San Diego Long Term Care Integration Project

1
San Diego Long Term Care Integration Project

• Planning Committee Meeting
• June 9, 2004

2
Todays Discussion

• Draft AAP
• Stakeholder feedback (almost 100)
• Revised Draft AAP

3
Todays Goal

• Consensus development
• To continue development of all 3 options
• To accept Draft AAP as working blueprint to
  continue planning for HSD

4
The Big Picture

• Network of Care
• Physician Strategy
• Healthy San Diego Plus

5
Highlights of Feedback

• Physician response to more managed care
• Care manager sub-contracting
• Enough in system? (like MassSCO)
• Detail, detail, detail (all categories) needed,
  including TA for potential contractors (State
  resources?)
• CBOs will go for HCBC? How much?
• Mental Health, other specialty svcs included?

6
Highlights of Revisions

• Eliminated 300/mo. and included elderly
  disabled
• Eliminated planning or recommending mandatory
• Care management sub-contract joint development
  of standards
• Clarified need for systematic chronic care
  management

7
Challenges added to AAP

• Lack of interest/participation by contractors
• Lack of member choice of enrollment into HSD
• Inability to negotiate w/CMS DHS in timely
  manner

8
Challenges (continued)

• Actual or perceived insufficient funding
• Insufficient provider support across the
  continuum
• Insufficient admin funding for
  pre-implementation activities

9
Challenges (continued)

• Diversion of attention to other opportunities
  that may present

10
Consensus Discussion/Development

• To continue development of all 3 options
• To accept Draft AAP as working blueprint to
  continue planning for HSD