CommCare Resuming Auto Assignment

As you know, individuals who apply and are eligible for Commonwealth Care have 90 days of Health Safety Net, during which time they must select a Commonwealth Care plan. If they do not select a plan, they are unenrolled and become self-pay patients.

Prior to July 2009, Plan Type 1 (i.e., non-premium paying) members were auto-assigned to a Commonwealth Care plan after two weeks if they did not select one on their own. The state eliminated auto-assignment in July 2009 as a cost savings measure. The state has announced that they will resume auto-assignments of Commonwealth Care Plan Type 1 members again in April. Here is what we know about this process:

• The Connector will auto-assign individuals who are currently Commonwealth Care eligible but unenrolled.
• This will happen in a phased-in way over the next several months: approximately 3,500 will be auto-assigned in April, 3,500 in May, and the rest in June. This will take care of those patients who are currently eligible but unenrolled. We think that this will also apply to newly eligible Plan Type 1 members who apply during those months.
• In the Boston area, 45% of the auto-assignments will go to Network Health, 45% to CeltiCare (both of which are accepted by MGH) and 10% to BMC HealthNet.
• In the North, 45% of the auto-assignments will go to BMC HealthNet, 45% to CeltiCare, and 10% to Network Health.
• There is a possibility that this will continue beyond June 30th, but it depends on the state funding available.

This does not change our process. We need to encourage all patients to call the Connector and pro-actively select a plan. However, this does mean that we may see patients coming in on plans without realizing that they have been auto-assigned. Since we do accept Network Health and CeltiCare, many of these patients will be able to continue their care with us easily. Patients who want to switch plans have a 60 day grace period, or can wait until the next open enrollment period later this spring.

-From “Auto-assignment of Commonwealth Care members” e-mail, Kim Simonian, MPH, Associate Director, Patient Access, Partners HealthCare Community Benefit Programs, March 24, 2010.

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