Evaluation Peer Workgroup Call Evaluating the Cost Effectiveness of ADRCs Potential Indicators and Discussion May 24, 2007

2 Goals for today’s call Begin discussion of how to evaluate ADRC costs Explore possible indicators of cost savings and cost effectiveness Answer questions about the kinds of data we need and how to obtain the data Discuss some of the challenges to data collection, interpretation and reporting regarding program costs and effectiveness

3 Cost Evaluation Addresses: –How much the program or program components cost –Justify expenditures (to improve, modify or expand the program, for strategic planning) –Optimize fiscal resources –Demonstrate the benefit of the program compared to alternatives

4 ADRC Cost Evaluation Demonstrate the impact that the program has achieved in terms of costs –for individuals –for the program –for public and private payers –for policy makers and planners

5 Methodology Major methodological challenges: Key question: what changes are actually attributable to the ADRC? Complexity demands that you approach your analysis from multiple perspectives Pre-post analysis Comparing pilot areas with rest of state

6 Two Categories of ADRC Cost Data: ADRC program-specific information LTC Service Use and Spending –Medicaid waivers –State Plan community services –Institutional services

7 Costs of Operating ADRC To assess operational costs, you must consider any functions that the ADRC is absorbing from other entities If you are obtaining FFP, you may want to focus only on the state share of costs May want to factor out ADRC grant funding

8 Costs of Medicaid and LTC Spending Nursing facility utilization and costs Waiver enrollment and costs

9 Other Data to Complement Analysis Institutional occupancy rates and bed supply Waiting lists

10 Data Collection--Considerations Managing multiple sources of data from multiple agencies Time lag – Medicaid claims data are not complete until many months go by

11 Data Interpretation and Reporting-- Considerations Provider taxes – these can distort the true costs of institutional services FFP – not available for IMD services for working age adults Length of stay – differs between settings in important ways, especially during waiver expansions Counting “diversions”

12 Data Interpretation and Reporting-- Considerations Major reimbursement rate changes may affect cost analysis Infrastructure changes in local areas may have one-time effects

13 Putting Cost Analysis in Perspective ADRCs are multi-dimensional Many of the desired ADRC outcomes are intangible and difficult to quantify >> Making one less phone call >> Empowerment >> Societal benefit of inclusive citizen participation