A PASSE is a risk-based medical and specialty service provider organization. It is certified and regulated by the State of Arkansas Insurance Department to perform the administrative functions of managed care.
Depending on the developmental disability, some children’s parents, parental figure, or guardian may need access to extra support or therapy resources beyond what is offered in school. The new PASSE model will manage care and costs for these patients.
What is PASSE?
A PASSE, or Provider-led Arkansas Shared Savings Entity, is an all-in-one healthcare plan for individuals in very high spend Medicaid populations. It is a new model of organized care created to manage the services of individuals with behavioral disorders or significant intellectual developmental disabilities who are Medicaid beneficiaries. Not taking over full risk until March 1, 2019, it addresses the total health care needs of Medicaid beneficiaries who have behavioral health disorders or intellectual developmental disabilities. The purpose of PASSE is to improve the health services of those who need specialized care by linking providers with special care community-based services.
How does it work?
PASSEs are designed to be a managed care entity to control unnecessary spending in Long Term Services and Supports. They are designed to focus, like any managed care organization, on reducing unnecessary costs, expediting services, effectively coordinating services, preventive services, and focusing on healthy lifestyles.
Effective March 1, 2019, recipients under the PASSE system regardless of their age will be qualified and assigned to PASSEs based on a thorough evaluation. At that point the Care Coordinator will take over the coordination of all services billed to Medicaid. The PASSE team will organize all behavioral health and community-based social and developmental services, making sure all support and care is utilized appropriately.
A PASSE will make more variety of services and service providers available. Each PASSE maintains a network of specialists that include independent primary care physicians, behavioral health providers, patient-centered medical homes, federally qualified health centers, rural health centers, and pharmacists. The network is ever expanding.
Impact of PASSE on children with disabilities
If you have a child or adult, or are providing care for a person with disabilities, then the PASSE will work with you to coordinate all care for your PASSE member. The PASSE will play an active role in your recipient’s care. PASSE will serve patients by coordinating all care for any patients with behavioral disorders or significant intellectual developmental disabilities regardless of their age. PASSE care coordinators will assess current beneficiaries to re-identify needs. Following an independent assessment, they will be assigned to a PASSE. A care coordinator will contact you to start the care coordination process, coordinate the services your recipient will receive, and meet monthly to connect with you and provide support.
The PASSE assigned to their case will begin to pay for all the services they receive, including medicine, doctor visits, emergency room visits, and specialty services for behavioral health and developmental disabilities. You will give the PASSE ID card to doctors and pharmacists who are providing services, just like you would an insurance card.
For more information
Contact Integrity, Inc. at 501-406-0442 to learn more about PASSE and how Integrity can help you support a child or adult with disabilities.