Key Points
- In 2023, the Medicare-Medicaid Coordination Office (MMCO) released guidance via Chapter 16-B of the Medicare Managed Care Manual outlining the screening instruments special needs plans must use to meet the new screening requirement.
- Beginning in 2024, all Medicare Advantage special needs plans must include questions about housing stability, food security, and access to transportation in enrollee health risk assessments, which are completed at enrollment and annually.
- This requirement for special needs plans will help better identify the risk factors that may inhibit enrollees from accessing care and achieving optimal health outcomes and independence and enable Medicare Advantage special needs plans to take these risk factors into account in enrollee care plans.
FIM Opportunities
Including questions about housing stability, food security, and access to transportation in health risk assessments will help better identify the risk factors that may inhibit special needs plan enrollees from accessing care and achieving optimal health outcomes and independence and enable special needs plans to take these risk factors into account in enrollee care plans.
In addition to allowing special needs plans to use any existing state-required screening instrument, the guidance requires selecting questions from validated, health information-encoded screening instruments. This will help standardize the information special needs plans are collecting about enrollees’ housing, food, and transportation needs.
