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MASSHEALTH IS CHANGING: DON'T BE LEFT OUT IN THE COLD WHY CHANGES - - PowerPoint PPT Presentation
MASSHEALTH IS CHANGING: DON'T BE LEFT OUT IN THE COLD WHY CHANGES - - PowerPoint PPT Presentation
MASSHEALTH IS CHANGING: DON'T BE LEFT OUT IN THE COLD WHY CHANGES ARE NEEDED Healthcare costs are rising People are not getting the care they need Medical, Behavioral Health and LTSS (Long- Term Supports and Services) providers do not
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CHANGES COMING TO MASSHEALTH
“Accountable Care Organizations” (ACOs) Coordinated care “care teams“ Integrated medical and behavioral health services
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WHAT IS AN ACO?
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WHAT IS A CARE TEAM?
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INTEGRATED CARE
Primary Care Mental Health Substance Abuse LTSS
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ADVOCACY: WHO GETS THE DOLLARS?
Community-based and healthcare organizations Big hospitals and medical provider groups
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ADVOCACY: GOVERNANCE
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ADVOCACY: IT'S NOT ABOUT THE PAYER
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ADVOCACY: CONSUMER CHOICE
Conflict-free care Hospital access
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ADVOCACY: ADA COMPLIANCE
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ADVOCACY: CONSUMER CHOICE
Open network Closed network
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ADVOCACY: CARE TEAM COMPOSITION
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ADVOCACY: PRIVACY
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ADVOCACY: LONG-TERM SERVICES AND SUPPORTS (LTSS)
Certified peer specialists Personal Care Attendants
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ADVOCACY: LTSS
Transportation Durable Medical Equipment
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ADVOCACY: QUALITY
Independent Ombudsman Tracking quality
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ADVOCACY: ENHANCED SERVICES
No co-pay Access to oral health
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ADVOCACY: OTHER SERVICES
Housing supports Food and nutrition
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