The Family Care Partnership program is a comprehensive program of services for frail elders and adults with developmental or 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 member'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 Partnership is team-based care management. Under this arrangement, the member, his or her physician, and a team of nurses and social workers work together to develop a care plan. The team coordinates all service delivery. Members 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.
The goals of Partnership are to:
- Improve quality of health care and service delivery while containing costs.
- Reduce fragmentation and inefficiency in the existing health care delivery system.
- Increase the ability of people to live in the community and participate in decisions regarding their own health care.
The Wisconsin Department of Health Services (DHS) started the Partnership program in December 1995. By January 1999, Partnership operated as a fully capitated, dual Medicaid and Medicare program. Under this arrangement, qualified managed care organizations (MCOs) enter into a Medicaid managed care contract with DHS and a Medicare contract with the federal Centers for Medicare & Medicaid Services (CMS). MCOs receive monthly capitation payments for each member. MCOs use the capitation payments to pay for services for all members. MCOs are responsible for the care of each person regardless of the agency that provides the services or where the service is provided.
Monitoring and Oversight
Partnership MCOs operate extensive internal quality assurance and improvement programs. MCOs report regularly on carefully defined data elements that provide information on indicators of quality care. DHS has used the Partnership quality assurance system as a model for other managed care programs serving special populations.
DHS has received verification through CMS that the following Partnership Plan's acute and primary provider networks are approved for 2018:
- Care Wisconsin
- Community Care
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 were made possible by a major grant from the Robert Wood Johnson Foundation.
If you are interested in more information, please contact either the Department of Health Services at email@example.com or the Partnership organizations directly:
|Care Wisconsin Health Plan||1-800-963-0035|
|Community Care Health Plan, Inc.||1-866-992-6600|
|Independent Care Health Plan (iCare)||1-800-777-4376|