Special Needs Plan: Care Plans - Provider

Every member enrolled into a Special Needs Plan (SNP) has a Care Plan developed specifically from the responses given on the Disease Specific Assessment. Member responses on the Initial Health Assessment Tool will also provide the Plan with information regarding their health as well as functional and emotional needs. From those responses, members are placed into one of three “tiers”.

Tier 1:

These Care Plans are for members who are adequately and appropriately managing their disease. The Care Plan that will be available to you for these members are based on Clinical Practice Guidelines for the monitoring of these diseases. Below is a link of a Tier 1 Care Plan sample.

Tier 2:

These Care Plans are developed based on the individual responses the member provided on their Disease Specific Assessment. These Care Plans will be mailed to you for inclusion in the patient's medical record as a helpful tool in managing their health outcomes. Below is a link of a Tier 2 Care Plan sample.

Tier 3:

These Care Plans are developed in coordination with the member’s assigned Nurse Case Manager and/or Social Worker who will contact the member and do another in-depth assessment of the member’s needs. This Care Plan will be coordinated through information from you and the member and will include specific interventions and goals to help the member reach their maximum health and psychosocial potential. Tier 3 Case Management is strictly voluntary for members and they may elect to “opt out” or not receive these services.

Care Plan Samples

Last Updated: 10/01/2018