Case Management provide list of groups eliminated – Services for Individuals Age 65 or Older in an Institution for Mental Disease (IMD) Mid-Term Strategy: Eligibility Changes Review spend down eligibility and current medical expenses considered for eligibility. Increased use of generics need to explore – Rebates - cross over pharmacy claims and specialty pharmacy costs in Maine compared to other states HIT explore restricted card program – Mid-Term Strategy: Program Integrity Need to review contracts for program integrity language Overview: PCCM vs. MCO Model Members felt additional information on the successful components of managed care Members will forward any additional initiatives they feel worth discussion to When caring for the high cost user how do medical homes versus managed Nick for distribution to Task Force prior care work to the next meeting. An idea discussed was the possibility of tailoring the solutions by specific population i.e. Managed care for high cost user Additional information needed on PACE Need to consider the effect of any initiatives that will affect Maine’s current initiatives (long range plans) of health homes and ACO There was a brief discussion regarding next steps in the drafting of the final report. Presentation by Seema Verma Draft of MaineCare Redesign Task Force Report will be presented at the and Rob Dalmer cont.
Presentation by Seema Verma and Rob Dalmer cont. Case Management – provide list of groups eliminated Services for Individuals Age 65 or Older in an Institution for Mental Disease (IMD) Mid-Term Strategy: Eligibility Changes Review spend down eligibility and current medical expenses considered for eligibility. Increased use of generics – need to explore Rebates - cross over pharmacy claims and specialty pharmacy costs in Maine compared to other states HIT – explore restricted card program Mid-Term Strategy: Program Integrity Need to review contracts for program integrity language Overview: PCCM vs. MCO Model Members felt additional information on the successful components of managed care When caring for the high cost user how do medical homes versus managed care work An idea discussed was the possibility of tailoring the solutions by specific population i.e. Managed care for high cost user Additional information needed on PACE Need to consider the effect of any initiatives that will affect Maine’s current initiatives (long range plans) of health homes and ACO There was a brief discussion regarding next steps in the drafting of the final report. Members will forward any additional initiatives they feel worth discussion to Nick for distribution to Task Force prior to the next meeting. Draft of MaineCare Redesign Task Force Report will be presented at the