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Key Differences between Family Care and Family Care Partnership

The following information describes three key differences between the Family Care and Family Care Partnership (also known as Partnership) programs. These are the general categories of services that are integrated into the benefit (long-term care services and health care services), specific services that are covered in the provider network. and the composition of the interdisciplinary team.

Service Integration

Family Care Partnership
Partial Integration. The Family Care program integrates home and community-based services, institutional care (such as nursing home care), Medicaid personal care, home health, and other services that were previously funded separately. Family Care does NOT pay for health care costs (acute/primary care) such as hospital stays, emergency room visits, medications, and doctor visits. Family Care participants use Medicare and Medicaid to purchase these health care services. Full Integration. The Partnership program integrates a personís long-term care services and health and medical care services (primary and acute care), and prescription medications. Therefore, all home and community based services, institutional care (such as a nursing home), physician services, hospital stays, medications, and all other medical care is integrated into the Partnership benefit.

Covered Services and the Provider Network

Family Care Partnership
Long-Term Care Services. A personís long-term care services are covered by Family Care. 

Primary Care Services (including services for acute and chronic conditions). Family Care does not pay for primary care services. Members use their own physician and their Medicaid Forward card to pay for their primary care services. Members obtain prescription drugs through their Medicare (Part D) and/or Medicaid (Senior Care) coverage. The interdisciplinary team can assist an individual in communicating with and coordinating primary care providers and services.
Long-Term Care Services. A personís long-term care services are covered by Partnership.

Primary Care Services (including services for acute and chronic conditions) are integrated in the Partnership benefit that is managed by the care team along with long-term care services. Members use physicians who are in the Managed Care Organizationís provider network that may include the memberís current physician. Members obtain prescription drugs through Partnership. Those who join a Partnership program do not use Senior Care or any other Medicare Part D provider, since medication coverage is also integrated into the benefit.

Interdisciplinary Team Composition

Family Care Partnership
At a minimum, the service coordination team includes a registered nurse, social worker, and the member. Members may choose to include family members, loved ones, and other professionals to participate on their team. At a minimum, the service coordination team includes a nurse practitioner, registered nurse, social worker, the member, and a physician. Members may choose to include family members, love ones, and other professionals to participate on their team.

 

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Last Revised: November 25, 2013