PALTC23 Conference Recordings FR11 Understanding Institutional Special Needs Plans: The Ins and Outs of I-SNPs

Understanding Institutional Special Needs Plans: The Ins and Outs of I-SNPs

Over the 90 minute session, four different speakers with different perspectives and involvement in the implementation of I-SNPs will provide an overview of the I-SNP model, its potential to improve care and potential pitfalls. The session will begin with an introduction into the history behind creation of I-SNPs . We will then discuss the unique aspects of I-SNPs that impact care and quality; including the Model of Care, STARs and HEDIS measures, and utilization management strategies. An I-SNP medical director will then differentiate the role of an I-SNP medical director from a traditional corporate medical director. The roles of NP/Pas within I-SNPs will be distinguished from other models of long-term care and an I-SNP provider will discuss a day to day view of what working in an I-SNP means in terms of hospital mitigation, workflow, collaboration with IDT and other providers, and data capture.

Learning Objectives:

At the completion of this session, learners will be able to:

  • Define Historical Background for Institutional Special Needs Plans.
  • Outline the model of care and explain the individual components, including utilization management and integration of STARs, HEDIS measures.
  • Demonstrate the differences in medical direction of an I-SNP including hospital mitigation, collaboration with PCPs, and integration into the nursing home.
  • Provide insight into the day to day work flow of an I-SNP provider including individualized plans of care, contingency planning, and utilization management.

Cari Levy, MD, PhD, CMD

Cari Levy, MD, PhD, CMD is a Professor of Medicine at the University of Colorado Denver with board certification in Internal Medicine, Geriatrics and Palliative Medicine. She graduated from Pepperdine University, received her Medical Degree and PhD in health services research from the University of Colorado Medical School and completed residency and a chief resident year at Vanderbilt University. Dr. Levy is currently Director of the Denver–Seattle Center for Veteran Centered and Value Driven Research and Section Chief of Palliative Medicine at the Rocky Mountain Regional VA Medical Center. As a health services researcher, she focuses her research on innovative models of long-term care such. Dr. Levy has over 120 publications in peer-reviewed journals based on this work.

Elizabeth Shedd, DNP

Elizabeth Shedd, DNP, is a collaborative and supportive individual contributor and team player committed to best practices to continually elevate and adhere to meticulous standards of patient diagnosis, quality care and safety.

Cheryl Phillips, MD, CMDR, AGSF

Cheryl Phillips, MD, CMDR, AGSF, is the President and CEO of the Special Needs Plan Alliance, a national leadership association for special needs and Medicare-Medicaid plans serving vulnerable adults. Prior to this, she was the Senior VP for Public Policy and Health Services at LeadingAge. She has also served as the Chief Medical Officer of On Lok Lifeways, the originator of the PACE (Program of All-Inclusive care for the Elderly) model based in San Francisco, CA, and the Medical Director for Senior Services and Chronic Disease Management, for the Sutter Health System in Northern California. As a fellowship-trained geriatrician her clinical practice focused on nursing homes and the long-term care continuum. She continues to serve on a number of LTC quality expert panels. Dr. Phillips is a past president of the American Geriatrics Society, and is also a past president of the American Medical Directors Association, the society for post-acute and long term care medicine.

Allison Villegas, PA-C

Allison Villegas, PA-C, has been providing post-acute and long-term care in Denver nursing homes for the last 10 years. She is Vice President of CMDA: Colorado's Society for Post-Acute and Long Term Medicine. She is on the PALTmed Board of Directors and is involved in multiple committees and workgroups.

  • 1.5 CME
  • 1.5 CMD Management
  • 1.5 MOC

Release Date: 03/29/2023   |   Expiration: 03/01/2026

Credit Statements:

Accreditation: Post-Acute and Long-Term Care Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

CME Designation: Post-Acute and Long-Term Care Medical Association designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CMD Credit Hours: This CME activity has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for up to 1.5 management hour(s) toward certification or recertification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. Each physician should claim only those hours of credit actually spent on the activity.

The CMD Program is administered by the ABPLM. For further information, contact ABPLM at 410-992-3117 or at cmd@paltmed.org.

ABIM Maintenance of Certification (MOC): Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.5 Medical Knowledge MOC points and patient safety credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program.

Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Financial Disclosure Statement:

The Association requires the disclosure of all speaker/faculty/planner’s relevant financial relationships; presence of off-label use of a device or medication; and discussion of any experimental, new or evolving topic prior to each accredited education activity.

If the learner perceives any bias toward a commercial product or service, advocation of unscientific approaches to diagnosis or therapy, or recommendation, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients please report this to the Association's staff.


The following speaker(s) disclosed relevant financial relationship(s): 

  • Julie Gammack, MD, CMD (Planner & Speaker): Stockholder: Amarin
  • Kenya Rivas Velasquez, MD, CMD, FAAFP (Planner & Speaker): OptumRx: Stockholder
  • All other planners, speakers, and AMDA staff have no relationships with ineligible companies.

All relevant financial relationships have been identified and mitigated.

Components visible upon registration.