SHAP funding will be used to implement Phase II of BadgerCare Plus, covering approximately 2,600 low-income (<200% FPL), childless adults using the following elements:
- Centralized Enrollment: Cover Wisconsin will implement a centralized enrollment/application/renewal process (via ‘ACCESS’ online portal, distinct from the county-administered process used for BadgerCare Plus’ Phase I population)
- Core Plan of Benefits: BadgerCare Plus will provide a flexible core set of limited primary and preventive care benefits to enrollees; nearly all services are available through HMOs
- Clinical Advisory Committee on Health and Emerging Technology (CACHET): The CACHET provides guidance and recommendations on Cover Wisconsin’s benefit plan and other quality and cost-containment measures; key CACHET members include clinicians and researchers, with a focus on primary care and quality measurement
- Health Needs Assessment (HNA): Cover Wisconsin enrollees will be required, as a condition of enrollment, to complete a short, self-report survey assessing basic health conditions, immediate health needs, and health history during the application process, via ACCESS; the HNA will help match enrollees with HMOs and providers that meet the individual’s specific needs
- Physical Exam: As a condition of continued enrollment, all childless adults will be required to undergo a first-year physical exam, to establish a detailed health status baseline and aid in securing a medical home
For Wisconsin specific resources click here.