Value to the Member IC1122 (low res)

Value to the
Member
Value to the
Member
Friends for Health. Friends for Life.Friends for Health. Friends for Life.
www.icare-wi.org
H2237_IC1122 CMS Accepted

Corporate Management
Thomas Lutzow, PhD, MBA
President & CEO, Independent Care Health Plan
Liz Bartlett, JD
Vice President & General Counsel
Linda Ellis, MD, MJ
Medical Director
Bill Jensen, MBA
Vice President
Carolyn Krause, PhD, RN
Vice President, Accountable Care
Vinay Pandey, BS
Vice President & Chief Information Officer
Don Slowik, CPA
Vice President
Craig Steffes, CPA
Vice President & Chief Financial Officer
Board of Directors
Howard L. Garber, PhD
Chairman, Independent Care Health Plan Board of Directors
President, Centers for Independence, Inc.
Stephen Arnhold, FSA, MAAA, CFA
Vice President, Actuarial, Humana Inc.
Alex Chou, JD, MBA
Director of Corporate Development, Centers for Independence, Inc
Cheri Greenfield-LaTour, MBA
Vice President of Patient Experience and MSO Development, Humana, Inc.
James Hartwig, JD
Officer and Board Member, Centers for Independence, Inc.
Anita Holloway, MD, MBA
Market Vice President and Medical Officer, Humana, Inc.
Elwood I. Kleaver, Jr., CPA
Health Care Consultant
John Moats, MBA
Consulting Leader, HumanaOne and Humana Small Group Division
Richard F. Zalewski, CPA, MBA
Executive Vice President, Centers for Independence, Inc.

Our Value...................................................1
iCare Core Values.....................................2
Member Profiles.........................................3-9
Dorothy Douglas.....................................3
Anthony St. Louis.....................................4
Ana Rios...................................................5
Genesis Pena-Delgado..........................6
Agnes Turner...........................................7
Linda McGhee Qtairi..............................8
Miller Brown.............................................9
The iCare Experience................................10
Mission, Purpose, Vision, ..........................11
Goals, History
A Different Approach to Care..................12
Quality Through Care Coordination........13
Diversity.......................................................14
Access to Community Services...............15
Innovation...................................................16-25
High Level Care Coordination...............16
Specialty Services..............................16
Behavioral Health Team....................17
Medical Disease Management........19
Team
Re-Admission Prevention..................20
(RAP) Program
Wisconsin Statewide Health..................20
Information Network
TruCare.....................................................22
Nurse Advice Line...................................23
MarketPOINT............................................23
iCare part of studies on best.................24
practices for Medicare,
Medicaid
Choice..........................................................25-27
What is the iCare Medicaid SSI.............25
Program?
iCare BadgerCare Plus..........................26
Get to Know the iCare...........................27
Medicare Plan
iCare Family Care Partnership..............28
for Long-Term Care and Acute
Care Needs
Results Through Care Coordination..........29
Accomplishments.......................................30
Quality, Choice, Results.............................31
Member Demographics.............................32-33
Membership by Ethnicity.......................32
Membership by Age Group..................32
Initial Assessment Statistics of...............33
Membership
Membership Growth (1994 - 2013).......33
Table of Contents
Page

Our members know that if they are in need of someone to talk to
when there is no one else around, they can call their care coordinator.
Someone from our Care Management team is always on call to make
sure that a member is not alone in their moment of need.
Our Value
From the beginning, Independent Care Health Plan (iCare) has been there for those
with special needs and limited means, providing access to needed health care services
and community resources. Our members value the outstanding care management
services offered by iCare, and their ability to reach out to their care coordinators and
care teams.
Our members know that if they need someone to turn to, their care coordinator is right
there in their corner, ready to assist with providing access to quality health care and
community services.
When our members are in need of a champion to ensure that his or her medical,
behavioral health or social service needs are met, their iCare care coordinator is just a
phone call away.
1

iCare Core Values
Inspire Wellbeing
• Motivate Members to peak health
• Listen to what is important to Members
• Build partners to achieve health outcomes
• Promote wellbeing as a personal habit
Brave New Solutions
• Imagine Member-unique solutions
• Optimize care resources
• Share best practices
• Drive continuous improvement
Radiate Compassion
• Reflect sensitivity to Member preferences
• Withhold judgments that may cloud decisions
• Treat others as if they were me
• Make iCare feel like home
Thrive Together
• Celebrate success of shared responsibility
• Lead even when no one’s looking
• Honor our legacy of integrity
• Be an “Effectiveness Multiplier”

iCare members can expect to receive help in determining which
medications to take, when to take them, and combinability with other
medications. A trusted resource is just a phone call away.
Dorothy Douglas
Dorothy Douglas lost her continuity of care after her
doctor changed practices. Dorothy is afflicted with
diabetes and mental health issues. Without anyone
to help her access the medical services or prescription
drugs that she needed, Dorothy experienced six
inpatient visits during an 18-month period from March
2007 to November 2008. After becoming a member
of our Medicaid Supplemental Security Income (SI)
program in September 2008, her high utilization of
inpatient services was noted by iCare.
Her care coordinator referred her to the Specialty
Services Department, where care manager Michelle
Elliott intervened by working diligently to contact
Health Care for the Homeless to schedule a behavioral
health appointment to update her prescription and ensure continuity of care. Michelle
also worked with a Specialty Services Department RN to contact Dorothy’s nurse
practitioner, advocating for a refill of her original prescription until she was able to
schedule the appointment.
Now, with a regular regimen of care through a nurse practitioner program and monthly
medication monitoring by Michelle, Dorothy is living a more stable life and has not had
any further inpatient visits. Dorothy knows that she can depend on her care manager,
stating, “Michelle helps me, if I have a problem I can call her.” Michelle indicated that
Dorothy lives an independent life, and will sometimes call her with questions about
accessing specialists or obtaining DME to meet her medical needs. Dorothy later
became a member of the iCare Medicare Plan, where she continues to receive the
care management that iCare provides, as well as Part D prescription drug services.
Dorothy lives in a modest two-bedroom apartment that she shares with her son on
Milwaukee’s north side. Formerly an instructor with the Head Start program from 1995
to 2003, Dorothy is retired, but she is studying to become a medical assistant, attending
Bryant and Stratton College through a federal loan and grant.
Quality, Choice, Results
Member Profiles
3

Anthony St. Louis
Anthony St. Louis is a self-taught computer whiz. He
finished his studies at South Milwaukee High School
and has taken classes at the Milwaukee Area
Technical College to study animation. He has been
an iCare Medicare Plan member since October
2009. Anthony has a mild heart condition, ADHD,
mood disorder and a pervasive developmental
disorder, which he keeps stable with medications
that he has used since he was 4 years old. His
mother, Donna Wheeler, indicated she found out
about iCare when she applied for SSI for Anthony
after he finished high school. Donna was formerly
a medical assistant, but because of a disability she
no longer works. Her husband David works full-time
servicing heating, ventilating and air conditioning units.
After working with the State’s Division of Vocational Rehabilitation (DVR) to determine if
Anthony could work, Donna indicated, “Nothing worked out, they basically said he was
unemployable. I was kind of disappointed, I had been supporting Tony for two years
and it’s expensive, especially when I’m on disability, so that’s when I applied for SSI and
Social Security. When we got the SSI, Tony was automatically enrolled into iCare. At
that time I didn’t know a lot about iCare until Maggie explained everything to me.”
Maggie is Anthony’s care coordinator.
All iCare Medicaid/SSI and Medicare Plan members have their own care coordinator to
help them access health and community services. Donna likes to mention the money
she saves with iCare’s Over-the-Counter (OTC) Medication and prescription drug
benefit programs. “I do take advantage of those OTC drugs; it can be very helpful with
band aids and all kinds of things we can get from that.” The OTC benefit allows iCare
Medicare Plan and Partnership members to purchase OTC medications that are home-
delivered.
Donna would like Anthony to be able to live on his own or in a group setting. Maggie
informed her of a community resource to help her search for a group-home setting for
Anthony. Donna also knows that after he moves out on his own, his care coordinator
can point him in the right direction for filling his prescriptions, accessing medical care
and finding social services.
With iCare, living life to the fullest is an important goal. Not only do we keep your child
from falling though the cracks, we provide the safety net on which your family can
depend as you plan for the future.
Friends for Health. Friends for Life.

Sometimes it can take as long as a week for a doctor’s office to return
a phone call, but with iCare, members can expect to talk to their care
coordinator right away.
Ana Rios
Having been struck by an errant taxi cab that left
her disabled and unable to stand for long periods
of time, a friend recommended that Ana Rios join
iCare because of the comprehensive services that
we provide. Ana has been an iCare Medicaid
SSI member since March 2006. Unfortunately, the
accident that left Ana disabled was not the last
time that she had to visit a hospital emergency
room. Within a two-year period she used ER services
four times for chest pain, abdominal pain, eye
problems and an ankle injury. Ana’s care coordinator
educated her on the use of urgent care to help
ensure appropriate use of healthcare services, and she has not used ER services since.
Originally from Puerto Rico, Ana has lived in the United States since she was a little girl,
moving to Milwaukee in 1991.
Ana has a bilingual care coordinator who also assists with scheduling appointments
and interpreter services when she sees her therapist and psychologist. Ana was once
assaulted and her assailant broke her fingers, requiring her to have surgery on her hand.
She now has regular rehabilitative therapy for her hand and attends counseling for the
mental trauma caused from the assault. Ana credits open communication with her
care coordinator for keeping her from preventable inpatient and ER visits. Ana thanked
her care coordinator for his constant reminders on preventive health measures,
including breast self-exams, which helped her to find a small lump in her breast.
Fortunately, tests indicated the lump was only a cyst. In all of these situations, Ana says,
“As long as God is on my side I march forward.”
Ana indicated that she is very satisfied with her providers, interpreters and her care
coordinator. Because of her counseling, she says she has the confidence to take walks
again and be more independent. She likes to take walks in Walkers Square Park on
Milwaukee’s south side.
Before her accident Ana worked at La Causa, a social services agency that provides
shelter, education and emotional support for neglected and abused children. She
resides on Milwaukee’s south side with her cat Paulina in a two-bedroom upper flat.
Ana has six children and 19 grandchildren. She likes to help out in the community by
donating items to the church, saying that the community has been good to her. Her
philosophy, “You need to get along with everyone, even your enemies.”
Member Profiles
5

Genesis Pena-Delgado
Victoria Delgado, Ildefonso Pena and their daughter
Genesis Pena-Delgado, live in a house perched on
a winding street on the south side of Milwaukee.
Their daughter Genesis became an iCare member
in January 2009, and is presently in the iCare Family
Care Partnership program. Genesis was diagnosed
with epilepsy at the age of three and has mild mental
retardation.
Having attended Pulaski High School’s special
education program, Genesis has since transitioned
from her classes and lives with her parents, where her father took on the responsibility of
providing full-time care.
Originally from Puerto Rico, Ildefonso and Victoria moved to the United States in 2001
and do not speak English. Independent Care provides free Spanish translation services
to ensure that they understand the benefits for which they are entitled and to maintain
consistent communication in caring for Genesis.
When describing Genesis’s care manager, Victoria stated, “She helps a lot, she
coordinates a lot, is always willing, and when I leave a message, she always gets
back to me.” In keeping with iCare’s role to promote healthier living, Genesis’s
care manager provided her with a referral to Columbia St. Marys for physical and
occupational therapy sessions. When Genesis’s safety helmet didn’t fit, her care
manager arranged to obtain a new one. Genesis’s care manager proved instrumental
in ensuring that she remained active by helping her to enroll in recreational programs
sponsored by the Milwaukee Recreation Division, where she could participate in crafts,
pool activities, and field trips to the zoo and museum. Victoria indicated that Genesis is
very much into crafts, loves to go shopping and is always occupied with something.
Victoria also expressed how pleased she was with iCare services, especially in
monitoring the medications being used by Genesis. She described a visit to a doctor
where she believed the physician was unresponsive to her concerns regarding a
medication that was affecting Genesis’s liver. On her next appointment she was
accompanied by Karen, a Partnership team nurse, where it was agreed that the
doctor would reduce the dosage and then discontinue using it. “She went with me
and he listened. That’s why I give thanks to Karen, and she is going with me on my next
appointment,” Victoria exclaimed.
At iCare, we don’t just provide services, we act as your advocate and guide in
managing your medical, social and mental health needs. You will get to know our
voices and faces, and we will quickly get to know yours. We are in your corner at all
times and make ourselves easily accessible through frequent home visits and phone
updates.

Going through a three hundred page provider directory can be confusing
at times. Our members can call their care coordinator to help them find
the right doctor for their needs.
Agnes Turner
Agnes likes to compose poetry to sway people to
change their attitudes and behaviors, explaining, “It’s
hard out there.” She knows from experience, having
contracted post-Polio syndrome at an early age, she
walked on crutches for 33 years and now uses a scooter
to get around. “I was never able to do too much,” she
said. She has endured the stares and whispers of people
who are not like her, which has made her hesitant to
interact with others, but defiantly she says, “You have
to be strong, keep your head to the sky.” She said her
doctor told her she was the strongest woman he knew.
Agnes has been in iCare’s Medicaid SSI program from the beginning when it started
in 1994. She says that iCare has helped her to be independent. Her care coordinator
stated, “One of the things I most admire about Ms. Turner is her ability to be proactive.
When she was in need of a scooter she contacted me for assistance. When she
had problems with the scooter’s battery, she never hesitated to follow up with me or
Home Care Medical. I used to be scared to go places, but with my scooter I can get
groceries and take out the garbage.”
Besides writing poetry, Agnes said she has been crocheting since she was 24 years-old,
but that she has to take medication for her carpal tunnel syndrome first. She likes to
read, having read the Bible eight times, she said that she finds something new every
time. Agnes also likes to garden, sew, and cook her specialty meal of spaghetti with
meat sauce.
Like the majority of iCare members, Agnes appreciates the benefits of membership,
where help and information is just a phone call away. “I love iCare. If I have problems,
I call my care coordinator and she helps me. When I am upset I can call her, and her
voice just calms me down.”
Member Profiles
7

Linda McGhee Qtairi
Independent Care Medicare Plan member Linda
Qtairi became an advocate for iCare because of
the assistance provided by her care coordinator
to help her recover from a stroke, stating, “I
thought it would be a good thing to convince
people to join iCare.” Linda has been with iCare
since 2003 and if anyone can vouch for the
benefits and services offered by the Plan, it would
be her. After she became eligible for SSI benefits,
she joined iCare. “When I had surgery, I needed
a nurse at home because of an infection. The
nurse had to come in and bandage me every
day,” describing the help she received from
iCare, noting that some health insurance does not
provide that type of coverage.
Linda’s care coordinator is Paulette Lee. When
Linda joined iCare, Paulette provided her with
education on the role of a primary care provider, and proper use of urgent care clinics
and emergency room services. She noted that Linda was motivated to participate
in preventive care routines, including obtaining her flu shot and scheduling for a
mammogram and pap/pelvic exam. Linda also needed glasses and Paulette provided
information on which providers offered this service.
When Paulette completed Linda’s assessment, she noted that she expected her
transition into iCare to go smoothly. She stated, “I have worked directly with Linda
to answer questions or resolve problems with her medications or dental services.
Linda takes her health care seriously and has participated in health related incentive
programming offered by iCare.”
Linda likes the services provided by Paulette stating, “My care coordinator is beautiful
to me, she set me up with a dentist. Any problems I don’t understand, I call her and she
explains it to the fullest. We get a good deal with our medications. I was with another
plan with higher co-pays. For people with low incomes, iCare’s Medicare Plan makes it
easier to pay for your medications.”

Dental care is a high priority for iCare members, and care coordinators
play a major role in locating dental providers with experience in helping
people with special needs.
Miller Brown
One can describe Miller Brown as a gentle
giant, standing at over 6 feet and 210 pounds,
this Vietnam War veteran from Tennessee has
been with iCare since 2003. He spends some of
his spare time at Career youth Development
(CYD), a community based organization that
provides counseling services for people fighting
alcohol or other drug addictions. Noting that
young people tend to act out their frustrations
in a negative way, he tries to set an example
at CYD by channeling his everyday frustrations
into social activities such as playing cards, pool or dominoes, which he says, “Keeps me
from acting out.” He graduated from CYD’s program in December 2008.
Miller is in the iCare Family Care Partnership program, where most of his medical and
long-term care needs are covered by iCare. He said he tried other insurance, “It
didn’t work too good, every time I went to the doctor it came out of my pocket. Every
time I had to pay for medicine, I payed more than I do now.” Miller is afflicted with
osteoarthritis, which causes pain in his back and ankles.
When Miller first joined iCare in 2003, he was in the Medicaid SSI program and his care
coordinator was Connie Kafka. He credited Connie with helping him to obtain the
proper treatment that he needed. “My care coordinator always tells me where I can
go to get something done. Since I got iCare, I got the right doctor that cares for me.”
In 2012 Miller enrolled in the iCare Family Care Partnership program, and now has an
entire care team to help him access medical and long-term care services.
Miller likes to tell people about iCare’s benefits and services. He said, “Since someone
tries to help me, I wanted to help someone else get what they need.” Connie had this
to say about her former charge, “He has always had motivation to move forward and
insight into recognizing things or people who were holding him back. In working with
Mr. Brown through the years, I know that he works on a daily basis to achieve his goals.
When he does not know something, he asks for the information and follows through. He
is truly a motivated individual and works to motivate others as well.”
Member Profiles
9

The iCare
Experience
Since 1994 Independent Care Health Plan (iCare)
has provided quality health care benefits to
eastern Wisconsin’s low income and special needs
population. Over the years we have experienced
tremendous growth as we continue in our goal of
delivering efficient and effective health care services
to our members through care coordination. We are
proud of our accomplishments and look forward to
continued success in a future where quality health
care benefits, optimum provider access and choice, and knowledge of community
resources creates strong, solid results for our members.
Independent Care offers a comprehensive health and social services program for people
ages 19 and older with special needs, who receive both Medicaid and Supplemental
Security Income (SSI) benefits. With over 8,000 members in the iCare Medicaid SSI program,
iCare is one of the largest providers of health care services for people with special needs in
the state of Wisconsin.
In 2007 we introduced our Medicare Advantage Special Needs Plan, the iCare Medicare
Plan HMO SNP. It is a managed care plan for people who dually qualify for Medicaid
and Medicare. Members participating in this plan benefit from the same model of care
as provided under our Medicaid SSI program but qualify for extra benefits covered under
Medicare.
We also offer the iCare BadgerCare Plus program for low-income childless adults, parents,
pregnant women and children. The program covers basic health care services, including
primary and preventive care, as well as prescription drugs.
Finally, in 2010 we added the iCare Family Care Partnership HMO SNP program to our
portfolio. Our Partnership program serves people with physical and developmental
disabilities and frail elders. The program is designed to enable people with have long-term
care needs receive care within their home environment, where experience demonstrates
better outcomes in comparison to nursing homes. There are also significant cost savings
involved when a person can avoid institutionalization.
We are taking the necessary steps to ensure iCare’s future growth and availability for our
members. We will continue the expansion of our care coordination model throughout
our service area to ensure that those with unique and complex medical, behavioral and
human service needs have access to quality health care services.
1994 - Joint venture between MCFI
and Humana forms iCare. Focus:
Providing access to care for those
with special needs.
*Dec. 1994 - 925 members
Dec. 1995 - 2,320 members
1996 - Emphasis on guiding
members to social service
programs.
1998 - Focus on evaluation of care
coordination model and
deliverables. Move to fully
capitated risk model.
Timeline
* Enrollment figures taken from Executive Monthly Enrollment Reports

Mission
To secure the wellness of persons with complex medical and behavioral conditions,
respecting their dignity and the values of caring stakeholders.
Purpose
To measurably improve the health of iCare members through personalized, sustained
and integrated care coordination.
Vision
Independent Care is the national leader for advanced managed care programs that
serve people with complex health and social needs.
Goals
Independent Care is grounded in the premise that quality health care can be provided
effectively and efficiently through care coordination. We strive to empower our
members to participate actively in self-care management, which ultimately leads to
a higher quality of life. Together with providers and community resources we achieve
strong, solid medical, behavioral and social outcomes, ensuring results are recognized
for individuals with special needs now and into the future.
History
Formed in 1994, iCare was a joint venture between a for-profit health care company,
Humana Wisconsin Health Organization (WHO), and a nonprofit, the Milwaukee Center
for Independence. The two distinct organizations resolved to create a program allow-
ing for improved quality and access to care for individuals in the Medicaid market. The
result is a partnership that integrates managed care with social services.
Today, iCare provides medical, dental, behavioral health, vision and prescription drug
coverage through care coordination. Care coordination recognizes that medical,
behavioral and social needs must be met in order to improve an individual’s quality of
life. Benefits also include health outreach, treatment information and follow-up and
assistance in choosing providers.
1999 - Focus on evaluation of care
coordination model and
deliverables.
2000 - Development of a
comprehensive quality
improvement program.
2001 - Defining care coordination
process. Refined assessment tool.
Timeline
11

iCare care coordinators build trust with their members, where they
become comfortable in talking about anything. This sharing of
information helps ensure that members are prepared for meaningful
doctor visits.
A Different
Approach to Care
Independent Care was one of the first managed care
organizations to recognize that in serving people with
complex medical needs, we have to address social
and mental health issues in order to treat the medical
condition. Since 1994 we have been providing health
care services for people with special needs, creating
a member-centered model of care, with a focus on
“whole person” management.
Members of iCare receive baseline as well as yearly
health assessments to develop a member-centered
plan of care specifically for their needs. We also offer
programs where members can benefit from different
levels of care, and their needs are addressed accord-
ing to the severity of their condition. Most importantly,
we place an emphasis on preventive care and persis-
tent follow-up with our members. This may involve a
phone call to remind a member of his/her
doctor’s appointment to scheduling transportation for
them to get there.
This personal focus on care has enabled us to maintain steady member satisfaction
rates over a long period of time. In our “whole person” approach to care, we also
point our members in the right direction to access community services that they might
not have known were available to them.
2002 - Move to an integrated
multi-disciplinary model of care
approach, with emphasis on
behavioral change. Based upon
iCare calculations, new model of
care provided significant savings to
the State.
2003 - Intervention strategies
developed. Defined care coordina-
tion performance model. Member
satisfaction over 97%.*
* iCare annual member satisfaction
survey.
Timeline

If a member finds that they cannot obtain proper care from their doctor,
they can count on their care coordinator to be an advocate on their
behalf. Members have extra clout with iCare.
Q u a l i t y
Through Care Coordination
Delivering quality health care services to individuals with
physical, mental or emotional disabilities is often challeng-
ing. Many of our members have more than one disability,
including problems with substance abuse and mental
illness. In addition, medical care for people with special
needs has often lacked preventive and chronic care
management, combined with the expertise needed to
manage multiple medications.
A study release by The National Minority Quality Forum
(The Forum) suggested that low-consuming Medicare FFS
beneficiaries with chronic diseases are more costly to the
program because they are more likely to under-manage
their disease, resulting in acute events that require costly emergency room visits and
hospitalizations. Gary Puckrein, PhD, President/CEO of the Forum stated;
“If we can identify these patients, who are under-managing their chronic condition put-
ting them at high-risk for disease complications, we can intervene to help these individ-
uals manage their disease more effectively, and, ultimately, reduce overall health care
costs.”
This is where iCare’s multiple levels of care coordination prevail. Independent Care uti-
lizes a care coordination model that helps caregivers when addressing disease process
issues, identifying and obtaining treatment for modifiable illnesses, avoiding futile inter-
ventions, improving outcomes and quality of care, and encouraging client participa-
tion in self-health management. As iCare collaborates with physician offices in helping
to ensure that members are compliant, we can work as a team with caregivers and
care providers to benefit the people we are serving.
When someone becomes a member of our iCare Medicaid SSI or iCare Medicare Plan
they are assigned a care coordinator or care manager according to their condition.
2004 - Enhanced care planning
and intervention management
process. State and iCare negotiate
a severity adjusted rate to reflect
member risk. Member satisfaction
over 97%.*
2005 - State SSI expansion and
introduction of competitors.
Mandatory enrollment. Staff level
adjustment to service growing
membership. Member satisfaction
stands at 96.9%.*
Timeline
13

Care coordinators and care managers iden-
tify health care needs by performing initial and
yearly assessments. They clarify needs and goals
and support efforts toward self-care manage-
ment. Members are empowered to participate
in self-care. Nurse case managers work with
iCare staff and members with more complex
medical, behavioral or social needs. A care co-
ordinator or care manager will continue to work
with the member while the nurse case manager provides assistance. Nurse case man-
agers are registered nurses with years of experience in primary and specialty care.
Some members benefit from a higher level of care management involvement. If a
member is struggling with mental health issues or substance abuse, iCare’s intervention
specialist and psychiatric social worker may provide support for behavioral change and
assistance locating community resources. Our health outreach works with members
with special needs and assists them in accessing preventive services.
iCare Partnership members are a part of an assigned care team consisting of a social
services coordinator, a registered nurse, a nurse practitioner and a wide network of
providers. The Partnership Care Team conducts initial and six-month assessments to
develop a member-centered plan. In the process, needs and goals are discussed and
members’ families are encouraged to participate in preparing a member-centered
plan that includes self-management of the member’s condition. The care team will
teach, model and prompt activities that promote healthier living.
Diversity
Independent Care has several multilingual care co-
ordinators. Wisconsin has a diverse population, with
thousands of residents who do not consider English
their primary language. Our multilingual care coordi-
nators speak fluently in languages such as Spanish and
Hmong. This allows us to effectively coordinate the
health care of these individuals with less confusion and
better understanding of benefits and services.
We also provide over-the-phone interpreter services for
those members who do not speak English. This service
can be accessed by calling our Customer Service
department.
2006 - Signed contract with CMS to
offer Medicare Advantage Special
Needs Plan. Milwaukee Major Tom
Barrett nominates iCare for the Inc.
Magazine“Inner City 100”award,
which profiles fast growing inner-
city companies like iCare.
2007 - Launched iCare Medicare
Plan in Milwaukee County. Sub-
mitted bid to Milwaukee County
Department of Aging to become a
Care Management Unit (CMU) for
Family Care.
Timeline

All non-English speaking members are directed to network physicians who understand
their culture. One reason people choose iCare is that our provider network includes pri-
mary and specialty care providers who practice in areas where our members live and
spend time. Our Network Development staff works hard to sign quality providers that
focus on members’ needs and expectations.
In addition to a multilingual staff, iCare also provides a TDD phone number for the
hearing-impaired. Special services also are available for those who are blind or have
limited vision.
Access to
Community Services
Independent Care is unique and innovative in its
approach to community services that can help
someone achieve a higher quality of life. This
approach is what sets the program apart from
other managed care plans and traditional
Medicaid/Medicare programs. Care coordina-
tors assist in finding support groups, locating
affordable housing, food and clothing, and
suggest opportunities for social interaction.
Independent Care works with durable medical
equipment companies, social service agencies,
home care providers and advocacy groups. We also collaborate with organizations
and providers to ensure adequate
services for people who are disabled in facilities and other venues. We perform this
function through a variety of mediums, starting with our care coordinators and care
teams, but also utilizing social media to provide information on preventive health and
community resources that can benefit people with disabilities.
2008 - Expanded iCare Medicaid
SSI service area into Kenosha,
Ozaukee, Racine, Sheboygan,
Washington and Waukesha
counties.
2009 - Launched iCare BadgerCare
Plus. Completion of office suite
expansion in Schiltz Park.
Dec. 2009 - 18,519 members
2010 - Launched the iCare
Family Care Partnership program in
Milwaukee County.
Dec. 2010 - 15,654 members
Timeline
Diversity
15

When a member is having trouble getting their prescriptions filled, their
iCare care coordinator will step in for them and resolve the issue.
Innovation
With the passage of the Affordable Care Act, care coordination is a hot topic with
major health plans hailing it as a way to reduce health care spending. Since 1994
iCare has been at the forefront in advocating a care coordination model for manag-
ing chronic health conditions. The State of Wisconsin’s Medicaid SSI managed care
program expansion implemented in 2005 utilizes a similar care coordination model that
was pioneered by iCare. Independent Care’s innovative approach to providing quality
care coordination is reflective of the people and resources dedicated to improving the
lives of our members.
High Level Care Coordination
Specialty Services
Independent Care’s Specialty Services Department provides the
highest level of care available through our care coordination
model. Led by Marlena Anderson, a registered nurse with seven
years of experience at iCare, Specialty Services performs multiple
functions through a variety of programs including:
• Discharge planning (Medical admissions)
• Utilization review (Behavioral health)
• Medical and behavioral health disease management (DM)
• Outpatient BH “Gatekeeping”
• ReAdmission Prevention (RAP)
As outlined by Anderson, Specialty Services receives internal referrals from care coordi-
nators for members who have demonstrated the need for a higher level of intervention
and guidance in navigating the health care system. Anderson indicated that in both
the Medical and Behavioral Health Disease Management programs, Specialty Services
staff function as resources for members and their caregivers while empowering them,
through education and encouragement, to assume an active role in the manage-
ment of their disease. The department works to ensure that members are adequately
treated at the appropriate level of care with the goal of reducing avoidable disease
related admissions and ER visits. With lower case loads, Specialty Services staff are able
to develop targeted care plans with the members, conduct home and facility visits as
2011 - Expanded iCare Medicare
Plan service area to Brown, Manito-
woc, Outagamie, Walworth, Wau-
paca and Winnebago counties.
Dec. 2011 - 15,594 members
2012 - Expanded iCare Medicaid
SSI/BadgerCare Plus Core Plan
service area to Brown, Manitowoc,
Outagamie, Walworth, Waupaca
and Winnebago counties.
2012 - Expanded iCare Family Care
Partnership service area into
Kenosha and Racine counties.
Dec. 2012 - 15,407 members
Timeline
Specialty Services Department
Manager Marlena Anderson, RN

needed, and collaborate with providers more frequently. The multidisciplinary teams
meet weekly to discuss missed opportunities, to receive feedback and guidance, and
to update each other about interventions that have proven effective.
Behavioral Health Team
Once a week Specialty Services’ Behavioral Health (BH) Team meet to go over member
caseloads or staffings, which outlines the member’s diagnoses, last contact date with
iCare, high risk criteria, dates of inpatient stays and outpatient visits, prescription drugs
prescribed, and the treatment plan/goal. The BH Team is led by Care Manager Eleni
Voulgaris, who has over 9 years of experience at iCare. The team is charged with inpa-
tient and outpatient utilization review, crisis intervention and BH disease management.
The team is composed of registered nurses, care managers, a psychiatric social worker
and an intervention specialist. Voulgaris outlined how the team interacts with iCare’s
network of caregivers;
“The BH Team works collaboratively with providers, targeted case managers and
community support workers to assure the best overall treatment for the member.
The BH Team is able to provide information such as emergency room and hospital
visits, medication profiles (including medications from other providers), and com-
pleted examinations in clinics and with other treating providers. This helps minimize
duplication of services, over prescribing of medications, and alerts providers to
member needs.”
During the morning meeting, four to six staffings print-outs are circulated to discuss the
specifics of each member’s condition. The staffings reveal that the members who are
recommended for this level of care are usually afflicted with a multitude of chronic be-
havioral health and medical conditions; ranging from diabetes, congestive heart failure
and asthma to alcohol dependence, depression, opiate addiction and schizophrenia.
Top 10 Mental Health Conditions of iCare Members
2013 - Expanded iCare Medicare
Plan service area to Dane, Oconto
and Shawano counties.
2013 - Expanded Medicaid SSI
service area into Calumet, Dane,
Dodge, Door, Fond du Lac,
Jefferson, Kewaunee, and
Marinette counties.
Dec. 2013 - 15,039 members
March 2014 - Opened enrollment
to Dane County Medicaid SSI and
dual-eligible beneficiaries.
April 2014 - Opened Madison
office location for local care
coordination and community
outreach.
Timeline
0% 10% 20% 30%
Depressive Disorder
Anxiety Disorder
Bi-Polar
Alcohol Abuse/Dependence
Schizoaffective Disorder
Altered Mental Status
Drug Abuse
Paranoid Schizophrenia
Psychosis
Episodic Mood Disorder
34%
18%
12%
9.7%
6.4%
6.2%
5.6%
5.1%
4.5%
3.5%
17

Many of these members are hard to contact
and do not follow their plan of care. The team
describes a constant struggle to get members
to their doctor appointments or to take their
medications to address their illness.
After each staffings review, questions emerge
from the team; is the member in compliance
with their medication regimen or their plan
of care — is their doctor aware that another
physician has prescribed a particular medica-
tion — has the member been responsive to
outreach from their care manager? Recom-
mendations from the team include tips on how
to get a member to see their doctor — an unscheduled home visit to check on a mem-
ber’s living condition — follow-up with a doctor to obtain clarification on a prescription
— sometimes a member simply needs encouragement. BH Team Care Manager
Michelle Elliot described how she interacts with one of her members stating;
“My role is like a cheerleader. There are times when due to an individual’s mental
health they isolate and don’t have anyone to point out to them how hard they’ve
worked or what they’ve accomplished. I’ve seen people who have accom-
plished a lot, especially when given the barriers that they face, and it’s a great ex-
perience to be able to point out to someone how far they’ve come and give real
life examples. A lot of times the member is actually surprised and never looked at
it from that perspective.”
Members are assigned to the BH Team when referred from their care coordinator. The
criteria for assigning a member to the team includes;
• Three or more BH hospital stays within the last 6 months
• Having missed 3 consecutive BH follow-ups in the last 6 months
• Three months of failed medication compliance
• Member has had 15 or more AODA/BH emergency room visits in the last 12 months
• Member has an active disease process and has refused to see their provider for
over a year
The BH Team’s plan of action after a member has been assigned requires that the psychi-
atric social worker (AODA) or the intervention specialist (BH) and team RN take ownership
of the case. These team staff will work intensively with the member for 90 days, following
up by:
• Contacting the member within 72 hours of being assigned
• Initiating a minimum of weekly interventions
• Completing a specialty assessment within 7 days
• Face to face contact with the member within 14 days
• Staffings meetings with the team for additional recommendations and
discussion of progress
BH staffing meeting with RN Care Manager Kristin Gillan
(left) and Care Manager Michelle Elliot.
Innovation

If after 90 days the member has progressed to a less intensive level of care, they
are reassigned to their original care coordinator, with recommendations for future
outreach. If the member is in need of further assistance, they are transferred to a team
care manager where intervention is continued; including monitoring appointments,
medications, and collaborating with service providers. Each member is serviced by
team staff according to their care stratification level, with the goal of reducing inpatient
stays and emergency room visits, as well as ensuring medication compliance and
access to providers and community services.
Medical Disease Management Team
Members in iCare’s Medicaid SSI and
Medicare Plan programs have an
average of up to 6 medical and/or
mental health conditions. The Specialty
Services Department’s Medical Disease
Management (MDM) Team is available
for those members afflicted with chronic
medical conditions that require more
intensive interaction to ensure compliance
with a plan of care, require medication
management, or need education on their
disease state. Staffed by a registered nurse
and two care managers, the MDM Team receives referrals from a member’s CC or from
the Re-Admission Prevention (RAP) Team. Referrals are reviewed by the team RN, who
uses the following criteria to determine if a member should be elevated to a higher
level of care:
• Three or more hospital stays in a 6 month period
• Non-compliance (follow-up, meds)
MDM staffings meeting with Care Managers Davette Baker
(left) and Denise Dable.
Top 10 Diagnoses of iCare Members
Unspecified Essential Hypertension
Diabetes Type II
Hyperlipidemia
Lumbago
Chest Pain
Tobacco Use Disorder
Esophageal Reflux
Depressive Disorder
Pain in Limbs
Asthma
0% 10% 20% 30% 40% 50%
19

• Member has an active disease process and has refused to see their provider over a
one year period
• Disease related knowledge deficit, outstanding needs
After a member has been assigned to the
MDM Team with a referral from their CC, the
next steps for the team include; transfer staff-
ing, scheduling of an assessment/home visit
within 14 days, staffing review for additional
recommendations and discussion of progress,
referrals for needed services and intensive
case management. Case closure for mem-
bers referred to the team occurs when the
member has demonstrated compliance with
the plan of care, inpatient stays and ER visits
are reduced, or difficulty in contacting the
member precludes further attempts at inter-
vention.
In the case where a member is referred by the Re-Admission Prevention Team, the
member receives 60 days of intensive education on their disease process and a home
visit if needed. The team conducts staffing meetings for additional recommendations
and discussion of progress, where it is decided if the member requires ongoing disease
management or has progressed to the point where they can be returned to their CC.
Care Manager Denise Dable provided an example of how her team intervenes when a
member is non-compliant with their plan of care;
“A dual-eligible woman enrolled in both our Medicare SNP and Medicaid SSI pro-
gram was recorded to have had 11 hospitalizations within a 9 month period. She
has numerous co-morbid diseases including diabetes, CHF, and chronic pain and
was transferred to Specialty Services for completion of an assessment to determine
her needs. The CM and RNCM were instrumental in getting her set up with daily
medication management and education on the importance of attending provid-
er appointments, taking medications as prescribed, and the benefits of a healthy
diet. Now she has a very positive relationship with her care manager and also with
her primary care provider, with whom she attends regular appointments and fol-
lows the plan of care. The results are evidenced by a drastic reduction in hospital-
izations during the past two years; with only two in 2013 and three in 2012.”
Re-Admission Prevention (RAP) Program
Specialty Services is home to iCare’s Re-Admission Prevention (RAP) program, which
focuses on preventing avoidable inpatient readmissions within the 30-day contiguous
period following hospital discharge. This program is targeted toward members in the
iCare Medicare Plan. All diagnosed conditions are targeted to prevent avoidable re-
admissions.
Discharge Planning RN Barbara Ludke (left) and Disease
Management RN Kezza Frye during staffings review.
Innovation

When a member is admitted to the hospital,
discharge planner RNs review their clinical in-
formation and use a Readmission Risk Assess-
ment tool to see how likely a member is to
readmit. The RAP program provides members
with an RN and CM after discharge for either
an in-home or telephonic assessment based
on the members readmission risk score.
During the assessment members receive
on-the-spot education about their disease process. Communication with the primary
provider is initiated for needed services, durable medical equipment, reconciliation of
medications and intervention assistance. A new care plan is then devised with specific
interventions assigned to either a CM or RN. Care plan interventions and frequency of
interventions are scheduled and the member remains in the program until education
and compliance are complete and no readmissions occur.
RAP Follow-up Process
• Home visits completed within 72 hrs of discharge notification
• Hospital follow-up completed within 48 hrs of discharge notification
• PCP visit scheduled within 7-14 days of discharge
• Care Plan sent to provider within 72 hrs of discharge notification
• Telephonic contact based on risk level
Specialty Services Manager Marlena An-
derson stated that the goals of the pro-
gram are: safe transition from hospital to
home; stabilization within the home; care
plan sharing with the members’ providers
between transition settings; and education
on their illness.
More specifically, the RAP Team aims for
members to complete a 30-day period
without a readmission. If the team meets
this goal, the member is returned to their
care coordinator or stays with the RAP Team
for additional case management. If a member is readmitted
before the 30 days are complete, the entire process begins anew. Since the program’s
initiation iCare has seen a measurable drop in the readmission rate for members.
Wisconsin Statewide Health Information Network
To better facilitate the exchange of health information between providers and our care
management team, iCare will participate in the Wisconsin Statewide Health Informa-
tion Network (WISHIN). It will oversee the implementation of a statewide health infor-
mation network and health information exchange services in Wisconsin. It is one of the
(l-r) RAP Team Nurse Practitioner Laurel Marek, CM
Davette Baker and Disharge Planning RN Joyce Thao
RAP Team CM Joanna Porterfield (left) and CM Josie Marquez.
21

nation’s leading efforts to improve health care through regional electronic information
exchange.
Health information exchange technology will sup-
port the flow of health information among physician
practices, hospitals, labs, managed care organiza-
tions and others, allowing for delivery of health infor-
mation at the point of contact, providing safer, more
efficient, patient-centered care. More than simply
a data system, WISHIN will support emergency room
(ER) coordination that allows a physician to retrieve
a patient’s information quickly, speed the delivery of
appropriate care, and avoid unnecessary duplica-
tive testing, medical errors and extra costs.
It will also assist in arranging follow-up care. Inde-
pendent Care will provide care coordination con-
tact details and related clinical information to the
exchange. This information will assist hospital case
managers, with the goal of reducing ER admissions
and obtaining medical homes for iCare members.
Our unique ability to combine social services with a results-oriented health plan helps
providers to effectively manage care for challenged members. We help our providers
identify the needs of people who use the ER and multiple other health resources, and
assist them to develop a planned program of care.
TruCare
iCare members benefit from a cutting edge model of care, where modern technology
as embodied in our TruCare system can easily coordinate their care and help to im-
prove outcomes. The TruCare system can assist care coordinators in assessing member
needs to determine which disease management programs and resources they would
most benefit from. It can help care coordinators address various conditions and modify
care plans based on a member’s specific needs. The TruCare system automatically
monitors how a member follows their plan of care, identifies gaps in care, departures
from established medical practices or whether various combinations of medicines are
safe to use. TruCare can also provide predictive modeling, assessing whether a depar-
ture in a plan of care will result in future hospitalization. This allows iCare’s care manage-
ment team to address how a member follows their plan of care before hospitalization is
required.
With the ability to coordinate care with the iCare care management team, as well as
external referral channels such as a county case worker or a group home house par-
ent, TruCare can create “virtual communities,” where clinical staff and outside health
services providers can log into TruCare using a lap-top computer to check on a mem-
ber’s plan of care. Users of the TruCare system have access to a single, prioritized view
of required activities to help members follow their plan of care. Tasks are automatically
populated from the care plan, and from the users themselves. Data can be exchanged
in real-time with eligibility, claims, pharmacy, predictive modeling and lab systems,
creating a true personal health summary.
Innovation

Nurse Advice Line
Staying healthy starts by asking questions and
getting up-to-date information. When iCare
members need answers the iCare Nurse
Advice Line is available 24 hours-a-day/7
days-a-week.
The Nurse Advice Line service also provides
an Audio Health Library that provides access
to hundreds of pre-recorded messages on
an array of health care topics ranging from
the common cold to heart disease. Each
message is about three to five minutes long. Members can access hundreds of health
care topics with the touch of a button.
MarketPOINT
We have partnered with Humana MarketPOINT insurance agents, who are immersed in
iCare’s whole-person model of outreach. Our no-pressure approach ensures that iCare
is a good fit for a person’s particular medical, behavioral health and social service
needs. Our MarketPOINT agents will walk a prospective member through the process,
from finding out which prescription drugs are covered to insuring that a doctor is in our
network. Our helpful agents will make sure that a prospective member is qualified for
the iCare Medicare Plan, visit their home to help with the paperwork, and leave infor-
mation about the benefits and services available through iCare.
After the paperwork is submitted by the MarketPOINT agent and eligibility is confirmed,
the member can expect a phone call from an iCare representative welcoming them to
the plan, where they will also have the opportunity to ask questions about the next step
in accessing iCare’s benefits and services.
23

Independent Care Health
Plan, known as iCare, was
among the first health
plans to focus on one of
the most complicated
and costly segments of
the population: people
eligible for both Medicare
and Medicaid because
they are disabled or aged
and impoverished.
The federal and state
governments spend a
combined $300 billion a
year on health care for
the more than 9 million
people eligible for the
two programs.
The group accounts for
about 38% of Medicare
and Medicaid’s total
costs.
Wisconsin is among the
few states that have long
contracted with health
insurers such as iCare to
manage their complex
care. Now more states
are doing the same,
with the hope of provid-
ing better care, control-
ling costs and enabling
people to remain in their
homes rather than nursing
homes.
ICare is getting some
attention as a result.
The company was one
of eight managed care
organizations and health
plans nationwide select-
ed for a study to help de-
termine the best practices
for assessing what is most
important to the individ-
ual, and communicating
those goals to the people
involved in his or her care.
The study is being done
by the National Commit-
tee for Quality Assurance,
which develops measures
for evaluating health
insurance plans on quality
and value.
“Part of what we are
trying to do is learn from
their experience,” said
Jessica Briefer French, a
senior consultant for re-
search for
NCQA.
Separately, iCare was
one of seven organiza-
tions selected for a proj-
ect to identify and test
new strategies that im-
prove and integrate med-
ical and behavioral care
and long-term support
services, such as home
care, for people covered
by both Medicare and
Medicaid.
The seven organizations
—known as the PRIDE
Consortium, for Promoting
Integrated Care for Dual
Eligibles — were selected
for their expertise in pro-
viding care for people in
the two programs.
The project is an initiative
of the Center for Health
Care Strategies, a health
policy resource center in
Hamilton, N.J., and is
supported by a grant
from the Commonwealth
Fund, a foundation in
New York that funds
health policy research.
ICare, which is owned
by Humana Inc. and the
Milwaukee Center for
Independence, manages
the care of some of the
most vulnerable people
covered by Medicare
and Medicaid.
They include people with
physical or developmen-
tal disabilities, such as
cerebral palsy and Down
Syndrome; people with
severe mental illness; and
people who are elderly
and require specialized
care to remain in their
homes.
The interest in iCare stems
partly from more states
turning to specialized
health plans and man-
aged care organizations
to provide integrated
care and to lower costs.
iCare part of studies on best practices for Medicare, Medicaid
By Guy Boulton of the Journal Sentinel
March 13, 2014
From the Milwaukee Journal Sentinel:
Innovation

The trend concerns some
advocates, who have
questioned whether the
organizations have the
expertise needed to pro-
vide care for people with
complex health problems
and limited resources.
Advocates also worry
that the health plans and
organizations will stint on
providing care to control
costs and to generate
profits.
Nationally, the success
stories are few, and
where there have been
successes, the programs
have remained small,
Bruce Vladeck, a senior
adviser at Nexera Con-
sulting, said last year at
the annual conference
of the Council on Health
Care Economics and
Policy.
The challenge in provid-
ing integrated care to
people covered by Medi-
care and Medicaid, how-
ever, is long-standing and
widely acknowledged.
The federal government
oversees Medicare while
states oversee Medicaid.
And the two programs
have different benefits,
different billing codes
and different regulations.
“We’ve created our own
complexity that is un-
necessary,” said Thomas
Lutzow, chief executive
officer of iCare.
The Affordable Care Act
created an office in the
Centers for Medicare and
Medicaid Services to cre-
ate demonstration pro-
jects designed to improve
the coordination be-
tween the two programs.
ICare, formed in 1994,
was an outgrowth of a
demonstration program
funded by the federal
government.
The study by the National
Committee for Quality
Assurance will focus on
400 people who are in
the
Family Care Partnership
program, one of the state
programs designed to
help keep people in their
homes rather than in nurs-
ing homes.
The committee plans to
develop a set of stan-
dards for integrated care
as well as for determin-
ing people’s goals and
developing care plans for
them.
“To develop standards,
they have to know how it
is done,” said Bill Jensen,
an iCare vice president.
Developing individual
care plans, he said, is part
science and part art.
“It is very much at the
heart of what we do,”
Jensen said.
ICare uses a “resource
allocation decision tool”
— a detailed question-
naire or decision-support
tool — developed by the
state to help determine
people’s goals and
develop a plan for their
care.
The care plans must
be highly personalized
because the medical
care and support ser-
vices needed by people
whose care is managed
by organizations such as
iCare varies widely.
Their personal goals also
vary. The goal of one
person may be to con-
tinue playing cards with
his or her friends on Friday
night, Lutzow said, while
someone else may want
to continue singing in the
church choir. At the same
time, someone with ce-
rebral palsy might have
much different goals.
The question, Lutzow said,
is how someone can
continue to live a pur-
poseful life. “You have to
be excited about living,”
he said.
25

Choice
The choice to join one of iCare’s programs is often related
to benefits, costs and social assistance. We provide a
choice of programs tailored to a member’s specific needs.
What is the
iCare Medicaid SSI Program?
iCare was started in 1994 as a federal demonstration
project, the program served as a pilot for the Department
of Health Services expansion of Medicaid SSI managed
care throughout the State of Wisconsin.
iCare’s Medicaid SSI program is a complete health care
services program for people with physical, developmental
or emotional disabilities.
What are some of the services covered by the Medicaid SSI
Program?
• Ambulatory Surgery Centers
• Doctor visits
• Dental
• Emergency care
• Hearing services
• Hospital services
• Mental health and substance abuse treatment
• Medical equipment
• Transportation for doctor’s visits
• A personal care coordinator to help manage your care.
We provide the same coverage as Medicaid SSI. When you are an iCare member,
there are no co-pays or deductibles for your medical or mental health services. Your
medications are covered by the State. When you fill your prescriptions, you will be
responsible for a co-pay.
iCare’s Medicaid SSI service area covers Brown, Dane, Dodge, Door, Fond du Lac, Jef-
ferson, Kenosha, Kewaunee, Manitowoc, Marinette, Milwaukee, Outagamie, Ozaukee,
Racine, Sheboygan, Walworth, Washington, Waukesha, Waupaca and Winnebago
counties.
Who Is Eligible for Medicaid SSI HMO Enrollment?
• Must be 19 years of age or older
• Receive Medicaid and Supplemental Security Income (SSI) or SSI-related benefits
• Have a Forward or ForwardHealth ID Card
• Medicare beneficiaries or those enrolled in a Medicare HMO are also eligible, as
long as they receive Medicaid or SSI benefits
To get more information on your SSI Medicaid HMO options, including iCare – Call the
State’s HMO Enrollment Specialist at 1-800-291-2002.

27
iCare BadgerCare Plus
The BadgerCare Plus program is a State program that covers health care services, including
preventive care and prescription drugs. iCare is a participating BadgerCare Plus HMO.
What are some of the services covered by the BadgerCare Plus Program?
• Ambulatory Surgery Centers
• Chiropractic services
• Dental
• Dialysis/kidney-related services
• Disposable medical supplies
• Doctor visits (office visits, surgical procedures, radiology and lab services)
• Durable medical equipment
• Emergency ambulance rides
• Emergency room visits
• Health screenings for children
• Hearing services
• Home health & hospice services
• Hospital services (including inpatient and outpatient visits)
• Mental health services
• Nursing home services
• Physical, occupational and speech therapy
• Podiatry
• Reproductive Health and Family Planning services
• Routine Vision services
• Substance abuse services by a physician
• Transportation for doctor’s visits
These covered services may change. You should always check with your provider to see if the ser-
vice you want is covered and if there are any limits on that service. Some services covered under the
BadgerCare Plus program will have a co-payment between $0.50 and $3.00. Co-payment amounts
are based on income.
iCare’s BadgerCare Plus service area covers Brown, Door, Fond du Lac, Kenosha, Kewaunee,
Manitowoc, Marinette, Milwaukee, Outagamie, Ozaukee, Racine, Sheboygan, Walworth,
Washington, Waukesha, Waupaca and Winnebago counties.
Who Qualifies for BadgerCare Plus?
• Childless adults with incomes at or below 100% of the Federal Poverty Level
• Parents and caretakers at or below 100% of the Federal Poverty Level
• Pregnant women with incomes at or below 306% of the Federal Poverty Level
• Children (ages 17 and younger) with household incomes at or below 300% of the
Federal Poverty Level
• Transitional medical assistance individuals, also known as members on extensions, with incomes
over 100 percent of the Federal Poverty Level.
To get more information on your BadgerCare Plus HMO options, including iCare – Call the State’s HMO
Enrollment Specialist at 1-800-291-2002.

Get to Know the iCare Medicare Plan
The iCare Medicare Plan (HMO SNP) is a
Coordinated Care plan with a Medicare
contract and a contract with the Wisconsin
Medicaid program. Enrollment in the iCare
Medicare Plan depends on contract renewal.
The iCare Medicare Plan is a Medicare Special
Needs Plan, which means its benefits are
designed for people with special health care
needs. This plan is available to anyone who has
both Medical Assistance from the State and
Medicare.
With assistance from Medicaid, members pay less for some of their Medicare health
care services. Medicaid may provide other benefits by covering health care services
that are not usually covered under Medicare. Members may also receive Extra Help
from Medicare to pay for the costs of their Medicare Part D prescription drugs.
The iCare Medicare Plan offers complete coverage for doctor and dental visits,
emergency care, hospital services, mental health and substance abuse treatment,
medical equipment and other services mostly at no cost to members. Members must
enroll in a full Medicaid HMO plan (including iCare’s or another plan) to receive full
benefit coverage. Premiums, co-pays, coinsurance and deductibles may vary based
on the level of Extra Help that a member receives. Please contact the plan for details.
Who is Eligible for the iCare Medicare Plan?
• Must be eligible for Medicare and Medicaid benefits or eligible for Medicare and
Medicare cost-sharing assistance under Medicaid
• Must have both Medicare Part A and Part B
• Cannot have End Stage Renal Disease (exceptions may apply)
• Must enroll in a full Medicaid HMO to receive full benefit coverage. Can remain in
Medicaid Fee-For-Service, but may be subject to small copays
• Must live in our service area of Brown, Calumet, Dane, Kenosha, Kewaunee,
Manitowoc, Marinette, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee,
Racine, Sauk, Shawano, Sheboygan, Walworth, Washington, Waukesha, Waupaca,
or Winnebago counties.
How to Sign Up
People can enroll in the iCare Medicare Plan at any time! Simply complete our
enrollment application and after eligibility has been determined, we will send a
membership packet explaining how to access iCare Medicare Plan benefits.
People can also enroll by calling one of our licensed insurance agents at
1-855-839-0918. For more information about the iCare Medicare Plan call Customer
Service at 1-800-777-4376 (TTY: 1-800-947-3529), 8:00 a.m. to 8:00 p.m., 7 days-a-week.
Choice

iCare Family Care Partnership for
Long-Term Care and Acute Care Needs
Our Family Care Partnership Plan is a health and
long-term care (LTC) program that fully integrates all
aspects of care. It is designed to meet the long-term
care needs of frail older adults and people who have
physical or developmental disabilities. Partnership
combines Medicare, Medicaid, dental, prescription
drugs and home/community-based LTC services.
Eligibility Requirements
• Live in Dane, Kenosha, Milwaukee, or
Racine counties
• People with physical/developmental
disabilities (18 years of age or older)
• In Dane County only people with physical
disabilities (18 years of age or older)
• Frail elderly adults 60 years of age or older
• Must be eligible for Medicaid
• Must have LTC service needs as determined by the state of Wisconsin LTC
Functional screen
• Must not have End Stage Renal Disease (exceptions apply)
How to Sign Up for Partnership
Contact the Aging & Disability Resource Center (ADRC) in your county to find assis-
tance in reviewing options and enrolling in the Partnership program. Membership is vol-
untary and members can disenroll at any time. For more information about long-term
care options available in your county contact the ADRC. The ADRC can also assist you
with information about eligibility and enrollment.
ADRC Contact Information
• ADRC of Dane County: 1-608-240-7400, 1-855-417-6892, (TTY: Wisconsin Relay 711)
• ADRC of Kenosha County: 262-605-6646, 1-800-472-8008 (TTY: 262-605-6663)
• Milwaukee Aging Resource Center (for residents of Milwaukee County who are 60
years of age or older): 866-229-9695 (TDD: 414-289-8591)
• Milwaukee Disability Resource Center (for residents of Milwaukee County under
60 years of age): 414-289-6660 (TTY/TDD: 414-289-8559)
• ADRC of Racine County: 262-833-8777, 1-866-219-1043 (TTY: Wisconsin relay 711)
The iCare Family Care Partnership (HMO SNP) is a Coordinated Care plan with a Medi-
care contract and a contract with the Wisconsin Medicaid program. Enrollment in the
iCare Partnership program depends on contract renewal. This plan is available to any-
one who is 18 years of age or older, and who has both Medicaid and long-term care
service needs as determined by the State of Wisconsin. Benefits, formulary, pharmacy
network, premium and/or copayments/co-insurance may change on January 1 of
each year.
29

R e s u l t s
Through Care Coordination
No matter what program a person chooses, they
will always have access to a dedicated care co-
ordinator or care team to help them access their
medical, mental health and social service needs.
A care coordinator or care team is available to:
• Answer questions
• Help to visit a doctor
• Help to manage prescription drugs
• Help find community services
• Speak with about personal health concerns
Independent Care will provide the most appro-
priate care for a member’s needs. We will take
extra steps to ensure that members obtain the
services they need when they need it.
Care coordinators will encourage members to get the care they need in order to cre-
ate better outcomes and results. The concept works. A few of our members serve as
role models for their peers by serving on iCare committees and promoting iCare to
people that can benefit from the program. Their success can be attributed to iCare’s
expertise in care coordination and the social and community service benefits it in-
cludes.
Helpful Customer Service
In addition to a dedicated care coordinator, iCare Customer Service is a member’s link
to everything they want to know about iCare. You can contact Customer Service at
1-800-777-4376 (TTY: 1-800-947-3529), 8 a.m. to 8 p.m., 7 days-a-week.
Independent Care’s Customer Service
department is the first line of contact in
accessing covered services. If a member is
in need of interpreter services at their next
doctor’s appointment, our Customer Service
staff will arrange that for them. If a member
needs help locating a provider, Customer
Service will provide assistance. With iCare,
members know that there is someone on their
side to ensure that they are getting the health
care and community services that they need. The emphasis on maintaining one’s
health through care coordination helps to foster better results for our members.

Accomplishments
• Awards of Excellence. A Special Honoree Award in the 1996 U.S. Depart-
ment of Health and Human Services’ “Models that Work” competition,
which reflects our commitment to improving the health status of
under-served and vulnerable populations.
• Winner of the Small Business Times’ 2004 Health Care Heroes Award in the
Corporate Achievement in Health Care category.
• Recipient of the 2006 and 2007 Metropolitan Milwaukee Association of
Commerce’s (MMAC) Future 50 Award. Presented to the fifty fastest-
growing companies in the Milwaukee metropolitan region.
• Recognized by Inc. Magazine as a 2007 and 2008 Inc. 5000 Award winner,
one of the 5,000 fastest-growing private companies in America.
• Recognized by the Initiative for a Competitive Milwaukee as a 2007 Inner
City Growth Award winner, highlighting iCare’s success in operating in
Milwaukee’s central city and contributing to its economic rebirth.
• Winner of the Small Business Times’ 2007 Health Care Heroes Award in the
Community Service category.
• 2009 Business Journal - Top Milwaukee Workplaces
• 2009, 2011, 2012 Sterling Awards - Outstanding Employer
• 2009 - 2014 American Heart Association Start! Fit Friendly Company Award
• 2010 Milwaukee Employment Services Network – Distinguished Employer
• 2010 - 2011, 2014 Milwaukee Journal Sentinel - Top 100 Workplaces
• 2012 - 2013 Business Journal - Milwaukee’s Healthiest Employers
31

Independent Care’s scope of capabili-
ties reaches throughout our service area
and touches not only those with special
needs, but also their families.
This Value to the Member is published
for all of the organizations, groups and
providers that act as advocates for those
with physical, mental or emotional
disabilities.
It is our hope that you will encourage
your patients, clients and family members who are eligible for a program like iCare to
give it a try. It could mean the difference in the quality of life for someone who is impor-
tant to you.
For more information about long-term care options available to you contact the Aging
& Disability Resource Centers. The Resource Center can also assist you with information
about eligibility and enrollment.
For more information about iCare call 1-800-777-4376 (TTY: 1-800-947-3529) 8:00 a.m. to
8:00 p.m., 7 days-a-week.
Member Demographics
Membership by Ethnicity Membership by Age Group
Ethnicity Medicaid SSI Medicare
Dual
Age Medicaid SSI Medicare
Dual

0
5,000
3,000
19,000
1,000
7,000
9,000
11,000
13,000
15,000
17,000
1994 95 96 97 0198 99 00 02 03 04 05 06 1007 08 09 11 12 13
Membership Growth (1994 - 2014)
Initial Assessment Statistics of Membership (2013)
Member Demographics
18,519
9,942
925
20,000
15,039
21,371
2014

1555 N. RiverCenter Dr. Suite 206
Milwaukee, WI 53212
1-800-777-4376, 414-223-4847
Fax: 414-231-1092
TTY 1-800-947-3529 or 7-1-1, Voice:1-800-947-6644 or 7-1-1
8:00 a.m. to 8:00 p.m., 7 days-a-week
www.icare-wi.org
The iCare Family Care Partnership (HMO SNP) and the iCare Medicare Plan (HMO SNP) are Coordinated Care Plans
with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in the iCare Family Care
Partnership (HMO SNP) and the iCare Medicare Plan (HMO SNP) depends upon contract renewal. The iCare Medicare Plan is
available to anyone who has both Medical Assistance from the State and Medicare. The iCare Partnership program is available
to anyone who has both Medical Assistance from the State and Medicare and functionally eligible as determined by the State of
WisconsinLong-TermCareFunctionalScreen.Benefits,formulary,pharmacynetwork,premiumand/orcopayments/coinsurance
maychangeonJanuary1,ofeachyear.Thebenefitinformationprovidedisabriefsummary,notacompletedescriptionofbenefits.
For more information contact the plan. Limitations, copayments, and restrictions may apply.You must use plan providers except
in emergent or urgent care situations. If your preferred provider is not in our plan, we will seek to include them in our network.
If you obtain routine care from out-of-network providers, without first contacting your Team and getting prior authorization,
neither Medicare, Wisconsin Medicaid or iCare Partnership will pay for these services. You must use network pharmacies to
access your prescription drug benefit, except under non routine circumstances when you cannot reasonably use network
pharmacies, quantity limitations and restrictions may apply. For full information on the iCare Medicare Plan and iCare Family
Care Partnership (e.g., routine physical exam, pharmacy, eyeglasses, dental) benefits, call our Customer Service department from
8:00 a.m. to 8:00 p.m., 7 days-a-week, at 1-800-777-4376 (TTY: 1-800-947-3529). For more information about Medicare benefits
and services, including general information regarding the health or Part D benefit, contact 1-800-MEDICARE (1-800-633-4227)
or visit www.medicare.gov; TTY users should call 1-887-486-2048, 24 hours-a-day, 7 days-a-week. For more information about
Wisconsin Medicaid benefits call the Department of Health Services at 1-800-362-3002 (TTY: 1-888-701-1251) or visit www.dhs.
wisconsin.gov/Medicaid. You can also write to, Independent Care Health Plan, 1555 N. RiverCenter Drive, Suite 206, Milwaukee,
WI 53212. For more information about long-term care options available to you in contact the Aging & Disability Resource
Centers. The Resource Center can also assist you with information about eligibility and enrollment. If you have special needs,
this document is available in different formats or languages. Call iCare at 1-800-777-4376, TTY users should call 1-800-947-3529.
© 2015 Independent Care Health Plan

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