Mission & Margin
Moving 450+ people out of nursing homes with 3% recidivism | Anna Keith
Overview
At Centene, the Pennsylvania plan transitioned over 450 people out of nursing homes last year with a 3 percent recidivism rate. Anna Keith, Vice President, LTSS Product & Strategy, helped build the playbook behind that result and is now carrying it across the company's other 12 markets.
Show Notes
At Centene, the Pennsylvania plan transitioned over 450 people out of nursing homes last year with a 3 percent recidivism rate. Anna Keith, Vice President, LTSS Product & Strategy, helped build the playbook behind that result and is now carrying it across the company's other 12 markets.
Anna tells Trey why duals integration has to anchor on the LTSS member's existing services, how Centene moved risk-averse nontraditional providers into shared savings by starting with bonus-only performance models, and how a new National Falls program uses predictive analytics to catch falls that 90-day-old claims data never sees.
Topics discussed:
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Scaling a foundation-first LTSS model across 12 additional markets
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Anchoring duals integration on the LTSS member's Medicaid services
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Separating person-centered plans from clinical care plans
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Easing risk-averse nontraditional providers into shared savings models
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Paying family caregivers while keeping quality measurable
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Predictive analytics for falls beyond 90-day-old claims data
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Incentivizing home care workers to close care gaps
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NCQA LTSS distinction as table stakes for health plans
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