Program Overview
The Family Care Partnership Program is a comprehensive program of services for older
adults and people with physical disabilities in Wisconsin. The program integrates health
and long-term support services, and includes home and community-based services, physician
services, and all medical care. Services are delivered in the participant’s home or a
setting of his or her choice.
Member choice is a cornerstone of the Partnership Program. Program agencies make every
effort to honor member preferences of how, when, and where services are delivered.
A key component of the Partnership Program is team-based care management. Under this
arrangement, the participant, his or her physician, and a team of nurses and social
workers develop a care plan together. The team coordinates all service delivery.
Participants often keep their own physician who, in most cases, is added to the
Partnership provider network.
Who is Eligible?
To participate in the Partnership Program, people must be eligible for Medicaid and be
certified at the Medicaid nursing home level of care. The program also serves people who
are eligible for both Medicaid and Medicare. Participation in the program is voluntary.
Program Goals
The goals of Partnership are to:
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Improve quality of health care and service delivery while containing costs;
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Reduce fragmentation and inefficiency in the existing health care delivery system;
and
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Increase the ability of people to live in the community and participate in decisions
regarding their own health care.
Operations
The Partnership Program began phase-in operations in December 1995. By
January 1999, Partnership operated as a fully-capitated, dual Medicaid and Medicare
program. Under this arrangement, qualified community-based organizations enter into a
Medicaid managed care contract with the Wisconsin Department of Health Services
and a Medicare contract with the federal Centers for Medicare and Medicaid
Services. Contractors
receive monthly capitation payments for each participant. From the funds they receive from
the capitation payments, contractors pay for all participant services. Contractors are
responsible for the care of each person regardless of what agency provides the services or
where the service is provided, i.e., whether the participant is at home, in the hospital,
or in a nursing home.
In addition to the managed care contract, the Department of Health Services
developed the Partnership Program Protocol Manual. The protocol guides the
development, implementation and oversight of the program.
Where
Monitoring and Oversight
Partnership contractors operate extensive internal quality assurance and improvement
programs. Contractors report regularly on carefully defined data elements that provide
information on indicators of quality care. The Partnership quality assurance system has
been used by the Department of Health Services as a model for other managed
care programs serving special populations.
For More Information
The Partnership Program is a collaborative effort of the Department of Health
Services, participating counties, and community-based
organizations. Its first three years of development was made possible by a major grant from the Robert Wood Johnson Foundation.
If you are interested in more information, please contact either the Partnership
Program Manager at the Department of Health Services or the Partnership
organizations directly at:
Last Revised: July 21, 2009 |
