Stepping-Up Conference Our MISSION To make a lasting difference in - PowerPoint PPT Presentation

Stepping-Up Conference

Our MISSION To make a lasting difference in our members' lives by improving their 1.8M health and well-being. members CARESOURCE • A nonprofit health plan and national leader in Managed Care • 27-year history of serving the low-income populations across multiple states and insurance products • Currently serving over 1.5 million members in Kentucky, Ohio, Indiana, West Virginia, and Georgia • 1.2 million Ohio Medicaid members Confidential & Proprietary

Why - Living Our Mission Making a lasting difference in the lives of our members by improving their health and well-being. Medicaid Expansion Disproportionate Chronic Health Conditions Behavioral Health (Institutionalization) Behavioral Health Carve-In 3

Behavioral Health Carve In and Redesign: What it Means

What is Carve In and Redesign Community Behavioral Health Systems are being “carved-in” to Managed Care 2 Phases Redesign 1/1/18 Carve In 7/1/18. At that time all FFS billing goes away and the state pays a capitated rate to the plans for Medicaid members.

What is the goal… Better address BH needs Ensure access to care Improve members experience Reduce ED and psychiatric inpatient care Bring BH codes up to NCCI

Who does it impact? Everyone who is receiving mental health services and is enrolled in an MCO 420+ CBHCs in Ohio Approximately 100K members in CBHCs Additional100K members that NEED CBHC

Managed Care’s Role Now responsible for members physical and behavioral health benefit. Opportunity to work with BH and CJ systems to identify and fill gaps. Provide population health approach to CJ population with high prevalence of BH and chronic conditions.

Community Transition Program (CTP)

Community Transition Program (CTP) Grant OhioMHAS Eligible Population Starts July 1, 2016 To administer clinical Individuals released • Initial 1 year SUD services (for from an Ohio prison contract renewed non-Medicaid who received SUD through June 2019 population) & treatment while • Goal to create Recovery Services, incarcerated quality, scalable including housing, program for prison transportation, reentry for SUD vocational support population Confidential & Proprietary

The CTP Benefit RECEIPIENTS WILL RECEIVE: Treatment Services Recovery Services Available to CTP Members without Non-Medicaid Reimbursable Medicaid or other Health Insurance available to all CTP Members Housing (Recovery Housing, Permanent Diagnostic Assessment Supporting Housing) Intensive Outpatient Services Employment Services, Job Training and Urinalysis Education Outpatient Individual and Group Peer Recovery Supporter SUD Residential Treatment Transportation Case Management Life Skills MAT Relapse Prevention Crisis Intervention Spiritual Support Individual and/or Group Ambulatory Detoxification including Naloxone Identity Fund Administrative (In-Reach, Recovery Case Management, Data Collection) Confidential & Proprietary

Provider Network 66 Providers OhioMHAS AOD Certified Current 230+ Locations 66 Counties Approx. 90 Providers AOD Certified + Additional Provider Types Future 88 County Coverage CJ Competencies (In-Reach, Rec Case Mgmt.) Confidential & Proprietary

CTP Housing Model CTP Member Assessed Prior to Release (JD VI SPDAT) Emergency Housing (14 Day Limit) Recovery Housing Ohio Recovery Housing Associates Peer Support CTP Provider Owned and Operated Four Month Max Rental Benefit Rapid Rehousing Landlord Based Housing Supports 4 Month Max Rental Benefit • Mitigation Services • Home Based Case Management PSH • Mental Health • Resource Referrals Benefit available until transition to permanent subsidy • Vocational Support Estimated to be 10% of housing population for CTP CSH MANAGED Confidential & Proprietary

Who Does Life Services Serve? CareSource Proprietary

̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ ̶ Social Determinants of Health HEALTH-RELATED SOCIAL NEEDS HEALTH $ + + + + ECONOMIC HOUSING & EDUCATION SOCIAL FOOD & RELATIONSHIPS STABILITY NEIGHBORHOODS NUTRITION EARLY CHILDHOOD EDUCATION & ACCESS TO HEALTHY SOCIAL COHESION REGULAR & ACCESS TO LONG- DEVELOPMENT FOODS CONSISTENT ACCESS TERM EMPLOYMENT TO HEALTHY FOODS CIVIC PARTICIPATION ACCESS TO ACCESS TO INCREASED QUALITY EXTRACURRICULAR FINANCIAL LITERACY OF SAFE & PERCEPTIONS OF EDUCATION ON ACTIVITIES & AFFORDABLE DISCRIMINATION & NUTRITION & MENTORING HOUSING EQUITY OVERALL HEALTH ACCESS TO ADULT Health-related social IMPACTS EDUCATION & JOB INCREASED HIGH needs are found where TRAINING IMPROVED INCARCERATION / SCHOOL ENVIRONMENTAL INSTITUTIONALIZA- ADDRESSING FOOD people live, learn, work GRADUATION CONDITIONS TION DESERTS & INCREASED ASSETS and socialize; they INEQUALITIES SUCH AS HOME ENROLLMENT IN JOB OWNERSHIP TRAINING OR POST impact health outcomes. SECONDARY EDUCATION CareSource Proprietary

Family of 3 in MONTGOMERY COUNTY OHIO Minimum Wage ($8.15/hr) Federal Poverty Line ($20,420 or $9.82/hr) Self-Sufficiency Standard Line ($40,840 or $19.63 / hr) (shown by percent of the population in each position) Retail Salespersons ($9.63) Food Svc. Prep ($8.71) Top Jobs in Ohio Registered Nurse ($29.17) Cashiers ($8.95) Office Clerks ($13.17) Stock and Material Movers ($10.97) Waiters& Waitress. ($8.75) Janitors. ($10.79) Customer Svc. Rep. ($14.63) Nursing Aides and Orderlies ($11.40) $4 $6 $8 $10 $12 $14 $16 $18 $20 $22 $24 $26 100% 133% 150% 200% 250% Childcare Assistance (125%-300%) 300% FPL SNAP(130%) Benefits WIC (185%) Medicaid – Kids (206%) Medicaid – Adults (138%) OWF* Housing** *50% of FPL (4.91 / hr) ** 80% of median income Current focus is on meeting needs of individuals below 30% of Median Income, which is $7.37/hr for Montgomery County*

Life Services Outcomes & Member Metrics • Currently operating in 10 Ohio Counties 1,509 568 Employed Members 4,671 Members who have opted into 87% Life Services. 64 Members Employer Partners who have interacted Active participants with Life working with Services. Coaches. Members who have Total Community 4,622 retained employment. 1,437 Referrals CareSource Proprietary

Unique Opportunity • CareSource Members are given Health Care access to holistic services. Including Mental & • CareSource Members are being Behavioral Health assisted in all areas of their life with a coordinated holistic approach. Coaching & Life Skills & Mentoring Assessments • CareSource Life Services has tracked the number of organizations LIFE and programs that member utilize – SERVICES on average members are engaged with 7-10 different organizations to help them survive month to month. Job Social & Connection & Community • We are tracking the time it takes Retention Needs to see government & community resources replaced Education & by income. Training CareSource Proprietary