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SCDuE Weekly Update | July 14, 2013

DUAL-ELIGIBLE BENEFICIARIES OF MEDICARE AND MEDICAID: CHARACTERISTICS, HEALTH CARE SPENDING, AND EVOLVING POLICIES
The Congressional Budget Office recently released a report examining the characteristics and health care costs of dual eligible beneficiaries.  This report also addresses federal and state initiatives to integrate the payment systems for Medicare and Medicaid and to coordinate care for this population.
Dual-Eligible Beneficiaries of Medicare and Medicaid:  Characteristics, Health Care Spending, and Evolving Policies | Link
 

HOSPICE AND THE DEMONSTRATION WEBINAR
On Wednesday, July 10, 2013, SCDuE team conducted a webinar on the topic of hospice and the Demonstration.  The training session was targeted to the hospice provider community and detailed information on the Demonstration’s focus of clinical integration.  Although hospice is not included in the capitated rate, selected health plans are expected to integrate this service into the overall care plan of their members.  During the presentation, the SCDuE team described the opt-in enrollment period and passive enrollment processes as they relate to hospice.  The presentation also highlighted palliative care as a new Demonstration only service.  The slide deck for this session is posted below as an attachment.
 
The team is in the process of developing a list of frequently asked questions related to hospice and the Demonstration.  Providers and other stakeholders can submit questions to scdue@scdhhs.gov.   The SCDuE team will provide follow up education sessions with both hospice providers and selected plans to further discuss the details of provider communication and coordination. 
 

INTRODUCING NEW SCDUE TEAM MEMBERS
The SCDuE team has grown immensely in the past two months as the Department prepares for a July 1, 2014 implementation.   The following new staff members will play an integral role in implementation activities: 
 
Candra Chassion is a health policy intern from the University of South Carolina.   She will graduate from the University in December 2013 with a dual undergraduate degree in biology and public health.  She plans to pursue an MPA and a PhD in Public Policy in the future.  Candra conducts policy research to support the team’s efforts to identify promising practices among states in the area of coordinated and integrated care. 
 
Stephanie Cox has a Bachelor’s degree in Family and Consumer Sciences in Early Intervention and Youth Issues from Winthrop University. She has spent the last five years at the University of South Carolina School of Medicine as a Pediatric Residency Coordinator and a Medical Student Coordinator.  Most of Stephanie’s professional career has been in private sector healthcare, working at The School of Medicine and Palmetto Health Richland. 
 
Larry Fernandez works as consultant to the Demonstration in the areas of contracting, procurement, quality management and managed care.  He holds a Bachelor’s degree in History and Master’s degree in Public Administration from the University of South Carolina.  Larry has over 35 years of experience in government, research and health care including working with several South Carolina legislative committees.  He has served as Director of the South Carolina Human Services Coordinating Council and held various leadership positions at the South Carolina Department of Health and Human Services (SCDHHS). 
 
Joshelyn James previously worked as an intern with SCDHHSin Legislative Affairs and Health Outcomes Initiatives.  She has a Bachelor’s in Communications from the University of South Carolina Aiken and is also a certified Paralegal. She volunteers with the South Carolina HIV Aids Council and aspires to obtain her Master’s degree in Public Health in the fall of 2014 from the University of South Carolina.   Joshelyn will provide support in the areas of communications and consumer protections. 
 
Christine E. Raper comes to SCDHHS as a Program Coordinator II with experience in public health promotion, education, psychology, and leadership development.  She received her Bachelor’s in Psychology and Leadership Studies from Christopher Newport University and her MPH from Columbia University’s Mailman School of Public Health in the Department of Sociomedical Sciences. Christine is a Certified Health Education Specialist (CHES) trained in designing needs assessments, planning theory and evidence-based health programs, and conducting program evaluation. She has previously worked on health program planning and intervention design, specifically with preadolescent obesity in culturally diverse New York City neighborhoods. Her public health skills along with her background and experience in teaching and curriculum development will be utilized in the education, training and outreach efforts of the Demonstration.
 
Katharine “Kate” Reynolds is an MHA graduate from the Arnold School of Public Health at the University of South Carolina. She brings a wealth of knowledge related in the patient centered medical home (PCMH) model from her work with Palmetto Health and will serve as an integral team member to support the Demonstration and managed care policy. Kate will work with the team in its efforts related to quality and clinical integration.
 
Stacey Shull holds a Master of Science in Public Health (MSPH) in Epidemiology from the Arnold School of Public Health at the University of South Carolina. She has more than 16 years of experience in program planning, development, data management, evaluation and surveillance for national, state and community-level health programs. Stacey’s primary focus will be related to Demonstration enrollment, IT systems integration and data management.
 
Jon Tapley has 17 years of experience in policy development and claims resolution at SCDHHS, including over a decade of professional experience in home and community based services.  In addition, he has also worked in programs related to physicians and other medical professionals.  Jon currently works in the Department’s managed care division and will support the team’s data reporting efforts. 
 
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Medicare-Medicaid FAQs (Frequently Asked Questions) | PDF
Contact CMS for any questions or concerns regarding the meetings, guidance, or the MMP application. Emails can be directed to MMCOcapsmodel@cms.hhs.gov
Contact the SCDuE Team for more information, questions, and/or comments related to the SCDuE Demonstration by email at scdue@scdhhs.gov.
For additional assistance, please contact the SCDuE Program Manager, Teeshla Curtis by email at curtist@scdhhs.govor by telephone at (803) 898-0070.
Visit the SCDuE Website at https://msp.scdhhs.gov/scdue/
Visit the CMS-MMCO Website at https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/index.html

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