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Integrated Care Meeting Focuses on Populations, Services, Care Management

Stakeholders and Department of Health (DOH) officials discussed which populations and services to include when designing models for the future of integrated Medicare/Medicaid services in the state. These topics as well as care coordination and assessment processes were the focus of the second stakeholder meeting held in Albany on Sept. 7th. With the Fully Integrated Duals Advantage (FIDA) program slated to end in December 2019, the state is seeking to explore ways to expand and improve integrated care models for individuals dually eligible for Medicare and Medicaid.

Erin Kate Calicchia, the Director of the Bureau of Managed Long Term Care, led the discussion. She stressed that the goal of the individual meetings was not to find solutions or come to a policy consensus, but rather to give DOH the opportunity to gather as much input as possible from stakeholders. When it came to which populations to include, commenters agreed that the target population should be broad and statewide and supported maintaining multiple options of care. There was some support for the idea of serving well dual eligibles in integrated plans but concern that combining all into a single plan would result in unwarranted reimbursement challenges. Those commenting expressed support for including the entire set of Medicare and Medicaid services and welcomed the flexibility to include services that meet the unique needs of individuals being served as well as the unique challenges of certain geographies, such as rural areas. Participants stressed that how services were carved in was as important as whether they were included and noted that there were challenges in recognizing costs of some of the social and environmental supports that help individuals stay independent.

The slides from the discussion are available here. DOH is welcoming comments on this set of topics from plans, providers, and consumers through Sept. 20th and has developed a template for stakeholder input, which is available here.

DOH has scheduled three more stakeholder meetings, each with a distinct set of discussion topics, which will be held before the end of the year. The schedule is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841