Common use of Delivery Systems and Benefits Clause in Contracts

Delivery Systems and Benefits. The Demonstration will not fundamentally change benefits packages, choice of providers and plans for Beneficiaries, or the ways in which the MSHO Plans contract with either the State and CMS. However, MSHO is an important vehicle for wider adoption of delivery system reforms throughout Minnesota. Building on provider contracting arrangements under MSHO and its current Medicaid Health Care Home benefit, the State will promote relationships between MSHO Plans and providers called Integrated Care System Partnerships (ICSPs). The goals of these ICSPs are to improve coordination between Medicare and Medicaid services and, ultimately, to help Beneficiaries remain in their homes or choice of community settings and improve health outcomes in all settings. The State has developed a range of ICSP arrangements based on provider interest and capacity, as well as geographic and demographic factors. The State’s MSHO contracts outline the following models:‌ strengthen and revise current primary care partnerships already existing within the MSHO Plans. The new contracting requirements tie provider performance to a range of financial metrics including pay for performance goals, performance pools, and total cost of care systems with risk/gain parameters. These arrangements facilitate the integration of HCH coordination provided by primary care providers with other all care coordination provided under the Medicaid acute and long term care and Medicare.