Care program set up for those who receive both Medicare, Medicaid

The Michigan Department of Community Health Friday announced that it has signed a Memorandum of Understanding with the Centers for Medicare and Medicaid Services for the new MI Health Link demonstration program to integrate care for individuals who are dually eligible for both Medicare and Medicaid.

Through the new MI Health Link program, all services currently covered separately through the Medicare and Medicaid programs will be integrated into a single health care delivery model. This model will feature coordinated care for physical health, long-term care, and behavioral health services and supports. The program will also focus on increasing access to home and community-based services and enhanced quality through performance monitoring. MI Health Link will include the use of person-centered processes and promote enrollee choice in all aspects of the program.

As partners, CMS and MDCH will ensure continuity of care during the transition to the new program for those enrolled. The final agreement outlines the state and federal responsibilities in the roll-out and administration of MI Health Link. Michigan will begin working with CMS and its contractors to develop readiness review protocols and three-way contracts between MDCH, CMS and the integrated care organizations that will administer the program.

"Our primary goal with MI Health Link is to improve quality and access to care for this vulnerable group of people who currently have to navigate two very different systems in Medicare and Medicaid," said James K Haveman, Director of the MDCH. "We appreciate the federal government’s thoughtful consideration of this program and its impact on improving care for Michigan residents."

The MI Health Link demonstration program will operate for three years in four regions of the state. Regions included in the demonstration are: the entire Upper Peninsula; a region in the Southwest part of the state consisting of the following counties: Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph, and Van Buren; Macomb as a single county region; and Wayne as a single county region.

The program will be implemented in two phases, beginning in the Upper Peninsula and the southwest region, followed by Macomb and Wayne counties in the second phase. Eight integrated care organizations were selected by MDCH to manage acute and primary care, pharmacy, dental and long-term supports and services for MI Health Link. Behavioral health services will be provided through the Michigan Prepaid Inpatient Health Plans.
Enrollment activities will begin later in 2014 for the first two regions of the program, the Upper Peninsula and Southwest Michigan. Service provision will start for individuals in these regions choosing to enroll no sooner than January 2015.

(For more information about MI Health Link, visit www.michigan.gov/mdch/0,4612,7-132-2939__2939__2939-259203--,00.html)
Jerry Wolffe is the writer-in-residence and advocate-at-large for the Macomb-Oakland Regional Center. He can be reached at 586 263-8950.