HHSC is marking another significant milestone in the expansion of Medicaid managed care.
As of March 1, people covered by Medicaid who are eligible for STAR+PLUS and live in a nursing facility will get their basic health services and long-term care services through STAR+PLUS. People who get both Medicaid and Medicare (dual eligible) will continue to get their basic health services through Medicare and their long-term care services through STAR+PLUS Medicaid.
With this most recent STAR+PLUS expansion, it’s estimated that nearly 87 percent of Texas Medicaid clients are now getting their services through a managed care plan.
“The long-term goal has been to improve service delivery and bring efficiencies to Medicaid by expanding managed care,” said HHSC’s Gary Jessee. “With this transition, people with Medicaid coverage in nursing facilities will now get their services through a STAR+PLUS plan and enhanced service coordination provided by that plan.”
The service coordinator works with the STAR+PLUS member (or caretaker) and staff of the facility to make sure the person’s care is coordinated. The coordinator also looks for ways to avoid preventable hospital admissions, readmissions and emergency room visits.
To prepare for the transition, HHSC sent each client letters explaining the transition, how to pick a STAR+PLUS medical plan and how to get help picking a plan. HHSC also conducted 1,100 enrollment events at nursing facilities in every region of the state, where people got one-on-one help picking a STAR+PLUS medical plan and getting their questions answered. For providers, HHSC conducted trainings in each region of the state and by way of computer/phone webinars.
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