Priority Health meets needs of most vulnerable population

(GRAND RAPIDS, Mich. – May 23, 2022) Some Priority Health members across Michigan experience a variety of chronic conditions, disabilities and functional impairments along with a wide range of medical, behavioral, long-term service and supports and social service needs. Meeting them where they are and providing exceptional, affordable care is our top priority. To accomplish this, Priority Health, a nationally recognized nonprofit health plan, offers the Dual Eligible Special Needs Plan (D-SNP), which recently received a score of 100% on its Model of Care (MOC) and was given a three-year approval by Centers for Medicare & Medicaid Services (CMS).

Michigan’s dual eligible beneficiary population is among the most vulnerable of all state residents covered under the Medicaid and Medicare programs. They face enormous challenges in navigating the health care system for many reasons, including their high medical and behavioral health needs, the system’s lack of integration and coordination between Medicare and Medicaid and an array of social risk factors across the social determinants of health (SDoH).

“Leveraging the experience of Priority Health, PriorityMedicare D-SNP is uniquely qualified to address the complex and diverse needs of the D-SNP population,” said Sheila Wilson, senior director of care management at Priority Health. “We approach our management of this population with an interdisciplinary team of nurses, social workers, medical care coordinators and community health workers. We want to ensure our members are getting exceptional and affordable care in the most appropriate settings. Each person is unique. We meet our members where they are, in their homes, community setting or provider’s office, with the services tailored specifically for them.”

Since the launch of Priority Health’s D-SNP in 2020, membership in these plans across the state has tripled. Members are presented with options that bring supplemental benefits and solutions, traditionally not offered by original Medicare or Medicaid. Social isolation is prevalent among this population, and Priority Health was the first plan to offer companion care through Papa, a company that connects college students to Medicare members who need assistance with transportation, house chores, technology and other senior services.

“Health care is local. We are physically present in the communities we serve and have our own community health workers and social workers engaging directly with our members,” said Lana Djordjevic, director of D-SNP product development at Priority Health. “Through strong partnerships with community-based organizations that serve as an extension to our efforts to engage and support our members, we look holistically on the supplemental benefits offered for this population and remain focused on SDoH. Through benefits and engagement, we can help these members overcome some of the barriers to achieving optimal health and promote health equality.”

While all D-SNP plans are required to have CMS-approved MOC, Priority Health continues to find ways to meet the health needs of the most vulnerable populations.

About Priority Health:

With over 30 years in business, Priority Health is the second largest health plan in Michigan, offering an extensive portfolio of health benefits options for employer groups and individuals, including Medicare and Medicaid plans. Serving more than 1.3 million members each year and offering a broad network of primary care physicians in Michigan, Priority Health continues to be recognized as a leader for quality, customer service, transparency and product innovation. Learn more about affordable, quality health coverage options from Priority Health.