Managed Care Organizations and Integrated Employment

1
Managed Care Organizations and Integrated
Employment

• Efforts to Expand Integrated Employment Options
  for MCO Members

2
Key Questions

• What are MCOs doing to support members
  employment goals?
• What systems change efforts have MCOs made and
  what lessons have they learned ?
• What are MCO Employment Coordinators, what do
  they do, and why are they so important?

3
Background

• Managed Care Pilots (Family Care) start in five
  counties in 2000
• Rapid expansion MCOs now operational in 38
  counties accounting for 59 of the state
  population (27,500 members).
• Steep learning curvefocus on basic tenants of
  managed care
• Employment took a back seat

4
The Beginning of Pathways and Family Care
Collaboration

• Collaboration began small in 2005
• Clear message Family Care to be Wisconsins new
  LTC system
• Small pilot with DVR and several MCOs
• Began looking at employment outcomes
• Identifying the barriers/issues around employment
  in MCOs

5
First steps

• MCO Employment Forumsstarted in 2005
• Increase collaboration/joint training
• Analyze strengths and weaknesses/barriers
  analysis
• Share learning, resources and innovative ideas
• Pilot innovative employment practices

6
Initiation of MCO Employment Grants

• Grants began in 2007
• Up to 60,000 offered to all MCOs serving people
  of working age
• Non competitive/Pathways TA provided during
  development

7
Grant Purpose

• Decrease real and perceived barriers
• Promote integrated employment as a desirable and
  realistic option
• Increase integrated employment options
• Pilot innovative/promising practices
• Target unique needs of MCO

8
Grant Parameters

• Focus on systems change
• Written sustainability plan
• Consumer Involvement
• Direct Impact on Consumer Employment Outcomes

9
Key Systems Change Efforts

• Established Employment Coordinator Positions
• Created missions and values statements about
  integrated employment
• Modified guidelines/policies and procedures to
  better support integrated employment as an
  outcome for members.
• Conducted extensive trainings on IE for MCO
  staff, providers and consumers
• Developed easy access on line resources, toolkits
  and informational materials

10
Key Systems Change Efforts contd

• Piloted alternative/unique approaches to
  employment
• Piloted innovative practices
• Developed DVR liaisons /MOUs
• Shared employment success stories

11
Impact/Outcomes Reported

• Significant Shift in MCO culture and awareness of
  the importance of employment as an outcome
• Expansion of Employment Coordinator Positions
• Providers offering more individualized services
• Increase in creative employment options
• Increased collaboration with DVR
• More members reporting an increase in options,
  support and choice

12
Impact/Outcomes Reported

• Increased visibility of employment in assessment
  and MCP process
• Increased systematic processes and clear
  guidelines for IDTs
• Increased IDT knowledge of resources needed to
  discuss employment with members
• Increased IDT knowledge of member preferences and
  choices about employment.
• Increase in provider requests for IE Training

13
Lessons Learned/Recommendations

• Set up strong systems, practices, and culture
  that supports integrated employment from the
  start
• Establish and internal Employment Coordinator
• Seek Opportunities for creative and blended
  funding
• Collect information/data on member employment
  preferences and outcomes
• Set up easy access/tools for MCO staff,
  providers, members to learn more about IE

14
Lessons Learned contd

• Think outside the box! Implement
  creative/innovative approaches to employment
• Generate interest with members and familyhelp
  them see the possibilities!
• Person-centered team approach is a must.
• Leadership must be strong supporters

15
Lessons Learned contd

• Expand the provider network
• Develop good relationship/clear communication
  with providers
• Support/acknowledge providers who are stepping
  up to the plate to offer more creative
  employment options
• Provide ongoing training opportunities for
  providers

16
MCO Employment Coordinator Position

• One of the most important systems change efforts
  made by the MCOs
• In house position focused on employment
• Evolving roles
• Variation in roles throughout state

17
Employment Coordinator Functions

• Go To person for Employment questions and
  information
• Conduct team/member consultation and problem
  solving
• Plan, organize and conduct educational sessions
  with staff and members
• Work collaboratively with DVR, schools and
  employment providers

18
Employment Coordinator Functions contd

• Obtain input on MCOs employment efforts
• Support Provider Network developers in expanding
  choice for members
• Manage all Pathways Employment Grant activities
  i.e., pilot innovative systems change efforts to
  promote Integrated Employment
• And much more!!!!