UCare adapts to state changes

The UCare health plan that dealt with very difficult news this summer will begin 2016 as a strong and leaner organization with a clear eye on its future.

UCareThe tough news was the loss of two state public program contracts for 2016: MinnesotaCare and Prepaid Medical Assistance Program (PMAP-Medicaid) in all but Olmsted County for 2016. This loss of approximately 350,000 UCare members of these plans followed a statewide competitive bidding process by the Department of Human Services (DHS) for the two programs. Many members of UCare Connect, our plan for people with disabilities in Minnesota, read Access Press. We’re in this issue now because all of us at UCare want every current and future UCare Connect member to know that UCare and their coverage will be here in 2016 – delivered by employees who put them and every member of our nine health plans at the heart of everything we do.

Here’s a look at what UCare will continue to offer in 2016:

• UCare Connect (a.k.a Special Needs BasicCare, or SNBC) – For adults with certified disabilities (physical, developmental, and/or mental illness) ages 18-64 (may remain in SNBC when they turn 65). UCare Connect offers a free SilverSneakers® Fitness membership, dental coverage, UCare’s Health Ride service, and more. It debuted in 2008 and serves Minnesotans in 42 counties.

• UCare Choices and Fairview UCare Choices – Commercial products accredited by the National Committee on Quality Assurance (NCQA) available on MNsure for individuals and families.

• Minnesota Senior Health Options– Integrates Medical Assistance and Medicare services and payments for people age 65 and older.

• Minnesota Senior Care Plus– For people eligible for Medical Assistance age 65 and older.

• UCare for Seniors – Medicare Advantage products with an excellent accreditation rating from NCQA and an Overall Rating of 4.5 out of 5 Medicare stars for people eligible for Medicare.

• EssentiaCare – A new Medicare Advantage product for 2016 offered with Essentia Health for Medicare-eligible people in 10 north central Minnesota counties.

• MinnesotaCare and Prepaid Medical Assistance in Olmsted County There’s no question that the loss of PMAP and MinnesotaCare was pretty tough for us. Our roots run long and deep in the communities with members served by these plans. In fact, UCare was created by the University of Minnesota Department of Family Medicine in 1984 to serve lower-income and underserved people in Hennepin County.

For members no longer receiving UCare coverage, the DHS decision means the absence of the one health plan option in the state created with the express purpose of serving Minnesotans who had traditionally faced barriers to accessing health care. For all members of the two programs, it means the state must transition an unprecedented 465,000 members, many of whom live impermanently, from one plan to another.

Minnesotans who had traditionally faced barriers to accessing health care. For all members of the two programs, it means the state must transition an unprecedented 465,000 members, many of whom live impermanently, from one plan to another.

UCare made every effort possible to retain PMAP and MinnesotaCare service. Our new President and CEO Jim Eppel, who joined UCare in mid-June this year, met with DHS Commissioner Lucinda Jesson and Gov. Mark Dayton. He testified at a Senate Health and Human Services Committee hearing on the issue. He stressed UCare’s concerns about the impact of transitioning the large volume of state program members to new health plans. And he shared our many concerns with several aspects of the process and the potentially detrimental loss of competition among health plans now and in the future.

We all were gratified by the outpouring of support we received from diverse communities, provider partners and nonprofit agencies during this time. We deeply appreciated every letter and conversation with policymakers on our behalf. Twenty-five counties filed appeals with DHS in support of UCare; 14 of them proceeded with an expedited appeal process.

Unfortunately, these efforts were largely unsuccessful, with the exception of Olmsted County, which will keep UCare as a health plan option in 2016.

In October, UCare withdrew legal action filed earlier on the matter. Because open enrollment had begun for many Minnesota counties and the county appeals had concluded, leadership ended the action in the interests of allowing MinnesotaCare and PMAP enrollees to go forward with their 2016 health plan selections without further delays or confusion.

The loss of such a high number of valued members is compounded by our impending loss of 29 percent of our workforce. Most departing employees will remain with UCare until Jan. 8, 2016 to ensure members receive complete service in 2015 and a smooth transition to new health plans in 2016. Approximately 580-590 full-time staff will remain with UCare in the new year.

The bidding process and outcome are now behind us—and we are looking ahead to serving current and future members in the very best way we can. Leadership and a reconfigured UCare are focused on strengthening and growing UCare in 2016. And staff will continue to live our mission to improve the health of our members through innovative partnerships across communities.

“We are committed to serving an estimated 157,000 members enrolled in our high-quality plans at the start of 2016,” said Eppel. “There’s no question that we will deliver innovative, collaborative health care services throughout 2015 and well beyond as we craft the new shape and future of UCare.”

Deanne Probst is the Senior Communications Specialist at UCare