We are pleased to announce two
outreach initiatives in 2012 for our high-risk Medicare Advantage HMO members:
one for members who are currently in a contracted facility that provides
skilled or custodial care (SNF program), and another for select high-risk
members who reside at home (In-Home program). Through MedAssurant, local
physicians, nurse practitioners, and physician assistants will conduct
comprehensive health risk assessments for members either at the facility or in
the member?s home.
These programs provide face-to-face
comprehensive medical assessments for high-risk Medicare Advantage HMO members
with complex chronic conditions, at no cost to the member. These assessments
will help support the care that primary care physicians (PCP) give to these
Medicare Advantage HMO members and identify additional health risks and
additional medical management opportunities.
As noted in communications to SNF and
at-home members, a MedAssurant representative will contact applicable
facilities and members to arrange these comprehensive health risk assessments
and review charts as necessary with the members? consent. For the SNF program,
facilities are responsible for providing inpatient medical records and
assisting in contacting members? PCPs for information to complete the health
risk assessments.
Once the comprehensive health risk
assessment is completed, a letter will be sent to the Medicare Advantage HMO
members? PCP or other designated provider informing them that an assessment was
performed, along with the results. As part of the SNF program, a copy of the
comprehensive health risk assessment shall be placed in the patient?s medical
records in the facility. PCPs should file the comprehensive health risk
assessment in their patients? charts and review the results with them during
their next visit.
Last year, the comprehensive health
risk assessments were well-received by both patients and the provider
community. This year we look forward to serving the selected high-risk members
and the provider community.
Please call Customer Service at 1-800-275-2583 if you would like more information
about this initiative or if you have further questions.