Webinar Recap: Waiver 101 – How Passport Health Plan is Navigating the Change and Staying True to Their Mission

June 22, 2018

Passport Health Plan in Louisville, Kentucky, is a well-established Medicaid MCO whose mission-driven orientation has them deeply rooted in the community and focused on giving as much back to the community it serves as it can.  On January 12, 2018, the Centers for Medicare and Medicaid Services (CMS) approved a Section 1115 demonstration waiver in Kentucky, entitled “Kentucky Helping to Engage and Achieve Long Term Health” or Kentucky HEALTH. The health and well-being program is for certain low-income adults and their families.

Passport Health Plan’s Vice President and Chief Operating Officer, Carl Felix, and Evolent Health’s Regional Medicaid President, Scott Bowers, recently co-hosted a webinar for the Association for Community Affiliated Plans (ACAP) on how Passport Health Plan has been navigating and implementing the changes introduced in the waiver, while still maintaining their mission and focus on serving the community. Click here to view the webinar recording.

Waiver 101

The Kentucky 1115 Waiver takes effect July 1, 2018, but Passport and Evolent have been preparing for the changes since their first exposure to draft legislation in late 2016.  The waiver is a game-changer for Medicaid MCOs in terms of how the program is set up and what operational capabilities are required.  

The waiver covers more than 85% of Passport’s current Medicaid enrollees in specific categories. Key components of the waiver include cost sharing, a deductible account, a rewards account, community engagement requirements, education and training and premium assistance. To learn more about Kentucky HEALTH and each of the programs components visit: http://www.kentuckyhealth.ky.gov

To date, Evolent and Passport have collaborated heavily with Kentucky’s Department for Medicaid Services (DMS) and are working together to ensure these benefits are implemented without issue.

Lessons Learned (so far)….

Scott and Carl highlighted five key learnings from the effort so far:

  1. The devil is in the details. It’s important to identify not just a strong executive sponsor, but also the key staff members who will dedicate their time to get “into the weeds” on IT, eligibility requirements and the host of other issues tied up with the 1115 waiver. 
  2. Collaboration is key. To successfully implement this waiver, Passport and Evolent had to collaborate extensively with DMS as well as other competitor MCOs. DMS’s proactive approach was beneficial to ensuring the collaborative environment. 
  3. Fast alone, further together. The collaborative effort required paid off in terms of success. While DMS could have implemented several of these requirements, having the input and ideas of many MCOs furthered the success of the waiver program.  Additionally, the joint efforts of Evolent and Passport reinforced each other and propelled the success of the project. 
  4. Mission first. Keeping the organization’s mission front and center helped to drive the decision-making process. It allowed Passport and the MCOE to do not just what’s required according to the specs but doing what’s right for the member population. For instance, focus on the mission has changed and expanded Passport’s approach to community engagement.  
  5. Remember the intent. Remember what the waiver is intending to do for the member and base all engagements on those benefits. 

Passport’s Focus on the Community

With Passport’s mission-first mentality, they continue to be a leader in connecting to the community.  One of the most visible ways they are doing so is through their new corporate headquarters. The campus, which is designed to speak to their mission, is located in a disenfranchised area of West Louisville, KY, where 60% of the members within a 10-mile radius have costs that are on average twice that of the overall Medicaid population Passport serves. To benefit this population, the campus will house social service agencies and other social supports, in addition to providing much-needed space for Passport and Evolent’s Medicaid Center of Excellence, or MCOE. 

The MCOE is a partnership between Passport and Evolent that brings together leaders in provider-led Medicaid managed care. The MCOE provides innovation and infrastructure to providers and governmental entities across the nation seeking new ways to improve health outcomes and lower costs. 

To learn more about how Passport Health Plan and Evolent Health are delivering higher quality care to Kentuckians or the MCOE – contact partner@evolenthealth.com.

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