One Care Program Provides Update, Amends Financial Protections for Plans

The One Care initiative provided stakeholders with an update on enrollment population as well as the financial methodology governing the program and survey results illustrating enrollee opinions and satisfaction with services and the care team.

One Care, which coordinates Medicare and MassHealth services for dually eligible individuals between 21 and 64 years old, reported that the program has spent 14 percent – or $19.4million – on home and community-based services, including home health. This number reflects the life of the program thus far since it launched in October 2013. Pharmacy services represents the largest piece of the spending pie at 25 percent ($34.36 million).

The program has also conducted a round of enrollee surveys that found the following:

  • Over 80% of enrollees had met with their PCP; most are satisfied with the PCP
  • Over 70% had met with their Care Coordinator; 90% are satisfied
  • There was confusion about the role of the LTS Coordinator
  • When asked if they needed/wanted LTS Coordinator, many said no, or not sure;
  • Only 39% said they needed/wanted an LTS Coordinator;
  • Less than 45% had met with an LTS Coordinator

One Care administrators worked with CMS to update the financial methodology that was intended to protect the three plans (Commonwealth Care Alliance, Fallon Total Care, Network Health) and that info, along with the broader report to stakeholders, is available in a PowerPoint presentation.

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