Care Select care management system Changes

OMPP regarding the Care Select care management system. Please note the statement that Care Select has been redesigned. Members should be receiving a letter be the end of the month. Those not eligible for the newly designed program, or who do not voluntarily opt in, will continue to receive traditional Medicaid (sometimes also used to refer to Medicaid Disability).

INDIANAPOLIS (August 20, 2010) – Today the Indiana Family and Social Services Administration (FSSA) announced that beginning October 1 the scope of the state’s Care Select program will change to focus on disease management, specifically on members with chronic conditions.

“These changes will allow us to focus on members with chronic conditions, while at the same time providing benefits and services to all of our Medicaid recipients,” said Pat Casanova, Director of Indiana Medicaid. “Disease management will help patients with chronic illnesses lead healthier and more productive lives.”

Care Select was established by the State of Indiana in November, 2007, to improve the quality of care and health outcomes while controlling the growth of health care costs for members. Earlier this year, the Medicaid Medical Advisory Cabinet completed a study, which focused on claims from the first two years of the program, that failed to show the program was effective in producing positive health outcomes and controlling costs.

Beginning in October, eligible members with asthma, diabetes, congestive heart failure or coronary heart disease, hypertension, chronic kidney disease, severe mental illness and depression will have the option to participate in disease management programs that the Care Management Organizations (CMOs) provide for their chronic conditions. Members who do not opt-in as well as Home and Community Based Services (HCBS) waiver members will be enrolled in traditional Medicaid. HCBS waiver individuals receive case management services through the waiver.

Due to the voluntary nature of the redesigned Care Select Program, providers will no longer be auto-assigned members but members will choose their PMP at the time they opt-in to the program.

About 32,000 Medicaid members will be eligible for the disease management program. Currently, Care Select has 73,000 members. Members who are no longer eligible for Care Select will continue to receive traditional Medicaid. Care Select participants will be notified of changes by the end of August.

FSSA expects to save $7.6-$8 million in the current fiscal year and $10.7-$11.3 million for SFYs 2012 and 2013 as a result of a smaller client base as well as reduced fees for the delivery of disease management verses administratively costlier care managment.