third thursday webinar - pa.gov...third thursday webinars 18 o.. we will host an informational...
TRANSCRIPT
Third Thursday Webinar
OCTOBER 19 2017
Jennifer Burnett
Deputy Secretary
OFFICE OF LONG-TERM LIVING
DEPARTMENT OF HUMAN SERVICES
WELCOME TO THE THIRD THURSDAY WEBINAR
2
Communication Access Real-time Transcription
(CART) is available by clicking here
bull httpsarchivereporting1capappcom
bull Usernamepassword OLL
GoToWEBINAR HOUSEKEEPING WHAT
ATTENDEES SEE
3
GoToWEBINAR HOUSEKEEPING ATTENDEE
PARTICIPATION
4
AGENDA
5
Communication with Participants Communication with Providers Readiness Review amp Network AdequacyQuality Strategy Launch Indicators Priorities through Implementation Resources
SW PARTICIPANT COMMUNICATIONS
6
Late September thru early October First round SW Pre-transition notices and enrollment packets prior to implementation were
mailed to participants in the SW Pre-Enrollment Packets
October 6th pre-enrollment packets were mailed to participants
This packet contains information about each of the health plans benefits offered by each plan and tells
participants how to enroll in a health plan
There is a toll-free number and website for participants to use and make their selection
Automated calls will be made to let participants know that the packets are coming
October 11th thru November 2nd Southwest CHC participant education amp outreach sessions are underway More than 40 events were scheduled with at least one in each of the 14 impacted counties The meetings will give more information about CHC the LIFE program and answer questions
participants may have To register for a community meeting participants can go to wwwhealthchoicespagov or call 1-
833-735-4416
o
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
WELCOME TO THE THIRD THURSDAY WEBINAR
2
Communication Access Real-time Transcription
(CART) is available by clicking here
bull httpsarchivereporting1capappcom
bull Usernamepassword OLL
GoToWEBINAR HOUSEKEEPING WHAT
ATTENDEES SEE
3
GoToWEBINAR HOUSEKEEPING ATTENDEE
PARTICIPATION
4
AGENDA
5
Communication with Participants Communication with Providers Readiness Review amp Network AdequacyQuality Strategy Launch Indicators Priorities through Implementation Resources
SW PARTICIPANT COMMUNICATIONS
6
Late September thru early October First round SW Pre-transition notices and enrollment packets prior to implementation were
mailed to participants in the SW Pre-Enrollment Packets
October 6th pre-enrollment packets were mailed to participants
This packet contains information about each of the health plans benefits offered by each plan and tells
participants how to enroll in a health plan
There is a toll-free number and website for participants to use and make their selection
Automated calls will be made to let participants know that the packets are coming
October 11th thru November 2nd Southwest CHC participant education amp outreach sessions are underway More than 40 events were scheduled with at least one in each of the 14 impacted counties The meetings will give more information about CHC the LIFE program and answer questions
participants may have To register for a community meeting participants can go to wwwhealthchoicespagov or call 1-
833-735-4416
o
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
GoToWEBINAR HOUSEKEEPING WHAT
ATTENDEES SEE
3
GoToWEBINAR HOUSEKEEPING ATTENDEE
PARTICIPATION
4
AGENDA
5
Communication with Participants Communication with Providers Readiness Review amp Network AdequacyQuality Strategy Launch Indicators Priorities through Implementation Resources
SW PARTICIPANT COMMUNICATIONS
6
Late September thru early October First round SW Pre-transition notices and enrollment packets prior to implementation were
mailed to participants in the SW Pre-Enrollment Packets
October 6th pre-enrollment packets were mailed to participants
This packet contains information about each of the health plans benefits offered by each plan and tells
participants how to enroll in a health plan
There is a toll-free number and website for participants to use and make their selection
Automated calls will be made to let participants know that the packets are coming
October 11th thru November 2nd Southwest CHC participant education amp outreach sessions are underway More than 40 events were scheduled with at least one in each of the 14 impacted counties The meetings will give more information about CHC the LIFE program and answer questions
participants may have To register for a community meeting participants can go to wwwhealthchoicespagov or call 1-
833-735-4416
o
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
GoToWEBINAR HOUSEKEEPING ATTENDEE
PARTICIPATION
4
AGENDA
5
Communication with Participants Communication with Providers Readiness Review amp Network AdequacyQuality Strategy Launch Indicators Priorities through Implementation Resources
SW PARTICIPANT COMMUNICATIONS
6
Late September thru early October First round SW Pre-transition notices and enrollment packets prior to implementation were
mailed to participants in the SW Pre-Enrollment Packets
October 6th pre-enrollment packets were mailed to participants
This packet contains information about each of the health plans benefits offered by each plan and tells
participants how to enroll in a health plan
There is a toll-free number and website for participants to use and make their selection
Automated calls will be made to let participants know that the packets are coming
October 11th thru November 2nd Southwest CHC participant education amp outreach sessions are underway More than 40 events were scheduled with at least one in each of the 14 impacted counties The meetings will give more information about CHC the LIFE program and answer questions
participants may have To register for a community meeting participants can go to wwwhealthchoicespagov or call 1-
833-735-4416
o
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
AGENDA
5
Communication with Participants Communication with Providers Readiness Review amp Network AdequacyQuality Strategy Launch Indicators Priorities through Implementation Resources
SW PARTICIPANT COMMUNICATIONS
6
Late September thru early October First round SW Pre-transition notices and enrollment packets prior to implementation were
mailed to participants in the SW Pre-Enrollment Packets
October 6th pre-enrollment packets were mailed to participants
This packet contains information about each of the health plans benefits offered by each plan and tells
participants how to enroll in a health plan
There is a toll-free number and website for participants to use and make their selection
Automated calls will be made to let participants know that the packets are coming
October 11th thru November 2nd Southwest CHC participant education amp outreach sessions are underway More than 40 events were scheduled with at least one in each of the 14 impacted counties The meetings will give more information about CHC the LIFE program and answer questions
participants may have To register for a community meeting participants can go to wwwhealthchoicespagov or call 1-
833-735-4416
o
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
SW PARTICIPANT COMMUNICATIONS
6
Late September thru early October First round SW Pre-transition notices and enrollment packets prior to implementation were
mailed to participants in the SW Pre-Enrollment Packets
October 6th pre-enrollment packets were mailed to participants
This packet contains information about each of the health plans benefits offered by each plan and tells
participants how to enroll in a health plan
There is a toll-free number and website for participants to use and make their selection
Automated calls will be made to let participants know that the packets are coming
October 11th thru November 2nd Southwest CHC participant education amp outreach sessions are underway More than 40 events were scheduled with at least one in each of the 14 impacted counties The meetings will give more information about CHC the LIFE program and answer questions
participants may have To register for a community meeting participants can go to wwwhealthchoicespagov or call 1-
833-735-4416
o
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
SW PARTICIPANT COMMUNITY MEETINGS
7
o
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
SW COMMUNITY MEETINGS
8
o
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
SW COMMUNITY MEETINGS
9
o
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
SW PARTICIPANT COMMUNICATIONS
10
CHC-Pre-transition Timeline November 13th is the close of the pre-transition period but Southwest participants will be able to make
a plan selection change until the end of the calendar year 2017 and have it take effect on 112018
If participants do not select a health plan they will get a follow-up call
Individuals who do not select a plan by November 13 2017 will be assigned to a plan Again
individuals can change their plan at any time
Additional participant information on community meetings webinars health plans
enrollment and the PA CHC Helpline can be located at wwwenrollchccom
Participant Call Center The CHC Participant Call Center will be operational until December 2018 Participants will be asked to
call the IEB if they have not received their Enrollment Packet at 1-844-824-3655
Access Cards and CHC MCO Plan Cards Participants will need to continue to carry the ACCESS cards with their CHC Plan Cards to access other
benefits including MATP
o
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
PROVIDER COMMUNICATIONS
11
A CHC 101 training for service coordinators and nursing facilities in the SW is being
developed via webinars and online
Bi-weekly fact sheets on CHC related topics continue to be distributed
Third Thursday webinars will continue on monthly basis during the CHC rollout
Established Provider webpage httpwwwhealthchoicespagovinforesourcespublicationscommunityindexhtm
o
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
READINESS REVIEW amp NETWORK ADEQUACY
12
Participant Materials and Services Staffing and Training Provider Materials and Services QMUM Payment Data and other IT Systems Contracts Administration Record and Data Reporting Financial Requirements On-site Readiness Review Meetings
Network Adequacybull Department of Health Network Adequacy Review
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
QUALITY STRATEGY
13
o
Participants receive Services
Providers receive Payment
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
Primary
Aim
Key
Activities
Tools
Stake-
holders
Pre-LaunchLaunch
(Begins at ldquoGo Liverdquo)
Steady State (9-12
Mos amp Beyond)
Readiness Continuity Program Improvement
Readiness Reviews
System Testing
Baseline Analyses
Readiness Review Tool
Report Templates
Quality Strategy
Consumer Communications
Provider Communications
Local Advisory group
SubMAAC 3rd Thurs
CHC Website
Frequent Meetings with MCOs
Monitor Launch Indicators amp Reports
Conduct Implementation Study
Launch Indicators
Process Measures
Hot-lines (Consumer amp Provider)
Program and Financial Reports
MCO Participant Advisory Coms
Local Advisory Group
SubMAAC 3rd Thurs
CHC Website
Regular Meetings with MCOs
Quarterly Quality Reviews
Conduct Evaluation Analyses
Monitor Reports
Outcome Measures
Program and Financial Reports
Program Imp Projects (PIPs)
Pay for Performance (P4Ps)
MCO Participant Advisory Coms
Ad Hoc Public Engagements
SubMAAC CHC Website
LAUNCH INDICATORS
6
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
PRIORITIES THROUGH IMPLEMENTATION
ESSENTIAL PRIORITIES
bull No interruption in participant services
bull No interruption in provider payment
HOW WILL WE ENSURE NO INTERRUPTIONS
bull The Department of Human Services (Department) is engaged with the MCOs in a rigorous readiness review process that looks at provider network adequacy and IT systems
bull The Department of Health must also review and approve the MCOs to ensure they have adequate networks
15
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
COMMUNITY HEALTHCHOICES MCOs
16
AmeriHealth Caritas | CHCProvidersamerihealthcaritascom
Pennsylvania Health and Wellness (Centene) | informationpahealthwellnesscom
UPMC for You | CHCProvidersUPMCedu
o
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
RESOURCE INFORMATION
COMMUNITY HEALTHCHOICES WEBSITE
wwwhealthchoicespacom
MLTSS SUBMAAC WEBSITE
wwwdhspagovcommunitypartnersinformationforadvocatesandstakeholdersmltss
CHC LISTSERV STAY INFORMED
httplistservdpwstatepausScriptswaexeSUBED1=oltl-community
healthchoicesampA=1
EMAIL COMMENTS TO RA-MLTSSpagov
PROVIDER LINE 1-800-932-0939
PARTICIPANT LINE 1-800-757-5042
17
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
THIRD THURSDAY WEBINARS
18
o
We will host an informational webinar on the third Thursday of each month throughout the
implementation of CHC An invite and registration link will be sent out on the ListServe To ensure
you receive email communications distributed from the Office of Long-Term Living please visit the
ListServ Archives page at httplistservdpwstatepaus to update or register your email address
The next webinar will be held November 16 2017 130 PM
Webinar participants will also find this presentation at
wwwhealthchoicespagovinforesourcespublicationscommunitythird-thursday-webinars
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
Contact Information
Jennifer Burnett Deputy Secretary
jenburnettpagov
19
QUESTIONS
20
QUESTIONS
20