Members-Only Event: Specialized Mobile Dental Clinic Brings Care and Smiles to Partners Health Plan Members
A specialized mobile dental clinic, in partnership with Solvere Health, brought dental care and smiles to Partners Health Plan (PHP) members on February 18. PHP is the first-in-the-nation, non-profit, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with IDD. We are dedicated to expanding access to quality healthcare to assist members in living quality lives.
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Individuals with Intellectual and Developmental Disabilities (IDD) are known to have poorer oral/dental health than people without IDD. Studies show that people with IDD have 30% more untreated cavities, 50% more missing teeth, and 150% more gum disease.
The biggest reason for this health disparity is access to oral health care for children and adults with IDD: lack of preventive and regular care, including management of secondary medical conditions that are related to oral health, leads to more significant oral health problems. Wait times for IDD specialized services can be as long as a year at practices and dental school programs that offer them.
But Partners Health Plan (PHP), a NY-based health plan that is exclusively dedicated to supporting the health and well-being of individuals with IDD, is committed to ensuring the oral health of its members.
“Improving access to dental care for our community of service in New York State is mission-critical,” added Steven Merahn, MD, Medical Director, Partners Health Plan. “Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”
To achieve this goal, PHP has partnered with Solvere Health to deploy specialized IDD mobile dental clinics at select-day service locations in Metro New York to reduce travel demands.
Solvere Health is a company that specializes in the delivery of high-quality clinical services through group health events via mobile medical units or pop-up clinics to underserved populations. Individuals with IDD may struggle with the sights, sounds and experiences encountered during dental care, and the PHP-Solvere Dental Health Program will conduct specialized desensitization sessions to prepare individuals for the dental care experience and mobile clinic environments. The mobile dental units are also fully accessible for individuals with mobility challenges.
“Expanding the availability of quality healthcare services to underserved communities is central to Solvere Health's mission. We view the collaboration with Partner Health Plan as a way to make quality dental care accessible to persons with I/DD,” stated Edward Lorch, CEO, Solvere Health, “Our mobile clinics offer a solution that is empathetic and considerate. We factor in the patient population's comfort (including desensitization), convenience, mobility, and communication. When engineering and staffing the mobile clinic, we understand that taking a holistic view of the patient leads to a positive oral healthcare experience and repeat preventative care.”
“This mobile dental clinic initiative is a very exciting opportunity as it will open access to oral healthcare,” noted Rita Marie Bilello, DDS, CEO, and former Dental Director of Metro Community Health Centers. “This new dental care model will bridge a much-needed gap for Partners Health Plan (PHP) members, all adults with IDD, who have been unable to access routine preventative oral health care services. Mobilizing dental services will begin to address some of the access issues and will allow for PHP to better assist in getting their members the oral care that they need.”
About Partners Health Plan
Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.
About Solvere Health
Working with state and federal, institutional, and corporate partners, Solvere Health brings a business discipline to health challenges across the United States through onsite, mobile, and digital healthcare solutions. Deploying a team of highly motivated, accountable problem solvers, we stand up sustainable, end-to-end programs in rapid response to group health events, disaster relief, and underserved rural communities, via onsite pop-ups, mobile clinics, and strategically placed brick-and-mortar locations. Our efficient approach combines exacting strategic planning, comprehensive compliance management, unparalleled logistics, state-of-the-art mobile healthcare technology, and emerging digital health applications.
Please visit the The Arc of New York advocacy platform to email Governor Hochul and ask her to establish a wage enhancement and an 8.5% Cost -of-Living Adjustment (COLA) in the 2023-2024 NYS Executive Budget.
CLICK HERE to learn more about 2023-2024 Executive Budget Request.
Thank a Care
Manager Today!
Partners Health Plan will be celebrating Care Management Week 2023 beginning on Monday, October 9 through Friday, October 13.
Each year, we recognize this week to acknowledge and thank our Care Management employees for the important work they do each day in support of members and their families.
If you would like to thank or recognize a particular Care Manager, we invite you to submit an appreciation message by clicking on the button below. Your message will be shared directly with Care Management staff and help celebrate this important week.
Submit a Thank You Message!
Authors:
Stephan Deutsch, MD, Physician Consultant
Scott Doolan, RN, BSN, MBA, AVP Health Care Management
The Flu is a viral disease caused by Influenza A and B viruses. The annual flu season usually starts around September/October with the peak of cases typically occurring between December and February. Because of COVID-19 it is more important than ever to get the flu vaccine.
With the 2022-2023 Flu season currently ongoing, PHP’s number one goal is to educate you about the importance of getting your vaccine. If you have not received your flu vaccine for this season yet, it's not too late. We want to help increase the access to the Flu Shot and can provide assistance with scheduling an early appointment for vaccination and arranging transportation. Your Care Manager, can work with you to get access and can discuss the best way to keep you healthy and safe this flu season.
Common Flu symptoms include fever, chills, cough sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue, vomiting and diarrhea. Complications from the Flu can affect your heart, brain, kidneys, and lungs, causing respiratory and kidney failure. Annually the flu has been estimated to kill between 25,000 to 60,000 people per year, affecting certain groups of people worse than others. People 65 and older; people with heart disease, stroke, asthma, diabetes, cancer, pregnant women, young children, people with obesity and people with HIV and AIDs. You can reduce your risk of getting a severe case of the flu.
Wait a minute, have I been describing the Flu or COVID? A good question because they are similar regarding the symptoms and who is at highest risk for severe case. They are also similar when it comes to how the disease is spread and prevention techniques. For both the flu and COVID-19 the best protection is a vaccine that can prevent the disease or lessen its severity. You can even get both vaccines on the same day We know that the earlier in the flu season people get vaccinated the more effective it is. In both adults and children, it has been shown that once vaccinated, even if you get the flu, the severity of the disease is significantly decreased.
But what happens if you do start to feel ill? You can call StationMD, our telehealth partner, anytime, night or day, seven days a week. You will speak to an Emergency Room Doctor who will assess you and when possible, treat you from your home. These doctors have additional training in working with people with IDD. In most instances this will help you avoid crowded Emergency Rooms, which increases your exposure to the flu, COVID-19, or other infections. It has saved our members hundreds of emergency room visits and multiple unnecessary hospital admissions. Even though PHP has great programs to assist you if you get sick, what we really want to do is prevent you from getting sick. So please reach out to us so we can help you with avoiding the flu and get your vaccine.
Visit Partners Health Plan's Health Resources to learn more about the flu as well as other informative health-related articles.
H9869_Flu Season Article_2022
Winter 2024
Tips for Chasing the Winter Blues
The 2023 holiday season has ended, and we begin a new year filled with fresh hope and new resolutions to be happy and healthy. We’ve gathered some tips from our behavioral health and health care management team and the National Alliance on Mental Illness (NAMI) for managing your mental health.
- Socialize: As you enter the New Year, you may find you have an interest in new activities which can promote good physical and mental health. Social engagement is important to maintaining your overall wellness and as you know, opportunities to help others at the same time are abundant.
- Helping others: Doing something nice for someone else can result in positive emotions, a sense of meaningfulness and value, and new social connections, and it can provide a sense of intrinsic reward. It doesn't have to take a great deal of effort or time, and you can engage your family and/or friends in your efforts.
- Check your feelings: Acknowledging your feelings is the first step to addressing and nurturing them.
- Practice self-care: Treat yourself with kindness and avoid self-criticism. It is also important to schedule time for yourself and activities that recharge your mind and body.
- Taking care of your body: A big part of mental health has to do with your physical health. Make sure you drink plenty of water, eat a balanced diet, exercise throughout the week, and get enough sleep.
- Use your coping skills: Stress and anxiety are a natural part of life. Practicing good coping skills can help relieve overwhelming feelings. Take a walk, play with your pet, or even write in a journal. Research also shows that laughter not only boosts your immune system but also relieves pain, relaxes your body, and reduces stress.
- Make a plan: When you feel sad, stressed, or alone: This plan might include calling a friend or family member, going for a walk, participating in an activity that brings joy, or watching a favorite movie. Having a plan helps ensure that difficult moments are more manageable.
Please seek additional support if needed. If you or a loved one are experiencing anxiety, please contact your Care Manager. Care Design NY Care Managers received the nationally recognized evidence-based training program, Mental Health First Aid certification. They know the signs to look for and have skills to help develop a plan of action to get individuals the support they need. Click here to learn more. If you or someone you know needs immediate help, call or text the Suicide and Crisis Lifeline at 988.
We’d love your ideas on what you are doing this month to bring more joy into the winter months! Click on the button below to send us your thoughts. Wishing you a joy filled 2024!
Ideas for Chasing the Winter Blues
New Report Determines Partners Health Plan’s FIDA-IDD Demonstration Shows
Positive Impact and Progress for Enrollees with Complex Care Needs
BRONX, NY, July 6, 2022— Partners Health Plan (PHP), a nonprofit managed care organization dedicated to serving individuals with Intellectual and Developmental Disabilities (IDD), is pleased to announce that the results of an independent evaluation funded by the Centers for Medicare & Medicaid Services (CMS) indicate positive returns for enrollees in the New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) demonstration.
The FIDA-IDD demonstration is a pilot program established to test the success of delivering services that address the whole person and promote community involvement and independence for people with IDD eligible for both Medicare and Medicaid benefits. According to the findings, PHP is well on its way toward meeting those objectives.
“This is an extremely positive report,” said Kerry Delaney, CEO of PHP, “but also acknowledges in a realistic way the challenges we have faced.” Those challenges stemmed from the newness of managed care for providers in the space, lack of plan coverage awareness for covered entities, and providers’ refusal to participate or offer services to the population just to name a few. Despite these challenges, key findings reflect that if implemented correctly, managed care can be a viable option to serve people with IDD.”
Key Findings:
- Through the comprehensive “It’s All About Me” (I AM) assessment tool, PHP effectively elicited responses from the IDD population about health and wellness needs allowing enrollees to leverage control over benefit options impacting their everyday lives.
- Innovative solutions like the pharmacy management program reduced errors, unnecessary emergency department visits, and length of hospital stays. Similarly, the telehealth program successfully resolved 90% of consultations virtually. The rewards incentive program “Choose Health” also received positive feedback for motivating members to achieve preventive health goals.
- While the new rate payment method has been a challenge to cover certain member populations, like older and frailer members, programs like pharmacy management are viewed as innovative cost-savings strategies.
- Regularly engaging stakeholders from the Participant Advisory Committee helped to address real-time needs, like improvements to transportation services and communications efforts.
One of the best measures of the impact Partners Health Plan has had on member health and experiences comes from the members themselves. PHP FIDA-IDD plan member, Jessica, stated, “Recently I needed special comprehension therapy for my legs and was able to get something to help me at home. This keeps me healthy and helps my ability to walk. I want to keep my independence. I also have support from my Care Manager and my Broker with my self-direction!”
As the agency responsible for the IDD program in New York State, the Office for People With Developmental Disabilities (OPWDD) was integral in the demonstration’s design and implementation. “OPWDD has been pleased to collaborate with Partners Health Plan on the FIDA-IDD program, which has offered people an opportunity to coordinate their health and long-term care services in a new and innovative way,” said OPWDD Commissioner Kerri Neifeld. “We look forward to continuing to work with Partners Health Plan and the larger provider community to ensure quality supports and services are available to NYers with intellectual and developmental disabilities.”
Read the full report here: https://innovation.cms.gov/data-and-reports/2022/fai-ny-fida-idd-prelim-firstsecondevalrpt.
About Partners Health Plan: Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with intellectual and/or developmental disabilities (I/DD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.
About CMS Financial Alignment Initiative: The Centers for Medicare & Medicaid Services (CMS) created the Medicare-Medicaid Financial Alignment Initiatives (FAI) Demonstrations to test in partnership with States integrated care models for dually eligible beneficiaries with the goal to improve care for dually eligible beneficiaries and reduce program costs through an aligned financial and person-centered care coordination structure. A longstanding barrier to coordinating care for Medicare-Medicaid enrollees has been the financial misalignment between Medicare and Medicaid. For more information, visit Financial Alignment Initiative (FAI) | CMS.
