Constrained Innovation in Managing Care for High-Risk Seniors in Medicare + Choice Risk Plans. 3. Waiting Lists for Many Community Services


Seniors, care managers, and Area Agency on Aging directors all mentioned waiting lists as a challenge to delivering support services. Case managers frequently reported waiting lists for community-based social services such as home-delivered meals and chore assistance. Another problem was that different communities within an MCO’s service area differ in the level of services available, depending in part on government funding at the local level. Keeping track of services that were available was a challenge. Both governmental and private nonprofit agencies varied in their eligibility requirements, the application process, and staff attitudes and responsiveness, including whether phone calls were returned promptly. In one county, the funding allocation to the agency was depleted before the end of the fiscal year, and services were curtailed.

TABLE III.6. Home and Community-Based Services Used by High-Risk Seniors
(Percentages and Their Standard Errors)
    Survey Sample  
Home and Community-Based Services Received in Past Year
   Home-delivered meals 9.5 (1.0)
   Transportation to medical appointments   12.1 (1.1)
   Senior center 29.4 (1.6)
   Home health 29.4 (1.6)
SOURCE: Telephone survey of 1,657 high-risk seniors from three managed care organizations, conducted between March and December 1999 by MPR.
NOTE: Values are percentages and are weighted to represent the population and correct for nonresponse. Standard errors are in parentheses. None of the variables used in this table had more than a 5 percent nonresponse.

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