Informational Materials for Providers

OCK Informational Materials for Providers

• What is OneCare Kansas?

  OneCare Kansas (OCK) is a comprehensive and intense method of care coordination. OCK integrates and coordinates all services and supports to treat the “whole‐person” across the lifespan.

• Who can be a OneCare Kansas member?

  OneCare Kansas is intended for people with certain chronic conditions, like diabetes, asthma, or mental illness. These people must be Medicaid Members. They can be Members who also receive Medicare along with Medicaid.

• Does OneCare Kansas provide all services a person needs?

  No. OneCare Kansas (OCK) coordinates and manages care. It also provides supports and referrals for the person and their family. OCK does not replace services like doctor visits, prescription drugs, hospital care, or therapies.

   

• How is a OneCare Kansas different from a medical home?

  Medical homes usually have a doctor leading a team of other health providers. Medical homes are not limited to people with certain conditions. They also do not usually include community and social supports as OneCare Kansas will. OneCare Kansas can include what has been called a medical home.

   

• How does OneCare Kansas improve health?

  OneCare Kansas helps people live healthier lives by making sure:

  • Important information is shared among providers and with Member
  • The Member has the tools needed to help manage his chronic condition
  • Needed screenings and tests are done when they should be
  • Unnecessary emergency room visits and hospital stays are avoided
  • Community and social supports are in place to help maintain health

• How does OneCare Kansas be provided in KanCare?

  It is a partnership between the KanCare managed care organizations (MCOs) and a OneCare Kansas partner, which could be any one of a many different types of providers, like:

  • Doctors
  • Clinics, including FQHCs
  • Community mental health centers (CMHC)
  • Community developmental disability organizations (CDDO)
  • Other providers who meet the requirements and contract with an MCO

• What services are provided by OneCare Kansas?

  The Medicaid program requires these six core services:

  • Comprehensive care management
  • Care coordination and health promotion
  • Comprehensive transitional care, including appropriate follow-up, from inpatient to other settings
  • Individual and family support (including authorized representative)
  • Referral to community and social support services, if relevant
  • Use of health information technology (HIT) to link services

• Who pays for OneCare Kansas services?

  The State pays the MCOs a monthly amount to provide OneCare Kansas (OCK) for each person. The MCOs will sign agreements with different OCK partners to provide OCK services. These agreements will say how much the MCOs will pay the OCK partners.

• How will the payment amount for OneCare Kansas partners be decided?

  Many things will be looked at to help determine the payment. These things may include:

  • Costs for staff
  • Needs of the Member

• What is a Health Action Plan?

  The Health Action Plan (HAP) is a tool to document goals that the member will pursue within the OneCare Kansas (OCK) program. The HAP also documents the proposed process for achieving these goals, as well as progress made in achieving the goals.  
  
  

• Does CCBHC billing and reimbursement overlap with OneCare Kansas services, billing, and reimbursement?

  No, OCK services, codes, and billing procedures stand outside of the CCBHC certification and reimbursement structure. Therefore, OCKPs, regardless of CCBHC certification, should continue to provide OCK services to members and bill each OCK encounter, as per usual procedure. For more information on CCBHCs, please visit https://kdads.ks.gov/kdads-commissions/behavioral-health/certified-community-behavioral-health-centers.