into the Questions pane of the control panel.  You may send in your questions at any time during the presentation��Note: The attendee control panel will collapse automatically when not in use by an Attendee. To keep it open, Attendees can click the “View” menu and uncheck “Auto-hide Control Panel”.

GoToWEBINAR HOUSEKEEPING: ATTENDEE PARTICIPATION

4

PresenterPresentation NotesGive Attendees a closer look at the control panel and how they can participate. Text may be adjusted to suit your event needs.

AGENDA

Communications and Outreach Essential Priorities and Launch Indicators Resource Information New CHC Roll-Out Schedule Readiness Review Updates CHC MCO Representatives Next Third Thursday Webinar

5

Community ~

HealthCho1ces

Commun it

Healt

COMMUNITY MEETINGS BEGINNING JANUARY 2018, Community HealthCholces (CHC) will be the service program for persons enrolled In both Medicare and Medicaid (Medical Assistance); lndlvlduals enrolled In Medicaid waivers for physlcal dlsabllltles; and

Medlcald-ellglble consumers who reside In a nursing home .

..,...--CHC Is a managed care program. This means you wlll choose a health plan to

manage all of your physical health care and long-term services and supports. To hear more about this program, you are Invited to a community meeting to learn about CHC and have an opportunity to ask questions .

..,..--If you wish to attend one of these community meetings, a llst of locations and dates has been provided on the followlng pages. Most locations have two sessions - a morning session and an afternoon session. Each session wlll run for

approxlmately two hours In length .

..,..--There are two ways to register for a session:

1. Register onllne - www.HealthChoices.pa.gov. Go to the above link to register for the meeting you would llke to attend. Upon completion of your onllne registrati on, you wlll receive a confirmation email.

2. Register by telephone - Dlal 833-735-4416. Telephone registrations wlll be accepted Monday through Friday from 8:00 a.m.- 7:00 p.m .

..,...--Space Is limited. If you are not plannlng to attend alone, we request that only one addltlonal person accompany you. If you choose to bring an addltlonal person, there Is a space on the onllne registration form to Indicate this, and Include their name.

I FOR MORE INFORMATION ABOUT COMMUNITY HEALTHCHOICES, PLEASE VISIT WWW.HEALTHCHOICES.PA.GOV OR CALL 1.833.735.4416 ~ pennsylvania '1l!J pennsylvania ~ C~a

SW CHC Outreach & Education Community Information Meetings Summary 39 Meetings held at 22 sites in the Southwest counties of Allegheny, Armstrong,

Beaver, Bedford, Blair, Butler, Cambria, Fayette, Greene, Indiana, Lawrence, Somerset, Washington and Westmoreland.

Approximately 2,000 total attendees. 68 Individuals volunteered to serve as meeting facilitators (48 from AAA’s and 20

from non-AAA service coordination entities).

7

SW CHC Outreach & Education Community Information Meetings Summary Sample of Questions Received From the Meetings: Will CHC affect my Medicare? Will I be able to keep my physician/service coordinator/home health

aid/therapist? For Veterans, what happens if you have Medicare & Medicaid? Can I keep my mental health provider? Will we be getting a book from the MCO’s listing providers with enrollment

packets? If I keep the current Medicare plan, will I be able to keep the current network of

doctors?

8

SW Participant Pre-Transition and CHC MCO Enrollment

While November 13th was the last day for Southwest participants to pre-select a CHC-MCO, they will be able to make a plan selection change until the end of the calendar year 2017 and have it take effect on 1/1/2018 Participants should call the PA CHC Helpline at 1-844-824-3655 (TTY 1-

833-254-0690) if they have not done so. The call center is open Monday through Friday, 8:00 a.m. to 6:00 p.m. Participants should visit www.enrollchc.com for information about

providers, plans, benefits, and what they need to do to enroll

9

PresenterPresentation NotesThe enroll CHC website gives participants an opportunity to learn more about CHC, who qualifies, care coordination, physical and behavioral health benefits, LTSS, tips for choosing a providers and health, plan comparisons, and enrollment methods online, by phone, and by mail. Participants will also find MCO contacts and links, information on APPRISE, the PA Link Program and other program information and resources by county.

http://www.enrollchc.com/

SW Participant Communications

Participants will soon receive a post-enrollment packet that includes: Plan selection confirmation letter Brochure with CHC-related information

10

PresenterPresentation NotesNotification letter from the IEB will advise Participants of the auto assigned MCO or confirmation of their plan selection.Participants can change their MCO at any time up until the end of the calendar year for it to become effective January 1, 2018. After that they can change their MCO’s at any time.

CHC Completed and Upcoming Events

Completed: 10/3 – 11/3 Community Presentations throughout the SW 10/23/2017 Webinar for County Commissioners Association of PA 11/14/2017 “Focus on the 46th” TV discussion with Senator Bartolotta

Upcoming: 11/20-12/31 Post Enrollment Packets Confirming Plan Selection Mailed 12/5/2017 MLTSS SubMAAC Meeting 12/7/2017 SW Governor Kick Off Event

o ..

11

PROVIDER COMMUNICATIONS A CHC 101 training for nursing facilities in the SW was developed and held via

webinars on November 2nd and 3rd, 2017.

Web-based training will continue to be available for both nursing facilities and service coordinators on the AgingWell website.

Bi-weekly fact sheets on CHC related topics continue to be distributed

Third Thursday webinars will continue on monthly basis during the CHC rollout

Established Provider webpage http://www.healthchoices.pa.gov/info/resources/publications/community/index.htm

12

http://www.healthchoices.pa.gov/info/resources/publications/community/index.htm

CHC Launch Focus: Essential Priorities

ESSENTIAL PRIORITIES • No interruption in participant services • No interruption in provider payment

HOW WILL WE ENSURE NO INTERRUPTIONS? • The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review

process that looks at provider network adequacy and IT systems. • The Department of Health must also review and approve the MCOs to ensure they have adequate networks.

13

CHC LAUNCH INDICATORS

Primary Aim

Key Activities

Tools

Stakeholders

Pre-Launch Launch (Begins at “Go Live”) Steady State (9-12 Mos. & Beyond)

Readiness Continuity Program Improvement Frequent Meetings with MCOs

Monitor Launch Indicators & Reports Conduct Implementation Study

Launch Indicators Process Measures

Hot-lines (Consumer & Provider) Program and Financial Reports

MCO Participant Advisory Coms. Local Advisory Group SubMAAC, 3rd Thurs.

CHC Website

Regular Meetings with MCOs Quarterly Quality Reviews

Conduct Evaluation Analyses Monitor Reports

Outcome Measures Program and Financial Reports Program Imp. Projects (PIPs) Pay for Performance (P4Ps)

MCO Participant Advisory Coms. Ad Hoc Public Engagements

SubMAAC, CHC Website

Readiness Reviews System Testing

Baseline Analyses

Readiness Review Tool Report Templates Quality Strategy

Consumer Communications Provider Communications

Local Advisory group SubMAAC, 3rd Thurs.

CHC Website

6

CHC MCO Contact Information

AmeriHealth Caritas | CHCProviders@amerihealthcaritas.com www.amerihealthcaritaschc.com - 1-855-235-5115 (TTY 1-855-235-5112)

Pennsylvania Health and Wellness (Centene) | information@pahealthwellness.com www.PAHealthWellness.com – 1-844-626-6813 (TTY 1-844-349-8916)

UPMC for You | CHCProviders@UPMC.edu www.upmchealthplan.com/chc - 1-844-833-0523 (TTY 1-866-407-8762)

o ..

15

mailto:CHCProviders@amerihealthcaritas.comhttp://www.amerihealthcaritaschc.com/mailto:information@pahealthwellness.comhttp://www.pahealthwellness.com/mailto:CHCProviders@UPMC.eduhttp://www.upmchealthplan.com/chc

RESOURCE INFORMATION COMMUNITY HEALTHCHOICES WEBSITE: www.healthchoicespa.com

MLTSS SUBMAAC WEBSITE: www.dhs.pa.gov/communitypartners/informationforadvocatesandstakeholders/mltss/

CHC LISTSERV // STAY INFORMED: http://listserv.dpw.state.pa.us/Scripts/wa.exe?SUBED1=oltl-community healthchoices&A=1

EMAIL COMMENTS TO: RA-PWCHC@pa.gov

PROVIDER LINE: 1-800-932-0939

PARTICIPANT LINE: 1-800-757-5042

16

mailto:RA-PWCHC@pa.govhttp://listserv.dpw.state.pa.us/Scripts/wa.exe?SUBED1=oltl-communitywww.dhs.pa.gov/communitypartners/informationforadvocatesandstakeholders/mltsshttp:www.healthchoicespa.com

Reminder

Again, Participants should call the PA CHC Helpline at 1-844-824-3655 (TTY 1-833-254-0690) if they have not done so. The call center is open Monday through Friday, 8:00 a.m. to 6:00 p.m. Participants should visit www.enrollchc.com for

information about providers, plans, benefits, and what they need to do to enroll

17

http://www.enrollchc.com/

18

PHASE 1: January 1, 2018 PHASE 2: January 1, 2019 PHASE 3: January 1, 2020

NEW CHC ROLL-OUT SCHEDULE

READINESS REVIEW UPDATE – Randy Nolen

Provider Network Adequacy Policies and Procedures Technical Assistance Trainings Nursing Facility Claims Testing

19

COMMUNITY HEALTHCHOICES MCO REPRESENTATIVES

Chris Bruette, AmeriHealth Caritas

Anna Keith, Pennsylvania Health and Wellness (Centene)

Ray Prushnok, UPMC

o ..

20

MCO UPDATE

Overview of Network and Adequacy with Emphasis on Physical Health, Nursing Facilities and LTSS Providers Overview of Website Information (fully operational timeline) Approach to Customer Service Overview of Value Added Services Provider Training – Timeframes for Training and Testing of Payment

Systems Prior to Start Date Interaction with IEB to Improve Enrollment Process Other Relevant Topics

21

THIRD THURSDAY WEBINARS

We will host an informational webinar on the third Thursday of each month throughout the implementation of CHC. An invite and registration link will be sent out on the ListServe. To ensure you receive email communications distributed from the Office of Long-Term Living, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

The next webinar will be held: December 21, 2017 @ 1:30 PM

Webinar participants will also find this presentation at www.healthchoicespa.gov/info/resources/publications/community/third-thursday-webinars/

o ..

22

http://listserv.dpw.state.pa.us/http://www.healthchoicespa.gov/info/resources/publications/community/third-thursday-webinars/

Slide Number 1Slide Number 2Slide Number 3Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11Slide Number 12Slide Number 13Slide Number 14Slide Number 15Slide Number 16Slide Number 17Slide Number 18Slide Number 19Slide Number 20Slide Number 21Slide Number 22