SOUTH COUNTRY • 1

 SOUTH COUNTRY connection

SOUTH COUNTRY • 1

Keeping County Staff InformedFebruary 2016

calendar of events

Subscribe! SOUTH COUNTRY

connectionCLICKHERE

links:

Website Redesign

Directors Advisory Committee

2016 SNBC Procurement

JPB Committees

County Satisfaction Survey

New Dental Program Manager

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February 11 Public Relations Committee, 2300 Park Dr., ITV, 1-3 p.m.

February 15 Presidents’ Day, Main Office Closed, Member Services open 8 a.m.-8 p.m.

March 4 Quality Assurance Committee, 2300 Park Dr., ITV, 9 a.m.-noon

March 7 PH/HS Directors Advisory Committee, MCIT, St. Paul, 10 a.m.-2 p.m.March 30 Joint Powers Board, 2300 Park Dr., 9 a.m.-noon

New ITV Systems

Special Transportation Services

Antidepressant Management

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County Board Member Alternate

Brown Scott Windschitl* Richard Seeboth

Dodge Dave Erickson Rodney Peterson

Goodhue Dan Rechtzigel Brad Anderson

Kanabec Kathi Ellis Dennis McNally

Morrison Duane Johnson Mike Wilson

Sibley Gary Kruggel Joy Cohrs

Steele Nina Huntington Corky Ebeling

Todd Gary Kneisl* Dave Kircher

Wabasha Don Springer Mike Wobbe

Wadena Bill Stearns David Hillukka

Waseca Jim Peterson Richard Androli

2016 South Country Joint Powers Board

*Gary Kneisl was elected as the 2016 Board Chair and Scott Windschitl as Vice Chair.

The Joint Powers Board leads in the planning, oversight, and evaluation of South Country’s services, programs, and business. Board members also provide leadership in the areas of compliance, quality, and finance.Each member of the Joint Powers Board represents one of the 11 counties that own South Country Health Alliance. This year Gary Kneisl will serve as the Board chair, and Scott Windschitl will serve as the Vice Chair. The Joint Powers Board meets monthly at South Country’s home offices in Owatonna. South Country leadership staff and the Chair of the Public Health and Human Services Directors Advisory Committee also attend each meeting. This year’s Co-Chairs are Charity Floen of Minnesota Prairie County Alliance and Amy Roggenbuck of Dodge and Steele County. n

Gary Kneisl, Chair Scott Windschitl, Vice Chair Dan Rechtzigel, Past Chair

2016 Joint Powers Board Members & Alternates

SOUTH COUNTRY • 2

 SOUTH COUNTRY connection

2016 JPB CommitteesExecutive Committee

• Gary Kneisl, Chair• Scott Windschitl, Vice Chair• Dan Rechtzigel, Past Chair• Dave Erickson, QAC• Bill Stearns, Finance

Compliance Committee• Duane Johnson, Chair• Dan Rechtzigel• Gary Kruggel• Scott Windschitl• Nina Huntington, Alternate

Quality Assurance Committee• Dave Erickson, Chair• Nina Huntington• Don Springer• Jim Peterson, Alternate

Finance Committee• Bill Stearns, Chair• Gary Kneisl• Kathi Ellis• Jim Peterson• Deb Gruber, Administrator• Don Springer, Alternate

Coming Soon: SCHA Website RedesignWithin the next couple of months, South Country Health Alliance will release its redesigned website. The new website will feature several improvements to organization and usability, including the addition of a search function. Our main priority was to make the most useful tools and information more accessible and easier to find.As more and more people access information from their mobile phones, the new website will also be “responsive,” meaning it will work well on tablets and mobile devices. We are also adding a blog to the website, which we will use to provide real-time updates and articles about SCHA news, promotions, changes, and other things you may need to know. Weekly summaries of blog articles will be emailed to anyone subscribed to the mailing list. Stay tuned for more information. n

County Director County DirectorBrown Tom Henderson Sibley Vicki Stock

Brown Karen Moritz Steele Amy Roggenbuck, Chair

Dodge Amy Roggenbuck, Chair Todd Jackie Och, Vice Chair

Goodhue Nina Arneson Wabasha Judy Barton

Kanabec Wendy Thompson Wabasha John Dahlstrom

MN Prairie Charity Floen, Chair Wadena Cindy Pederson

Morrison Katy Kirchner Wadena Tanya Leskey

Morrison Brad Vold Waseca Sarah Berry

2016 Public Health & Human Services Directors Advisory Committee

County Sub-Committee Assignments

The Public Health and Human Services Directors Advisory Committee provides information and recommendations to the Joint Powers Board and works collaboratively to advance common goals of South Country Health Alliance.This year’s Co-Chairs are Charity Floen and Amy Roggenbuck and Vice Chair is Jackie Och. Together, they will provide the link between the Directors Advisory Committee and the Joint Powers Board.In sub-committees with South Country staff, the Directors Advisory Committee works to understand issues and develop functional methods to implement new initiatives. This joint effort best serves the members residing in the county communities. n

Charity Floen, Chair Amy Roggenbuck, Chair Jackie Och, Vice Chair

Service Enhancement CommitteeMary Heckman (Chair), Judy Barton, Kim DeCock, Karen Moritz, Mike Steinbeisser, Wendy Thompson

Public Relations CommitteeJohn Dahlstrom (Chair), Charity Floen, Tanya Leskey, Jackie Och, Vicki Stock

Transportation Committee Brad Vold (Chair), Helen Pieper, Cathy Skogen, Vicki Stock, Wendy Thompson

Quality Assurance CommitteeAmy Roggenbuck, Wendy Thompson

Health Outcomes Committee Amy Roggenbuck (Chair), Sarah Berry, Krista Early, Katy Kirchner, Cindy Pederson

Legislative CommitteeCharity Floen, Tom Henderson, Jackie Och, Brad Vold

Quality Assurance CommitteeAmy Roggenbuck, Wendy Thompson

Compliance CommitteeCharity Floen

SOUTH COUNTRY • 3

 SOUTH COUNTRY connectionCounty Satisfaction SurveyLet us know what you think about South Country's service!Your feedback helps us improve our service to you and our members.Click here to take our County Satisfaction Survey today! n

New ITV SystemsThe IT department is currently preparing new ITV equipment for participating county offices and hopes to have the new devices delivered by mid-February. The ITV devices will be pretested and configured before they are installed in the counties.The new systems are leading edge technology, creating better quality in the ITV experience. The counties will also have easier access to ITV support through South Country. n

Proposed LegislationMinnesota Association of County Health Plans (MACHP), which includes South Country Health Alliance, PrimeWest Health, and Itasca Medical Care, has drafted proposed legislation to strengthen and preserve county-based purchasing. This legislation is intended to provide the clarification needed as identified following the 2015 procurement.In February, South Country will be meeting with area legislators to provide information about the legislation, seeking their support before session begins March 8, 2016. We will share the bill language and number once they’re finalized. n

New Dental Program ManagerSouth Country is pleased to welcome Michele Grose, RDH, as our new Dental Program Manager! Michele will join the Operations team, where she’ll be responsible for providing oversight and management for South Country’s dental program.Michele has more than 24 years of clinical dental hygiene experience, previously working at general dental practices in Waseca and Waterville. She graduated from Bethany Lutheran College and Mankato State University as a Registered Dental Hygienist.As the Dental Program Manager at South Country, Michele will work closely with dental providers to maintain and build South Country’s dental provider network. She will serve as the primary contact for South Country’s dental benefits administrator, DentaQuest, as well as monitor and oversee all regulatory and contractual requirements pertaining to dental services. As South Country’s expert in dental benefits, Michele will also resolve specific member dental issues as needed.Michele looks forward to collaborating with the counties on dental initiatives in the future and working to improve members’ access to dental services. Michele can be reached at 507-431-6949 or mgrose@mnscha.org. n

Special Needs BasicCare (SNBC) ProcurementDHS will be holding a procurement in the spring of 2016 for the Special Needs BasicCare (SNBC) program. Because South Country already has an integrated SNBC product, SCHA counties do not need to respond to the RFP.One purpose for the SNBC procurement is to provide health plan choices in the northern part of the state, since Medica will no longer be an SNBC health plan choice in several northern Minnesota counties, effective July 1, 2016. South Country will continue to be a SNBC health plan option in all of our counties.

DHS is also encouraging more health plans to offer an integrated SNBC program (like our AbilityCare product) in 2017.This procurement affects ONLY SNBC, but will not include children under the age of 18. SNBC enrollees do NOT need to take any action at this time. Members affected by Medica no longer being a SNBC health plan choice in Morrison, Todd, and Wadena do not need to take action at this time. Affected enrollees will receive letters with more information in May 2016.South Country will be working closely with affected counties over the next several months to help make the transition as smooth as possible. n

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2087

233

228

154

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SCHA SCHA

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North consists of 37 countiesMetro consists of 7 countiesSouth consists of 43 counties

Prior to RFP responses e�ective 7-1-2016

SNBC Potential Changes July 1, 2016

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- Potentially without SNBC health plan

- SNBC health plan option remains available

- Una�ected by 7-1 changes

MetroNumbers written within county borders represent number of Medica SNBC members as of December 2015.

Freeborn Mower

Lake of the Woods

Koochiching

Beltrami

Polk

Itasca

CassHubbardCle

arw

ater

Norman

OtterTail

Crow Wing

Aitkin

Todd

DouglasGrant

StevensTraverseBig Stone

PopeStearns

St. Louis

Carlton

Pine

Mille Lacs

Morrison

Lake

Benton

Kana

bec

Wadena

Isanti

Sherburne

MeekerWright

Renville

McLeod Was

hing

ton

Chi

sago

Ram

sey

Hennepin

Waseca SteelePipestoneBrown

Blue Earth

Sibley Scott

Dakota

Goodhue

Rice

Anoka

Carver

HoustonRock Nobles Jackson Martin Faribault Fillmore

Kittson

Marshall

Roseau

Pennington

Red Lake

Mahnomen

BeckerClay

Wilkin

Swift

Cook

Kandiyohi

Chippewa

Lac Qui Parle

Yellow Medicine

Cottonwood

NicolletLe Sueur

Lincoln Lyon

Redwood

Watonwan

WinonaMurray Dodge

Wabasha

Olmsted

SOUTH COUNTRY • 4

 SOUTH COUNTRY connectionAntidepressant Medication Management for Major Depressive Disorder Promoting and Improving Effective Medication Adherence Through a Collaborative Care Approach

Changes to Special Transportation Services (STS) Authorizations

On February 1, 2016, South Country Health Alliance will begin a Quality Improvement Project (QIP) with our SeniorCare Complete and AbilityCare members and a Performance Improvement Project (PIP) with our Minnesota Senior Care Plus, SingleCare, and SharedCare members. The QIP is a contract requirement with CMS for our Medicare Advantage programs and the PIPs are contract requirements with the Minnesota Department of Human Services for all of our health care products.The topic was selected in response to CMS Quality Strategies to optimize health outcomes by promoting effective management of chronic diseases. Effective management is expected to slow the progress of chronic illness and/or disease, prevent complications and the development of comorbidities, prevent emergency department encounters and inpatient stays, improve the quality of life for enrollees, and facilitate cost savings to health care plans and the enrollee (CMS 2015).The intended outcome of these projects is to increase the rate of compliance among members who have a diagnosis of major depressive disorder, are being treated with an antidepressant medication, and remain on an antidepressant medication treatment for at least 180 days. Depressive symptoms in disabled individuals and the elderly can be under-recognized and under-treated, often complicated by cognitive impairment, co-morbid illnesses, and

adverse life events. South Country members often have a higher level of chronic, co-morbid conditions that can be negatively impacted by inadequate antidepressant medication management. Therefore, this project is clinically significant from the perspective of 1) addressing adherence to antidepressant medication management in conjunction with members’ understanding of the diagnosis and the intended outcomes of adherence with treatment protocols, 2) promoting continuity of care coordination, 3) connectivity to preventive services and available resources (including disease management programs), and 4) effective communication across the continuum of care. The interventions outlined in these improvement projects will focus on a collaborative care approach using proactive supportive outreach/education strategies with members, coordination of member treatment engagement through effective communication and collaboration with Connectors and care coordinators, and outreach strategies with providers in order to determine “best practices” for engaging members in their care. South Country looks forward to collaborating with our county owners to enhance and/or develop additional outreach strategies for the members identified in the QIP and PIP projects. For more information, please contact Senior Quality Manager Julie Stevermer at jstevermer@mnscha.org. n

The authorization process for South Country Health Alliance members to receive Special Transportation Services (STS) is changing, beginning April 1, 2016. This will not affect common carrier transportation.Effective April 1, 2016, members who need STS will call Member Services to make their request. Member Services will gather information and set the member up for an assessment with a nurse, who may contact others working with the member, such as a care coordinator, Connector, physician, or residential provider to gather information for the assessment. An STS authorization field will be available for county staff in CCM on the Member Details page and for providers in the Health Solutions Provider Portal. The authorization will indicate whether or not the member has the STS level of need, as well as the date span of the authorization. Members living in a nursing home or an ICF/DD facility will be automatically authorized because of their living arrangement. Once a member has been authorized, the member will be able to schedule his or her own STS rides with a provider. STS providers will need the authorization to be paid by South Country, beginning April 1, 2016. Transportation requests will require a 72-hour advance notice, or they may not be filled. South Country is working in February and March to contact members who are currently using STS rides to assess their need for

that level of transportation. Members will receive a letter notifying them of their authorization and the time span the authorization covers. If the assessment determines the member does not need STS transportation, a denial letter will be sent to the member. Eligible members would then be directed to a common carrier transportation provider. South Country will also be providing training for transportation providers, county staff, and facility staff in February and March. STS and common carrier are two types of Non-Emergency Medical Transportation (NEMT) that are a benefit for South Country members enrolled in PMAP, AbilityCare, SharedCare, SingleCare, Senior Care Complete, and MSC+. Typically transportation is not a benefit for members on MinnesotaCare, unless the member is pregnant, under the age of 21, or a refugee. Common carrier transportation is generally used for members who are able to enter and exit the vehicle independently, and STS is used for those who need assistance getting from their home to the vehicle and to their appointment. A listing of STS providers are available on the South Country website at www.mnscha.org or by calling Member Services at 1-866- 567-7242. Common carrier transportation requests will be directed to the member’s county staff or contracted providers as determined by the county. n

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SOUTH COUNTRY • 5

 SOUTH COUNTRY connection

SCHA believes it is the responsibility of everyone to report suspected

fraud, waste, or abuse. You can report anonymously

through our REPORT-IT hot line by calling 1-877-778-5463.

You can also make a report at www.reportit.net. Username: SCHA,

Password: Owatonna

REPORTING: Fraud, Waste and Abuse

South Country Health Alliance (SCHA) is a county-based

purchasing health plan providing coverage for Minnesota Health

Care programs in Brown, Dodge, Freeborn, Goodhue, Kanabec,

Morrison, Sibley, Steele, Todd, Wabasha, Wadena,

and Waseca Counties.

Copyright © 2016 by South Country Health Alliance.

The County Connection is a bimonthly publication of

South Country Health Alliance. For submission information or re-

print permission, please contact:

SCHA, 2300 Park Drive, Suite 100, Owatonna, MN 55060

Email: marketing@mnscha.org Website: www.mnscha.org

Have an idea for what you’d like to see in the next County Connection newsletter? Send us your requests at

marketing@mnscha.org.

The Use of Incentive Programs and Member Engagement in Well-Child VisitsMedicaid programs are increasingly using incentives to encourage beneficiaries to actively engage in best practices for personal health and wellness. The Affordable Care Act recommended that incentives be used to increase utilization of preventive care by Medicaid beneficiaries, as periodic well-child visits have been found to be an effective health care measure. Financial incentives have shown positive results in improving immunization rates in vulnerable communities, increasing attendance at prenatal and postnatal appointments and child/adolescent well-care visits. However, research on the use of incentives to facilitate changes in member behavior in respect to health care utilization is relatively new, therefore evaluative studies are still limited. Wisconsin’s Individual Incentive Initiative was designed to test whether or not financial incentives were effective in motivating Medicaid members to adopt heathier behaviors. Results suggested that incentives may be an effective tool in encouraging members to adopt modest behavior changes. They discovered that clear and concise marketing materials are critical to success, as are timely reward redemption. Additionally, patient education appears to be valued equally to the incentives, and the amount of time required to implement and improve effective programs should not be underestimated, including qualitative/quantitative data analysis. Well-care visits are important at all ages, but are especially important in a child’s toddler years when they are growing rapidly and are expected to reach defined developmental milestones. For the 3-6 year age group, an analysis of South Country’s 2013 compliance rates showed it was the 6 year well-care exam that is typically not completed, which negatively impacts our overall rate. Feedback from stakeholders suggested that parents do not find the 6 year visit to be necessary because children have received all vaccinations required for

school (typically during the 5 year well-care exam), and providers do not necessarily encourage a return visit at age 6 if the child is otherwise healthy. Similarly, regardless of age, if immunizations are not due then parents are less likely to make an appointment for their child to have a full well-care exam.To encourage compliance with annual well-care visits among 3-6 year olds, South Country implemented a gift card incentive program in May 2014. Still in place and gaining in popularity, parents of children who complete a well-care visit with a primary care provider are offered the opportunity to earn a $50 gift card to Walmart. Preliminary analyses suggest the incentive program improved compliance with the recommended well-care visits, as evidenced by a significant improvement in corresponding HEDIS rates overall and also specifically among 6 year olds:

However, there are a few data limitations to consider. The impact analysis is based solely on incentive vouchers returned and paid out and does not include the influence of reminder mailings sent to members’ parents/legal guardians. Further analysis will be conducted of 2015 data to assess the continued impact of the rewards program; this will provide South Country with a better understanding of the impact our prevention initiatives have on improving the percentage of child who receive well-child visits.n

Age Group Year HEDIS Rate

3-6 2013 62.84%

3-6 2014 70.28%

6 2013 56.26%

6 2014 59.20%