Appendix: Strategies to Maximize Special Needs Plan (SNP)
Enrollment in New York City (NYC)

  • Draft is also available in Portable Document Format (PDF, 18KB)

New York State´s Department of Health (DOH), Office of Mental Health (OMH), and Office of Alcohol and Substance Abuse Services (OASAS) will work with NYC to develop strategies to promote and maximize SNP enrollment, to assure that the SNP model of integrated specialty care is the dominant approach in NYC. These strategies may include:

  • Encouraging plans with large numbers of eligible members to develop a SNP as the preferred plan for their high-need Behavioral Health members.
  • SNP capitation rates should reflect the high needs of the eligible population, the additional responsibilities related to care management, greater administrative costs and enhanced benefit package for this special needs population.
  • Reinvestment of savings.
  • The development from savings of a member specific self-directed spending account available only through SNPs to purchase needed services or materials which will facilitate recovery outcomes.
  • Engage an expert consultant to work with DOH, OMH, OASAS and NYC to design additional strategies around enrollment, benefit and rates, which will maximize SNP enrollment.
  • The consultant will also facilitate stakeholder input into design strategies, including input from the Medicaid Redesign Team behavioral health workgroup, managed care plans, and other relevant parties.