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Michigan's Integrated Care Plan for People who are Medicare-Medicaid Eligible

Michigan's Integrated Care Plan for People who are Medicare-Medicaid Eligible






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  • The financing model will be capitation Dually eligible persons include: Frail elderly Mentally ill Developmentally disabled
  • There will be a three way contracting process developed. Contracts will specify expectations and include incentives to assure the relationships are built for maximum coordination and integration. State will configure ICO and PIHP boundaries so they will be aligned. Regions are unlikely to conform to current Medicaid HMO and PIHP regions. MDCH states that a major consideration of the two contract approach is to avoid destabalizing the current system and to recognize the value of the existing delivery system.
  • In addition, PIHPS and ICOs will be required to share a secure electronic platform that contains at a minimum- A current integrated problems list as required in medical records A single integrated person-centered plan of care A current medication list Care management notes that contain real-time information on most recent contacts, including emergency services. By the end of the demonstration, PIHPs and ICOs must share an integrated electronic record that also includes lab and diagnostic results, progress notes for all disciplines, physician orders, consultations and care planning and supports coordination team notes.
  • The quarterly phase-in will be done by region and within each region by population. Beneficiaries may have the choice between two or more ICOs; however, only one PIHP will be available. The state will configure the ICO and PIHP boundaries so they will be alligned. Therefore, geographic regions are unlikely to conform to current Medicaid HMO or PIHP regions. There will likely be 5 -8 regions developed.
  • MPCA will have staff at both events and will likely also be submitting email comments. Today at Health Policy we will discuss the proposed plan.
  • We still have questions about who will manage the care for the mild to moderate mental health needs The terms primary care medical home, patient centered medical home and health homes are used and we need to determine what was meant by each. We also need to determine if MDCH intended to say they would be applying for Health Homes, which is only referenced in relation to the PIHPs. We will need to determine how FQHC payment will get to centers We don’t know of the care coordination in the care bridge will be at the ICO/PIHP level or “one the ground” in the clinic setting.