RD354 - Annual Care Coordination Report – November 1, 2020

Executive Summary:

The Department of Medical Assistance Services (DMAS) has expanded coordinated care to all geographic areas, populations, and services under programs it administers to meet the stated objectives of the Virginia legislature. Turning to managed care to deliver and coordinate care and supports for Medicaid members, most Medicaid and FAMIS members now get their health care services through managed care, which incorporates the value-added service of care coordination. The expansion of Medicaid has resulted in approximately 450,000 more Virginians with access to quality health care and care coordination through enrollment into one of DMAS’ managed care programs. At the heart of managed care is the principle that coordinating care improves both the experience and health outcomes for individuals while controlling cost. For those members not enrolled in managed care, such as those under Fee-For-Service (FFS), applications of person-centered care coordination are still available. This report will discuss the features of care coordination within the various Medicaid programs and will include the number of individuals enrolled, the geographic areas served, populations and services affected and the development of any changes or advances. Demonstration of cost savings achieved directly resulting from care coordination is difficult to quantify, however highlights of successes associated with care coordination can be found in Appendix A of this report.