AdministrativeMedicaidJuly 11, 2023

Transitional Care Services – new requirements

On November, 28 2022, the Department of Health Care Services (DHCS) released All Plan Letter (APL) 22-024, Population Health Management (PHM) Policy Guide, and the associated PHM Policy Guide, outlining a common framework and set of expectations for the PHM Program. Anthem Blue Cross (Anthem) and all its subcontractors and network providers are required to comply with the expectations in the PHM Policy Guide, including Transitional Care Services (TCS).

Starting in 2023, the State requires that managed care plans (MCPs) provide TCS to any member undergoing a care transition. Care transitions are defined as a member transferring from one setting or level of care to another, including, but not limited to: discharges from hospitals, institutions, other acute care facilities, and skilled nursing facilities (SNFs) to home- or community-based settings, Community Supports, post-acute care facilities, or long-term care (LTC) settings.

How Anthem will support Transitional Care Services:

How Anthem will support Transitional Care Services

Description

Single Point of Contact

Anthem will designate a single point of contact, (care manager) who will assist members throughout care transitions.  Providers should expect communication from the assigned care manager. 

NOTE: the single point of contact will still coordinate care among the discharge facility, the primary care physician (PCP), and/or other treating providers, even if members choose to have limited or no contact with the single point of contact

CCM or ECM members

For members enrolled Complex Case Management (CCM) or Enhanced Care Management (ECM), the ECM or CCM lead care manager is the designated single point of contact.

Members not enrolled in ECM/CCM

For members not enrolled in CCM or ECM, the designated single point of contact may be employed by Anthem or by Anthem’s contracted entities (including but not limited to hospitals or primary care provider groups)

Discharge Risk Assessment & Discharge Planning Documents

While the single point of contact will not perform all activities directly, they will ensure all TCS activities occur, including completion of the discharge risk assessment, discharge planning document, and necessary post-discharge services and follow-ups. 

How Providers can support Transitional Care Services:

How Providers can support Transitional Care Services

Description

Notification of A/D/T

Notify the PCP and Anthem of members’ admissions/discharges/transfers as soon as possible and no later than 24 hours of an admission/discharge/transfer. 

Add Transitional Care language to the DC planning document

“Transitional Care Services are available for any Anthem member transitioning from one setting or level of care to another. The goal of these services is to provide members support from the time they enter a facility, throughout the stay, and post-discharge, until they’ve been successfully connected to all needed services and supports. Anthem members can call the customer service number on the back of their ID card to be connected with their designated care manager.” 

Discharge Planning Assistance

Partner with Anthem on discharge planning (includes participating in interdisciplinary care conferences, engaging with designated care managers, validating, and sharing member contact information, sharing discharge information, arranging follow-up care with PCP, specialists and/or ancillary providers prior to discharge). 

Discharge Planning Document

Ensure discharge planning document contains all required elements (see below) and is shared with the member, Anthem, and all appropriate parties

Educate patients about Transitional Care

Educate patients about Transitional Care Services prior to discharge, including what to expect after discharge (for example, follow-up care and continued outreach from care manager). 

Below are DHCS documentation requirements for Transitional Care Services:

Discharge risk assessment requirements:

Required elements in risk assessment 

  • Assess Risk of re-institutionalization/re-hospitalization
  • Assess Risk of destabilization of a mental health condition, and/or risk of substance use disorder (SUD) relapse 
  • Assess Eligibility for ongoing care management services (for example: CCM, ECM, HCBS Waiver Services)

When

Completed prior to discharge

Who

Completed by discharge facility or designated care manager

Discharge planning document requirements (completed by discharge facility):

Note: Members cannot receive two different discharge documents from discharging facility and from the designated care manager

Required Elements

Description

Admitting facility name

Name of admitting hospital/institution/facility 

Available resources

Information regarding available care and resources after discharge

Barriers

Anticipated barriers to post-discharge plans

Care Manager and TCS Information

The designated care manager’s name, contact information, and a description of TCS

Discharge planning participation

Summary of nature and outcome of participation of member and member’s authorized representatives in the discharge planning process

Name of discharge location

Discharge location recommended by discharging hospital/institution/facility

Discharge location preferred by and agreed upon by member

Pre-admission status

Living arrangements, physical & mental function, SUD needs, social support, DME & other services received prior to admission

Pre-discharge factors

Member’s medical condition, physical and mental function, financial resources, and social supports at time of discharge

Services need after discharge

Specific services needed after the member’s discharge

Recommended pre-discharge counseling

Recommended pre-discharge counseling

Please note: Except for members enrolled in Medicare Medicaid Plans (MMPs) or other Dual-Eligible Special Needs Plans (D-SNPs) plans, TCS requirements also apply to Anthem members when Anthem is not the primary source of coverage for the triggering service (for example, hospitalization for a Medicare FFS dual-eligible member, or an inpatient psychiatric admission covered by a County Mental Health Plan).

If you have any questions, reach out to your assigned Provider Relationship Management representative.

CABC-CD-028145-23

PUBLICATIONS: August 2023 Provider Newsletter