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U.S. Department of Health & Human Services aspe.hhs.gov Office of the Assistant Secretary for Planning and Evaluation
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Project Type:
(Event/Conference)
Project Officer(s):
Don Oellerich
Organization(s):
ASPE
Related Products:
The panel, organized under the Federal Advisory Committee Act, will review methods and assumptions underlying the annual Medicare Trustees' reports. The panel will make recommendations to the Secretary.
Project Type:
Report
Author(s):
Yonatan Ben-Shalom and David Stapleton
Published:
January, 2014
In this report, we assessed the feasibility of using existing claims-based algorithms to identify community-dwelling Medicare beneficiaries with disability based solely on the conditions for which they are being treated and to improve the algorithms by combining them in predictive models. [39 PDF pages]
Project Type:
Report
Author(s):
Greg Peterson, Randy Brown, Allison Barrett, Beny Wu and Christal Stone Valenzano
Published:
January, 2014
This report compares the risk of nursing home entry, hospitalization rates, and Medicaid long-term care costs, among people with disabilities who faced widely-varying waiting times (ranging from 3 to 25 months), depending on when they applied for home and community-based services (HCBS) though Iowa Medicaid 1915(c) waivers. The three waivers--Brain Injury, Health and Disability, and Physical Disability--provide HCBS to non-elderly adults with disabilities on a first-come, first-served basis. The report examines the effects of waiting periods for all applicants, as well as for the roughly half of applicants who, due to their older age, were at higher risk of entering a nursing home. [43 PDF pages]
Project Type:
Report
Author(s):
Vanessa Oddo, Angela Gerolamo, David R. Mann and Catherine DesRoches
Organization(s):
Mathematica Policy Research
Published:
January, 2014
Availability:
This report describes the organizational features of three prominent “disability competent” managed care plans for Medicaid enrollees: Commonwealth Care Alliance in Massachusetts; Community Health Partnership in Wisconsin; and Independence Care System in New York City. These programs integrate health and social services to deliver patient-centered care to Medicaid and Medicare beneficiaries with disabilities and particularly complex chronic care needs. [115 PDF pages]
Addressing Critical Incidents in the MLTSS Environment: Research Brief
Project Type:
Research Brief
Author(s):
Pat Rivard, Beth Jackson and Teja Stokes
Organization(s):
Truven Health Analytics
Published:
November, 2013
As states move their Medicaid populations with disabilities from fee-for-service arrangements into managed long-term services and supports (MLTSS) environments, there is interest in ensuring that member health and welfare is safeguarded in this environment. The Centers for Medicare and Medicaid Services' guidance on the design of Medicaid MLTSS programs includes a focus on member protections and the importance of having a critical incident reporting and management system. These systems are designed to respond to incidents that place a member at risk of harm. This Brief discusses the ways in which some established MLTSS programs manage critical incidents. In all of these programs, the managed care organization plays a key role in a state's MLTSS critical incident system. [8 PDF pages]
Performance Measures in MLTSS Programs: Research Brief
Project Type:
Research Brief
Author(s):
Pat Rivard, Beth Jackson and Teja Stokes
Organization(s):
Truven Health Analytics
Published:
November, 2013
This report describes how frequently the various quality elements appear in managed care organization contracts, as well as some similarities and differences in quality requirements. [8 PDF pages]
Did They or Didn't They?: A Brief Review of Service Delivery Verification in MLTSS
Project Type:
Research Brief
Author(s):
Teja Stokes, Beth Jackson and Pat Rivard
Organization(s):
Truven Health Analytics
Published:
September, 2013
This Brief describes the three main methods used to determine whether or to what extent MLTSS enrollees receive the services authorized as necessary for them in their care plans [8 PDF pages]
Project Type:
Report
Author(s):
Mark Sciegaj, Suzanne Crisp, Casey DeLuca and Kevin J. Mahoney
Organization(s):
Penn State University Boston College
Published:
August, 2013
As of the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans available, with enrollment being either mandatory or voluntary for target populations that varied by state (e.g., elderly, younger adults with adult-onset disabilities, persons with intellectual or other developmental disabilities). In 13 of these states, MLTSS plan members were afforded the choice to “participant-direct” (PD) at least some home and community-based services. Based on five in-depth state case studies, state expectations regarding availability and take-up of PD services in MLTSS varied as did states’ methods of communicating these expectations to managed care organizations. Take up of PD options varied from a low of 1.2% in Arizona to a high of 24% in New Mexico. [37 PDF pages]
Project Type:
Report
Author(s):
Jeffrey Ballou, Valerie Cheh, Dean Miller and Audra Wenzlow
Published:
August, 2013
Although states have begun to rebalance their long-term care systems toward a greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities (I/DD) continue to reside in institutions such as nursing homes or intermediate care facilities for the intellectually disabled (ICFs/IID). Through an analysis of Medicaid enrollment and long-term care claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS. [85 PDF pages]
Project Type:
Report
Author(s):
Audra Wenzlow, Rosemary Borck, Dean Miller, Pamela Doty and John Drabek
Organization(s):
Mathematica Policy Research
Published:
July, 2013
State long-term care (LTC) financing and delivery systems and, in particular, Medicaid funded LTC have long been criticized for being “institutionally biased.” Shifting the balance in publicly-funded long-term care provision away from institutional care (nursing homes, long-term hospitals, intermediate care facilities for the intellectually disabled) toward greater reliance on home and community-based services has been a federal goal for the past three decades -- a goal often referred to as “re-balancing” state LTC systems. This report explores inter-state variations in LTC expenditure and service use patterns, not only in terms of institutional and non-institutional services, but also by Medicaid LTC users’ age and type of disability (e.g., intellectual/developmental disabilities or other working-age adult disabilities). [86 PDF pages]