Program areas at SCAN
Scan Health care services:scan Health Plan has a culture of quality and a long history of fulfilling our mission: keeping seniors healthy and independent. As a medicare advantage and prescription drug Plan (mapd) in California, Scan collaborates with a network of delegated providers to offer medicare and medi-cal covered Health and behavioral healthcare and additional supplemental benefits. Our member-centric model of care ensures quality, individualized care for all members, including members with special needs such as members eligible for both medicare and medicaid, members with chronic conditions and frail members with functional deficits.the Health care services programs at Scan are evidenced-based and aligned with geriatric best practices. They include but are not limited to, complex care management, advanced illness management, memory program, disease management, and care navigation and coordination. The programs are aligned with the institute for healthcare improvement's triple aim and seek to ensure:- a safe and satisfying Health care experience- improved Health outcomes for individuals and populations- access and affordability for our members
Provider integration program:scan has a long recognized the importance of the provider network in supporting our mission to keep seniors healthy and independent and that our members highly value their relationship with their physicians. This appreciation has led Scan to charter the Scan provider integration steering committee, with membership coming from the clinical and operational leaders of our key physician groups and Health systems. A main area of focus for this effort has been quality improvement, including supporting medicare 5 star quality performance metrics. Scan and the provider organization leaders recognize that if we are to succeed in the cms medicare advantage 5 star program we must do so as a collective system. Through this program, Scan shares 5 star metrics and other quality data with our providers.physician group performance on hedis and part d quality measures,supporting identification of best practices within the Scan providernetwork. We invite the providers to share their best qualityimprovement practices with their colleagues from other providerorganizations, hosting a webinar series several times a year with abest practice organization leading the webinar, sharing theirapproaches and lessons learned.scan further supports advances in care for seniors by working closely with our provider networks to support their efforts, knowing that the work they do to improve systems and processes of care will benefit their entire patient population.for the year ending december 31, 2019, the provider intergration program incurred $509,093 in program expenses. Provider integration focuses on partnering with Scan's network medical groups to improve quality as measured by a variety of indicators, including but not limited to cms medicare stars performance. Specifically, this function enables: - sharing, facilitating and supporting the implementation of best practices to improve clinical outcomes and member/patient experience.- highlighting person-centered approach to caring for high needs seniors, while tailoring benefits, programs and services to meet both medical and social/social determinants of Health needs.- promoting cross-organizational/cross-sector collaboration otherwise not readily available in the broader Health care industry.provider integration hosts forums with executive-level decision makers from various providers to engage in mutual knowledge sharing around quality-focused interventions (business case development, approach/methodology, critical success factors, lessons learned). Targeted discussions center on the clinical, operational and data-driven considerations required to launch such programs successfully. Medical group executives utilize their learnings from provider integration to spur action at the provider site level to improve the care delivered to the broader medicare population. Previous knowledge-sharing forums have centered on best practice programs to drive improvement in managing chronic conditions (e.g., diabetes); promoting disease prevention strategies; medication adherence; and member satisfaction around access to care.
Independence at home:scan's mission of keeping seniors healthy and independent is not limited to Scan members. Scan recognizes its responsibility to enhance the quality of life for all those in the communities we serve. To that end, Scan sponsors and promotes innovative geriatric research, invests in significant community education and outreach efforts, and supports like-minded community organizations through grants. The cornerstone of Scan's community engagement comes through independence at home (iah), Scan's community benefit division.through the programs run by iah, Scan has connected with tens of thousands of seniors and caregivers across its service areas.iah is funded by state & county contracts as well as Scan Health Plan. The programs are geared to support the underserved, frail and disabled seniors in our community.iah's hallmark programs are:- multipurpose senior services program (mssp): since 1997, this program has provided long-term in-home care management for adults 65 plus who qualify for medi-cal. - California community transitions (cct): this program assists with the safe transition from healthcare facilities back to community living.- los angeles county's supportive services program (ssp): this program includes care management, planning, and daily living assistance services for functionally impaired older adults.- insights: this program provides in-home mental Health support.- community medication, education, data & safety (cmeds): in-home medication safety and adherence program.- caregivers & older adults connected and healthy (coach): in-home care management for seniors and/or their caregivers.scan Health Plan community giving program:scan's community giving (cg) program is focused on meeting an individual's basic needs including nutrition, shelter, Health and socialization, and on enhancing an individual's ability to remain independent in their own community.this is accomplished through one-time operating grants. The Scan community giving committee identifies organizations who's mission aligns with the program priorities. As a result of this approach, the majority of grantees are identified and contacted by our staff.policies and procedures:a. Identification and vetting of potential program grantees - the director, community outreach, collaborates with various Scan Health Plan departments (i.e., Health care services and independence at home) and reputable agencies to identify prospective grantee organizations. The prospective grantees undergo the community group vetting process and are measured against the following criteria: 1) alignment with the Scan Health Plan mission; 2) verified status as a nonprofit or governmental agency with tax-exempt status; and 3) the organization is at least two years old. Successful candidates are added to the larger Scan Health Plan grantee pool.b. Short listing potential grantees - the directors and the manager, community outreach and giving, use various methods, including outbound calls, internet research, and industry ratings to review the potential grantee pool and generate a shortlist.c. Evaluation and selection of grantees by the community giving committee (cgc) - the cgc is a nine-member committee representative of all levels of management and chaired by the vice-president of independence at home (iah). The cgc meets on a quarterly basis and itsrole is twofold: 1) evaluate, select, and decide the amount to be awarded to the grantee organizations, and 2) steer the community giving program. The cgc bases its decision to make awards on the infrastructure of the grantee organization, their perceived ability to effectively and efficiently impact the lives of seniors, and their ability to continue a sustainable relationship.d. Grantee outreach - subsequent to the cgc earmarking and approving grant funds, the manager, community outreach and giving, places an outreach call to the prospective grantee organization. The grantee organization is informed of its selection to apply for a one-time grant via Scan's online grant tracking system. The director, community outreach and giving, reviews each application and discusses criteria with the iah vice president and community outreach team, in order to make a recommendation for funding. The list of recommended grantees is submitted to the cgc each quarter to be discussed and voted on. A grant agreement is developed for each approved grant, containing information on funding restrictions and requirements for grant reporting. Only after a signed agreement has been fully executed will the grant payment phase be initiated.e. All grantees submit a quarterly report documenting metrics and performance year-to-date throughout the duration of the funding. The manager, community outreach and giving, tracks and reviews the reports to ensure compliance. The manager addresses any identified issues withthe grantee to determine the cause and any remediation required. Issues with compliance are raised to the vice president, iah, who will assist with remediation or elevate to the cgc for advisement and/or approval if a change to the grantee's scope of work is required.scan's volunteer action for aging: through this program, Scan recruits, trains and manages volunteers. In 2019, volunteers in the community donated over 7,182 hours to complete 94 senior support events/programs, hosted 675 community events, and delivered 2,100 thanksgiving meals.scan Health Plan community outreach:scan Health Plan has a 43 year history of creating programs and providing services to older adults and their caregivers. Scan's experience with this segment of the population has allowed us to develop a unique expertise in geriatric care and Health interventions. Scan Health Plan is committed to sharing this set of skills and vast knowledge with the broader community by developing community outreach initiatives. These initiatives are an important tool for bringingeducation directly to community members, as well as contributing to reducing Health disparities, and improving Health literacy, in particular among underserved communities. Through our outreach activities and community giving program, we work to support access tobasic needs such as food and nutrition, to encourage active and healthy lifestyles, to engage older adults in Health maintenance, and to collaborate with local service partners to meet gaps in community services. We do this in many ways, bringing needed resources and a thoughtful presence to older adults and their support networks throughout California. Our goal is to make an impact in all of the communities we serve and to improve the lives of all seniors - not just Scan members.scan recognizes that its responsibility to the communities we servegoes beyond business and providing quality healthcare.scan Health Plan community giving program:scan has supported the following: council on aging- southern California, project access, smiles for seniors, family service association, coachella valley, rescue mission, hope through housing foundation, mental Health association- los angeles, county of riverside, city of glendale, jfs of the desert, senior advocates of the desert, alzheimer's san diego, christian outreach appeal, engageability first, affordable living for the aging, alzheimer's los angeles, caregivers ventura, catholic charities of los angeles, chinese american coalition for compassionate care, human options, onegeneration, institute on aging, jewish family and children's service of long beach/west orange county, fallbrook healthcare foundation, conejo valley senior concerns, food finders, food share, lakewood meals on wheels, meals on wheels west, Colorado river senior citizens services, st. francis living room, food for thought, ventura county area agency on aging foundation, foodbank of southern California, jewish family service of san diego, san francisco-marin food bank, second harvest food bank of orange county, st. vincent meals on wheels, los angeles lgbt center, community action partnership-oc, meals on wheels- san francisco, project angel food, meals on wheels san diego, seniorserv, justice in aging, community seniorserv, alzheimer's orange county, aplastic anemia and mds international foundation, st. barnabas senior services, meals on wheels long beach, legacy film festival on aging, san fernando valley interfaith council, jewish federation, partners of parks, human services association, uci foundation, american society on aging, California association of long term care medicine, California commission on aging, csulb geriatrics scholarship fund.in 2019, Scan gave 45 grants in 9 counties, and supported 25organizations through sponsorships.for the year ending december 31, 2019, independence at home incurred $14,118,370 in program expenses including grants of $919,574 paid toother non-profit organizations and received $3,510,550 in grants.