Making Medicaid Better Newsletter 9.22.2011

A Message from DHH Secretary Bruce D. Greenstein:

I am writing today to update you on some important information about the implementation of Coordinated Care Networks (CCNs). Our team has been working diligently through the many and complex steps required to implement this complete transformation of Medicaid, and I am increasingly excited about the changes on the horizon that will improve health outcomes in our state for generations to come.

But those changes do not come easily, and we understand that this kind of reform can be challenging for our stakeholder community, including both enrollees and providers. To that end, our leadership team met last week and agreed that it is imperative that we provide all parties the time they need to absorb all the information coming at them related to Coordinated Care Networks. To that end, we decided to launch our first Geographic Service Area (the New Orleans and Northshore regions) one month later than originally announced. This means we expect to have all plans up and running and enrollees in those areas enrolled in the plan of their choice (or one selected) for a Feb. 1, 2012 "go live" date.

Each of the other Geographic Service Areas will phase in in 60-day increments following that Feb. 1 start date.  This will mean Geographic Service Area B (the Capital Area, Acadiana and South Central areas) will come on line April 1, and Geographic Service Area C (Southwest, Central, Northwest and Northeast Louisiana) will come on line June 1. Click here for a complete timeline of events leading to full implementation.

This phase-in will ensure that we are able to be in full implementation before the end of the state fiscal year. This is critical as we do not want to delay any longer than necessary the progress we expect in improved care for our Medicaid and LaCHIP enrollees.

At the same time, it helps us ensure a successful transition to a system that will enhance access to care and set a higher standard for improved health outcomes we can all be proud of as a state.

We look forward to continue working with all individuals and groups that are a part of this transformation of our health care delivery system. This is truly an exciting time to be involved in health care in Louisiana, and I am grateful to be experiencing it with you.

Bruce

Implementation in Brief

There has been much in the news related to the contracts between the state and the selected CCNs. Those contracts have all been signed by DHH and each CCN entity. They have all been reviewed by the Division of Administration's Procurement Support Team, and final approvals are expected very soon. A great deal of work is happening behind the scenes right now to prepare for open enrollment of Medicaid and LaCHIP recipients eligible for CCNs. The Enrollment Broker, Maximus, is working to set up the infrastructure, such as a Web-based enrollment system and call center that will ease the enrollment experience. DHH has also contracted with Baton-Rouge-based firm Wright/Feigley Communications to help develop the materials and advertising targeting recipients and encouraging them to make a pro-active choice. They are also working with Perry Franklin Industries who is helping organize events in every parish to reach recipients and SSA Consultants who will help with continued education for health care providers as well as field testing of the education materials for recipients.  These teams meet along with DHH's CCN leadership and Medicaid outreach staff weekly to ensure the consumer experience for this transition is seamless.

Provider Q and A

Q. I have been contacted by several companies about signing contracts to join their plan. As a health care provider, I want to ensure I contract with as many plans as possible to make sure my patients have the choice to stay with me, but I'm nervous about signing contracts if the state doesn't have contracts in place. What if someone doesn't pass their readiness review or doesn't make it through the whole process?

A. Our contract and readiness review process is moving along very well. All of our contracted CCNs are very experienced in Medicaid managed care and are expected to pass the readiness review process. We encourage you to work with the plans approaching you to structure a contract you are comfortable with. The CCNs must be able to show a strong network that meets specific standards of access to pass their readiness reviews, so it's important for providers to take time now to work out the details with each CCN they plan to contract with. If you haven't been contacted yet, you are free to reach out to the network specialists for each CCN. They can be found on our website.

It is important to note that only providers who have signed a contract by the time of each CCN's initial printing of the Provider Directory will be included in those directories, which their patients will be referring to when choosing a health plan.

Announcements

MARK YOUR CALENDARS:  DHH will be holding a day-long, state-wide Advocates' Conference on Oct. 14 at the Holiday Inn in Baton Rouge. Registration for this event will open Monday, Sept. 26. This event is for non-profit and health care advocacy groups who work with the eligible recipient populations to help them better understand the enrollment process, the outreach plan and their role as we move toward the first phase of enrollment. Because providers cannot assist recipients in enrolling (as they are contractors of specific plans and this presents a potential conflict of interest), this conference is not for health care providers. Other education efforts (see below) will target health care providers. Seating for the conference is limited to 300 people. We will be sending out invitations when registration opens Sept. 26.  Come back to MakingMedicaidBetter.com for more information soon.

COMING SOON: Just as we did prior to selecting the health plans, we will be planning a series of open conference calls for all health care providers. More information on dates and times to come soon.

Feedback

If you have questions about Coordinated Care Networks, contact DHH's Coordinated Care Network staff at coordinatedcarenetworks@la.gov.  Learn more at MakingMedicaidBetter.com.