Network Health to Participate in Dual-Eligible Demonstration Program

Tools

Only health plan selected to offer services statewide

Network Health to Participate in Dual-Eligible Demonstration Program

<0> Network HealthNadia Sharif, 781-393-3055Communications Program Manager </0>

Network Health, a Massachusetts health plan that provides access to high-quality, comprehensive health care coverage for nearly 215,000 Massachusetts residents with low and moderate incomes, today announced that it has been selected to enter contract negotiations to participate in the Massachusetts Medicare-Medicaid demonstration to integrate Medicare and Medicaid benefits for people who are “dually eligible” for both programs. The Commonwealth of Massachusetts has selected Network Health as the only health plan to offer services to eligible residents statewide as an Integrated Care Organization.

“Network Health is committed to a person-centered approach to serving individuals with all levels of needs, consistent with our mission to advance the health and well-being of our diverse communities. We are excited to play an important role in the advancement of a new approach to the delivery of care to those who are most in need of coordinated, holistic services. This new program is based upon the independent living philosophy that recognizes the whole person, rather a person’s diagnosis or condition,” said Christina Severin, Network Health president. “We applaud the administration and the many advocates who have helped design this demonstration and are proud to be part of such a groundbreaking initiative.”

Massachusetts was the first of 26 states to receive approval from Center for Medicare and Medicaid Services (CMS) for a demonstration program for their dual-eligible population. The program, scheduled to begin in April 2013, will be available to an estimated 110,000 Massachusetts Medicaid beneficiaries between the ages of 21 and 64 who are eligible for Medicare due to a disability. Network Health, upon successful readiness review and contract negotiations, will contract with Massachusetts Executive Office of Health and Human Services (EOHHS) and CMS to administer services.

According to data from the Kaiser Family Foundation, annual per capita health spending nationwide for persons who are “dually eligible” is approximately $16,000, more than twice the cost for the average American. Through its nationally recognized integrated care management program, Network Health has proven its ability to comprehensively and compassionately serve low to moderate income individuals from diverse communities while improving care quality and reducing health care system costs.

Since 1997, Network Health has provided access to high-quality health care for Massachusetts residents with low and moderate incomes. Network Health is a nonprofit, comprehensive health plan serving members through its (MassHealth), (Commonwealth Care), and (Medical Security Program) plans.

To improve the health and well-being of its nearly 215,000 members and their diverse communities, Network Health offers fully integrated, in-house care management, providing a team of medical, behavioral health, social care, and pharmacy professionals who coordinate member care. Network Health partners with more than 20,000 primary care providers, specialists, hospitals, and community organizations statewide.

Network Health earned the National Committee for Quality Assurance’s (NCQA) “Excellent” Health Plan Accreditation status, NCQA’s highest accreditation rating, for its plan. In 2012, NCQA’s Health Insurance Plan Rankings ranked Network Health as the third highest Medicaid Health Plan in the United States. Since 2010, Network Health has ranked among the top 10 Medicaid health plans nationally, according to NCQA’s Health Insurance Plan Rankings — Medicaid. Network Health is among 10 health plans nationally and the first health plan in New England to earn the NCQA Multicultural Health Care Distinction. Additionally, Network Health is nationally recognized for its innovative programs; it won the Dorland Health Case In Point Platinum Award for “Best Integrated Case Management Team” in 2012 and “Best Overall Case/Care Management Program” in 2010. Network Health is also recognized for its top leadership team among health plans nationwide by HealthLeaders Media.

Network Health became an affiliate of Tufts Health Plan in 2011. Headquartered in Watertown, Mass., Tufts Health Plan is a nonprofit organization nationally recognized for its commitment to providing innovative, high-quality health care coverage to its 980,000 members. Tufts Health Plan’s HMO and POS programs are ranked second in the nation, and its Medicare Advantage HMO program ranks among the nation’s top 10 Medicare Advantage plans according to NCQA.

For more information about Network Health, call or visit . Follow Network Health on and @_NetworkHealth on .

To learn about their health plan options, Massachusetts residents can call Commonwealth Care at 877-623-6765 (TTY: 877-623-7773), Monday through Friday, from 8 a.m. to 5 p.m., or visit ; call MassHealth at 800-841-2900 (TTY: 800-497-4648), Monday through Friday, from 8 a.m. to 5 p.m., or visit ; or call the Medical Security Program at 800-908-8801, Monday through Friday, from 8:30 a.m. to 4:30 p.m., or visit .