112410 medassur inhome by lz4SlQ1g

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									Date: November 24, 2010

During fall county/clinic training, Blue Plus staff reviewed a plan to build upon and expand the
MedAssurant In-Home Assessment Program. This expansion, offering an in-home assessment
to all newly enrolled SecureBlue MSHO members will begin December 2010. For the purposes
of this program, newly enrolled members will be defined as members who have not been enrolled
in SecureBlue MSHO in the previous six months.

Current Process
The 8-25-10 Blue Plus Communique (available on the Blue Plus web portal) outlined
MedAssurant’s current work which is to identify members with what appears to be unmanaged
chronic conditions twice per year and follow up with either:
    1. a letter encouraging members to visit their primary care physician with a corresponding
        letter to their primary care physician identifying the conditions, OR
    2. a letter and a phone call encouraging the member to visit their primary care physician
        with a corresponding letter to their primary care physician identifying the conditions, OR
    3. an offer of an in-home non-invasive assessment by a Nurse Practitioner or a Physician
        from Inspiris, an agency contracted with MedAssurant. A copy of the results of the
        assessment are left with the member and sent to the primary care physician.

Please note: By request, Care Coordination Delegates should soon be receiving a list of which
members are being presented with one of the three options above and an identification of the
chronic conditions that appear to be untreated according to Blue Plus claims data. Blue Plus is
also exploring the logistics of sharing the 3-4 page in-home assessment summaries with Care
Coordinator.



                                                         MedAssurant
                                                      Member Assessment Report
Attached is a sample of the assessment summary.

Additional Component to start December 2010
Beginning December 2010, MedAssurant will be expanding their offer of a non-invasive in-home
assessment to all newly enrolled MSHO members. The success of this program depends upon
MedAssurant, Inpiris, and Care Coordination Delegates working together to coordinate efforts
and ensure members understand the benefits of this program.

In order to do this, we will follow the time frames below:

    1. As always, Care Coordinators have 30 days to do the initial LTCC/HRA for new MSHO
       enrollees. Beginning with December enrollment, at the face to face assessment meeting,
       Care Coordinators will explain who MedAssurant and Inspiris are and inform the member
       of the phone call they will receive offering a non-evasive in-home assessment completed
       by an Inspiris Nurse Practitioner or Physician. The purpose of the assessment is to
       insure the member’s health care needs are identified early and shared with the member’s
       primary care physician.
    2. MedAssurant will call newly enrolled members no sooner than 45 days of enrollment to
       schedule the in-home assessment. The first calls will start January 15 for December
       enrollees. Attached is a copy of the script that will be used by MedAssurant when calling
       newly enrolled members.
           MedAssurant
        Member In-Home Outreach Call Script-new members (BCBS MN)
    3. A copy of the 3-4 page assessment results will be left with the member and sent to the
       primary care physician. (As noted above, Blue Plus is exploring the logistics of sharing
       the assessment summary with Care Coordinator.)

If members have any questions about the letter or about the In-Home Assessment Program,
please have them call Blue Cross Blue Shield of Minnesota Member Services at (651) 662-6013,
toll free 1-888-740-6013. For TTY, call (651) 662-8700 or toll free 1-888-878-0137. Customer
service staff is available 8 a.m. to 8 p.m. CST, seven days a week.

If you have any questions about the Care Coordinator role, please contact the Relationship
Management staff for your area.

Thank you for your continued work in making a healthy difference in our members’ lives.

Melody Bialke, LISW, MHP
Manager Government Programs Partner Relations

								
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