Note: Medicare Advantage (MA) may include Dual Special Needs Plans (DSNP).
Our MA plans provide a full spectrum of care management programs as part of our standard plan offerings. Clinical programs include inpatient care management, care and condition management, specialty care management (e.g., transplant and end stage renal disease (ESRD) management), behavioral health care management, Advanced Illness, HouseCalls (not all members are eligible for this program), and Solutions for Caregivers (available on select MA plans). Participation by the member is encouraged, but voluntary.
These programs help members with chronic conditions, such as diabetes, heart failure, and ESRD, to be their healthiest. We offer education and resources to support optimal health of members actively treated for chronic conditions. Members receive case management and can attend workshops to help manage their condition.
The MOC is the framework for care management processes and systems that enable coordinated care for SNP members. The MOC includes descriptions of:
The MOC helps ensure the unique needs of the population are identified and addressed through care management practices. We evaluate MOC goals on an annual basis to determine effectiveness.
To learn more, contact us at: snp_moc_providertraining@ uhc.com.
The Centers for Medicare & Medicaid Services (CMS) requires annual SNP MOC training for all care providers who treat SNP members. The training is reviewed and updated annually to reflect current practices related to care coordination. This includes communication of the Interdisciplinary Care Plan (ICP) for each member. The Annual SNP MOC Provider Training is available at UHCprovider.com/training. We use the Network Bulletin to remind you about the annual training requirement.