THOUGHTS ON DISASTER PLANNING FOR MCOs

Friends and Colleagues,

 As the reality of a catastrophic hurricane gets closer to home, I hope and trust that everyone has proactively prepared by stocking up on food, water, and securing valuables so you can care for your loved ones while bracing for the impact of yet another natural disaster.

 If you are in a leadership position at an MCO, I encourage you to professionally challenge your compliance departments and clinical operations teams to validate that policies, procedures, systems, and staff have an Emergency Preparedness plan currently in place. As a result of Hurricane Sandy in 2016, CMS released the final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers (Federal Register Vol. 81, No. 180) in September of 2016. Affecting all 17 provider and supplier types eligible for participation in Medicare, this rule became effective on November 16, 2016, and all applicable requirements should be implemented by November 16, 2017.

 If your organization and care teams are not prepared for the worst, I strongly encourage each of you to put effective policies, procedures, system configuration, and reporting capabilities in place as soon as possible to support your triple aim initiatives. Think of it this way: How are you determining each of your members’ "disaster plan" acuity levels? For example, a COPD member could very well be quite stable as far as their condition management, medication, and level of function, but in the event of a catastrophic event, they could need oxygen tanks delivered on a daily or bi-weekly basis in order to survive.

 So, ask yourselves:

? Does your internal disaster policy include your member population?

? Are your policies and procedures up to date and effective enough to support your regulatory requirements? What practices do you have in place to verify the accuracy of these actionable plans?

? Is your care management platform configured to meet your disaster preparedness business requirements?

? Do you have business rules in place to stratify your members in preparation of a catastrophic event? Can your Business Analytics team run a report to identify members with a Disaster Stratification level of 3 or above? 

? How prepared are you for this disaster? Or the next?

I hope and trust that I have at least encouraged you to speak with your internal teams and to consider extending your emergency preparedness reach to include your member population. For those of us who are in the path of the storm, best of luck and please be safe.

Warmest regards,

Marcus Fontaine