Long-Term Care

Care Coordination for People With Alzheimer's Disease and Related Dementias. Summary of Previous Review Articles

This review builds on previous examinations of the research literature on the effect of care coordination on people with Alzheimer's disease and their caregivers. Pimouguet et al. (2010) recently published a systematic review of eight randomized controlled trials (RCTs) of case management for people with dementia and their caregivers, concluding t

Care Coordination for People With Alzheimer's Disease and Related Dementias. Executive Summary

Alzheimer's disease is an irreversible, progressive form of dementia that affects more than 5 million Americans (HHS, 2012). It slowly destroys memory, thinking skills, and eventually the ability to perform activities of daily living (ADLs). People with Alzheimer's disease are often reliant on others for their daily care and are heavy users of med

Care Coordination for People With Alzheimer's Disease and Related Dementias. ACKNOWLEDGMENT/DISCLAIMER

This paper was supported by the Office of the Assistant Secretary for Planning and Evaluation through Contract #HHSP23320100021WI. The authors gratefully acknowledge the useful comments of Helen Lamont, PhD, of the Office of Disability, Aging and Long-Term Care Program within the Office of the Assistant Secretary for Planning and Evaluation, U.S.

Care Coordination for People With Alzheimer's Disease and Related Dementias

This report summarizes the research literature on care coordination for people with Alzheimer's disease, with a particular focus on programs that coordinate both medical care and long-term services and supports. Overall, there is limited evidence of the effectiveness of these programs in improving patient outcomes or reducing health care utilizati

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Quality in Managed Long-Term Services and Supports Programs. Appendix H. Wisconsin's Family CARE

Element Description MLTSS Program Family Care Lead Agency

Quality in Managed Long-Term Services and Supports Programs. Appendix G. Texas's Star+plus Program

Element Description MLTSS Program Texas STAR+PLUS Program Lead Agency

Quality in Managed Long-Term Services and Supports Programs. Appendix F. Tennessee's Choices in Long-term CARE

Element Description MLTSS Program CHOICES in Long-Term Services and Supports Lead Agency

Quality in Managed Long-Term Services and Supports Programs. Appendix E. Pennsylvania's Adult Community Autism Program

Element Description MLTSS Program Adult Community Autism Program (ACAP) Lead Agency

Quality in Managed Long-Term Services and Supports Programs. Appendix D. North Carolina's 1915(b)/(c) Medicaid Waiver for Mental HEALTH/ Developmental DISABILITIES/SUBSTANCE Abuse Services

Element Description MLTSS Program North Carolina 1915(b)/(c) Medicaid Waiver for MH/DD/SAS Lead Agency

Quality in Managed Long-Term Services and Supports Programs. Appendix C. Minnesota Senior CARE Plus and Minnesota Senior Health Options

Element Description MLTSS Program Minnesota Senior Care Plus (MSC+) Minnesota Senior Health Options (MSHO)

Quality in Managed Long-Term Services and Supports Programs. Appendix B. Michigan's Managed Specialty Supports and Services

Element Description MLTSS Program Medicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Waiver Program

Quality in Managed Long-Term Services and Supports Programs. Appendix A. Arizona Long-term CARE System

Element Description MLTSS Program Arizona Long-Term Care System (ALTCS) Lead Agency

Quality in Managed Long-Term Services and Supports Programs. Appendices

Quality in Managed Long-Term Services and Supports Programs. Notes

Saucier P., Kasten J., Burwell B., and Gold L. 2012. The Growth of Managed Long Term Services and Supports (MLTSS) Programs: A 2012 Update . Centers for Medicare and Medicaid Services. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-Systems/Downloads/MLTSSP_White_paper_combined.pdf . Accessed August 8, 2013.

Quality in Managed Long-Term Services and Supports Programs. Bibliography

Arizona Health Care Cost Containment System . (October 2012). Quality Assessment and Performance Improvement Strategy . http://www.azahcccs.gov/reporting/Downloads/QualityStrategy.pdf . Accessed September 4, 2013.

Quality in Managed Long-Term Services and Supports Programs. VII. Discussion

Diversity is a hallmark of the state-federal Medicaid program. The saying goes: "If you've seen one Medicaid program, you've seen one Medicaid program." In terms of MLTSS quality, the same holds true to a large extent. CMS has always accorded states discretion in the design and operation of their Medicaid programs, including quality monitoring, as

Quality in Managed Long-Term Services and Supports Programs. VI. Other Quality Considrations

As we talked with states a few other issues pertinent to quality in MLTSS emerged. The first of these was how aspects of their quality management system had developed since program inception. Several states' comments revolved around the evolution of performance measures. Michigan had decreased the number of measures dramatically over time, from ap

Quality in Managed Long-Term Services and Supports Programs. D. Ombudsman

Technically an ombudsman is a neutral party that can advocate for the member in disputes with the MCO or state regarding their services and supports. Three of the examined programs offered independent state ombudsman programs either devoted exclusively to the MLTSS program (Wisconsin) or to Medicaid managed care more generally (Texas, Minnesota).

Quality in Managed Long-Term Services and Supports Programs. C. 24-Hour Back-up

Twenty-four hour back-up can refer to having an informal back-up plan in the event that a direct care worker does not show, as well as to the existence of a formal systems-level back-up when the informal back-up plan fails. This may include on-call care coordinators and/or providers.

Quality in Managed Long-Term Services and Supports Programs. B. Critical Incident Review and Investigation

In recent years, CMS has placed substantial emphasis on the importance of critical incident management processes in the 1915(c) HCBS waiver programs. With CMS' MLTSS guidance, this expectation now extends to MLTSS programs.

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