zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Jessie Beebe, - - PowerPoint PPT Presentation

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Connecting Housing Providers and their clients to Medicaid Managed Care

Jessie Beebe, LCSW Health Services Specialist Center for Housing and Health

200 W E S T JAC K S O N BLV D . | S U ITE2100 | C H IC AG OIL 60606 | TE L 312-922-2322 | FA X312-922-2916 | A ID SC H IC A G O .O RG

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Health Care Landscape

• Illinoisexpanded Medicaid startingJanuary2013.
• Medicaid Managed C

areand C areC

• ordination began

January2014 and continued through January 2015.

• R

apid changesfor Illinoiswith atremendouslearningcurve for housingproviders,social service agenciesand medical providers.

• E

ducation and support around Medicaid application and Marketplace but not much on Managed C are enrollment.

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Health Services Specialist

• Designated role to work with housingprovidersand their

residentson enrollment into Medicaid and Medicaid Managed C areaswell aseducation and support to connect residentsto their Managed C are plan.

• Agency and housing case manager trainings
• Meets regularly with housingcase managers
• Home visits with clients
• Accompanyclientsto doctor’s appointments if needed

Challenges

• Manyclientswere auto-enrolled into Managed C

are

• C

arecoordination isan evolvingprocess

• V

ulnerable populationshave little to no accessto cell phones, aretransient,difficult to outreach for Managed C are

• Manyclientsnow have health insurance for the first time –

usingprimaryand outpatient careisa learned behavior

• Additional complications for clients living with HIV

/AIDS

• Assigned providers need to know how to treat HIV

, medication coverage

Best Practices

• C
• nsistent and continuouseducation and support – changing aculture
• Trainings
• One-on-one consultation
• Home visits
• Doctor appointments
• Developed health carematerials for housing casemanagers and

residents

• Pre-enrollment G

uide

• Post-enrollment G

uide

• E

nrollment C hecklist

• C
• llectingManaged C

are Data G uide

• Magnets with Managed C

areinformation

Best Practices: Clients

• C
• ncrete,specific and relevant exampleson how Managed

C arewill impact and improvetheir health care

• F
• cuson clients real and perceived needs
• Opportunityto talk about individual health of client
• Motivatingclientsto learn about and connect to their

Managed C arePlan and carecoordination services.

• Identifywhat matters to them
• R

esourcesfor clientsto refer to and use

• C
• nnecting to Managed C

are together

• Importanceof primarycare

Visuals work best

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Best Practices: Case Managers

• E

ncouragecasemanagersto connect with care coordinators and develop relationships.

• C

ase managersare the “experts” when it comes to understanding client needsand challenges.

• Health S

ervices S pecialist –resource for case managers

• IntegrateManaged C

are/C areC

• ordination dialogue into regular

case management visits

• C
• nsistent and continuous education and support on benefits and how to access
• Focus on engagement in primary care, pharmacy

and specialist referrals

• A

ddress challenges and barriers to care regularly

• Connecting to M

anaged Care together

• M

anaged Care Checklist

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Integrating Housing + Health

• Better Health through HousingC
• llaborative
• Housing and support servicesasa health care intervention to

improve health outcomesand reduce costs

• PilotsA,Band C
• S

trengthen connection between housing casemanagersand carecoordinators

• Demonstratingthe valueof supportivehousingand

integration with health caresystems