The IEHP DualChoice population is composed of individuals who are dual eligible for both Medicare and Medi-Cal in Riverside and San Bernardino counties, including the most vulnerable population. This also includes members transitioning from IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan).
- IEHP has identified the most vulnerable as the following:
- Age 21-70
- Identified as High and Rising Risk
- Diagnosed with Cardiovascular Disease AND/OR Diabetes
- RUB Score of 4 & 5. *RUB is Resource Utilization Band which is a predictor of using acute or costly services.
- IEHP will identify the most vulnerable members assigned to IPAs
- IEHP and its IPAs must design care management specific interventions to demonstrate how they support these member's health and wellness goals.
- Examples of Specially Tailored Services for the Most Vulnerable Population
- Remote Patient Monitoring
- Medically Tailored Meals and Other Community Supports
- Nutrition Education
- Pharmacy Services (medication reconciliation and other programs)
- Long-Term Services and Supports (LTSS)
- Telehealth Behavioral Health Services
- Transportation
- More frequent care management contact
