The 2011 Colorado Health Report Card

Slides:



Advertisements
Similar presentations
How Does A Fee For Service State Respond to the Need for Care Integration? Robert Applebaum Scripps Gerontology Center Miami University American Society.
Advertisements

MEDICAID – CONTEXT FOR CHANGE Mike Cheek Vice President, Medicaid and Long Term Care Policy.
Avalere Health LLC | The intersection of business strategy and public policy Long-Term Care Financing Reform: A Federal and Private Insurance Partnership.
The Department of Medical Assistance Services Barbara R. Seymour, BSW, HCCS 1.
March 15, 2012 The Long-Term Services and Supports Addressing the Boomer Challenge 2012 Health Policy Roundtables 1.
1115 WAIVER Utah Department of Health Division of Medicaid and Health Financing 1Chacon.
Webinar Basics How do I ask questions during the webinar? Recorded webinar and PowerPoint slides will be available after the webinar. Special thanks to.
Colorado Department of Health Care Policy and FinancingColorado Department of Health Care Policy and Financing 1 CCT & MDS 3.0 Section Q Return to the.
It’s All About MME Tasia Sinn September 18, 2014 Understanding Colorado’s New Medicare- Medicaid Enrollee (MME) Program.
MEDICARE: PAST, PRESENT AND FUTURE James G. Anderson, Ph.D. Department of Sociology & Anthropology.
MEDICARE: PAST, PRESENT AND F UTURE James G. Anderson, Ph.D. Department of Sociology & Anthropology.
SoonerCare and National Health Care Reform Oklahoma Health Care Authority Board Retreat August 26, 2010 Chad Shearer Senior Program Officer Center for.
A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado (Twitter)
Department of Medical Assistance Services Virginia Elder Rights Coalition Kristin Burhop and Elizabeth Smith December 5,
Michigan Long Term Care Conference March 23, 2006  Choosing from the Array of Long- Term Care Supports and Services.
Delaware Health and Social Services Delaware’s Delivery of Long Term Services and Supports The Need for Change Delaware Health Care Commission January.
Virginia’s Blueprint for the Integration of Acute and Long-Term Care Services The Second National Medicaid Congress Cindi B. Jones, Chief Deputy Director.
Sarah Broughton, MSW: Outreach and Education Coordinator Patti Davidson, MSW: Program Analyst Elizabeth Smith, RN: Program Analyst Virginia Department.
THE COMMONWEALTH FUND Developing Innovative Payment Approaches: Finding the Path to High Performance Stuart Guterman Assistant Vice President and Director,
Balancing Incentive Program and Community First Choice Eric Saber Health Policy Analyst Maryland Department of Health and Mental Hygiene.
A Presentation of the Colorado Health Institute 1576 Sherman Street, Suite 300 Denver, Colorado Hot Issues in.
San Diego Long Term Care Integration Project (LTCIP) April 13, 2005 LTCIP Planning Committee.
Problems and Improvements for the Financing of the Massachusetts Duals Demonstration A Presentation to the Implementation Council March 15, 2013 BD Group.
MassHealth Managed Care for Older Members and Members with Disabilities Lori Cavanaugh Director of Purchasing Strategy NASHP Annual Conference October.
Chapter 14 Financing. Copyright © 2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2 Personal Health Care Expenditures, 1965 Physicians 20% Nursing.
ALTCI Actuarial Study — Final Results September 14, 2005.
Healthy Alaska Plan Alaska Medicaid Redesign Initiative North Star Council on Aging Senior Center presented by Denise.
K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Long-Term Care: Exploring the Possibilities Diane Rowland, Sc.D. Executive Vice.
Executive Director Cathedral Square Corporation
September 20, “Real Choice” in Flexible Supports and Services A Pilot Project Kim Wamback, UMMS Center for Health Policy and Research (Grant Staff)
1. Welcome! 2. Objectives of the SNAC Labs 3. Presentation 4. Facilitated discussion Notes from the front lines Critical success factors Implications for.
1 CHOICES FOR CARE Blazing the Trail to Real Choices Joan K. Senecal, Commissioner Vermont Department of Disabilities, Aging and Independent Living
Health Care Reform IT’S COMPLEX! Jeffery Thompson, MD MPH Chief Medical Officer Washington State Medicaid.
K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Medicaid’s Origin Enacted in 1965 as companion legislation to Medicare (Title XIX)
Johns Hopkins Bloomberg School of Public Health Medicare Beneficiaries with Serious Physical or Cognitive Limitations (PCI) Karen Davis Roger C. Lipitz.
Long-term care insurance is underwritten by John Hancock Life Insurance Company (U.S.A.), Boston, MA LTC-8750CA 1/14 Policy Form: CA-06 7/12 Long-Term.
Home & Community-Based Services Policy Forum March 17, 2015 Peter Notarstefano, Director of HCBS.
Community Based Care for Older Adults with Complex Needs: The PACE Program Matthew McNabney, MD Medical Director, Hopkins ElderPlus June 25, 2016.
All-Payer Model Update
Division of Health Care Finance
Reining in Growth of Health Spending
Started Business 1971 Nations Largest Privately Held Agency Catering to Retiree’s Needs.
Core Values For a Good Long Term Care System
Consumer protections in Medicare – Medicaid coordinated care models SNP Executive roundtable March 30, 2015 Lynda Flowers Senior Strategic Policy Advisor.
Sarah Steenhausen Senior Policy Advisor
What Does a Debate on National Health Care Reform Mean for Medicaid in New York? James R. Tallon, Jr. President United Hospital Fund July 10, 2008.
Coordinating Services and Accessing Resources
Department of Medical Assistance Services
Medical Assistance Fact Check
Innovations to Improve Outcomes and Lower Expenditures
Health Care - What’s Next April 22, 2017
Dual eligible beneficiaries and care coordination
CALIFORNIA FOUNDATION FOR IDEPENDENT LIVING CENTERS STATEWIDE MEETING
Community Services Proposed 2017 Budget August 23, 2016
Managed Care Comes to LTSS: Get Ready!
Massachusetts Duals Demonstration
Sco Senior Care Options Bringing Medicare and MassHealth Together.
Wisconsin Medicaid Informational Series
Program of All-Inclusive Care for the Elderly.
The Long-Term Care Imperative 2009 Legislative Agenda
Mental Health and SUD: Opportunities in Health Reform
NC Dual Eligibles Advisory Committee September 23, 2016
67th Annual HSFO Conference Louisville, KY
All-Payer Model Update
Duke Carolina Visiting Professorship in Geriatric Nursing
Nicole Khaner, Consumer Services Director
Trends & Transitions: Future for Long Term Care
Mark Trail, Managing Principal
Second Medicaid Congress June 14, 2007
Lenya Robinson, Behavioral Health and Managed Care Section Manager
Presentation transcript:

The 2011 Colorado Health Report Card

The 2011 Colorado Health Report Card Release March 22, 2012 8:00am – 9:30am King Center, Auraria Campus RSVP: Kim Ribich, (303) 953-3669 KRibich@ColoradoHealth.org

Addressing the Boomer Challenge The Long-Term Services and Supports March 15, 2012 2012 Health Policy Roundtables

The urgency of long term services and supports—what’s the hurry? Today’s Discussion The urgency of long term services and supports—what’s the hurry? Changing demographics A summary of LTSS Financing LTSS On the Horizon: Where do we go from here?

The Challenge and Urgency of LTSS: Changing Demographics

What are Long Term Services and Supports? “A broad range of supportive services needed by people who have limitations in their ability to perform daily activities because of a physical, cognitive, or mental disability or condition.” SOURCE: O’Shaughnessy, C. (2010). The Basics: National Spending for Long-Term Services and Supports (LTSS). National Health Policy Forum.

65+ Age Distribution in Colorado SOURCE: Colorado State Demography Office, population estimates, 2000-2030

Where do Elders Receive Long-Term Services and Supports? At home Personal and skilled services; adult day care Residential setting Group homes; assisted living facilities; adult foster care Institutional setting Nursing facilities

Program for All Inclusive Care for the Elderly (PACE) Provides long term services and supports and acute care to individuals dually enrolled in Medicare and Medicaid Led by interdisciplinary team that coordinates care PACE providers receive a fixed monthly rate from Medicare/Medicaid or Medicare/private pay 1,900 PACE Medicaid enrollees in Colorado

Financing Long Term Services and Supports

Who Pays for Long term Services and Supports? SOURCE: Komisar, H, and L Thompson. (2006). National Spending for Long-term Care.

Interaction Between Acute and LTSS Insurance for Elders

The Lack of Long Term Care Insurance The CLASS Act Voluntary long term care insurance program Premiums not based on health status Feb. 2012 CLASS Act was repealed by US House of Reps. Adverse selection Financially insolvent – distributions would exceed collections

Colorado General Fund Operating Appropriations SOURCE: Joint Budget Committee, FY 2011-12 Appropriations Report.

Medicaid Medical Services Premiums, FY 2011-12 SOURCE: Colorado Department of Health Care Policy and Financing, FY 2012-2013 Budget Request Notes: Projected General Fund expenditures before bottom line financing adjustments.

Medicaid LTSS Expenditures, FY 03-04 to FY 10-11 In Millions 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 SOURCE: Colorado Department of Health Care Policy and Financing

Where do we go from here?

Mechanisms Being Considered to Reform Medicaid System

Moving people out of nursing facilities: Colorado Choice Transitions Colorado’s Money Follows the Person program Transitions people from nursing facilities to the community when desired and feasible

Changing Reimbursement to Prolong Assisted Living HB 10-1053 (Riesberg/Boyd) Analysis of tiered rate setting for assisted living Potential for increasing assisted living rates to postpone nursing facility placement SB 12-128 (Roberts/Summers): Allows HCPF to provide clients at risk of nursing facility placement enhanced assisted living services Moves individuals in nursing facilities to assisted living

Dual Eligibles Planning Grant: Coordinating Care Coordination of care for individuals dually enrolled in Medicaid and Medicare (“dual eligibles”) Possible inclusion of dual eligibles in Colorado Medicaid’s accountable care collaborative (ACC)

Coordination of Long Term and Acute Care SB 12-127 (Newell/Summers): Allows LTC providers to contract with RCCOs in ACC In response to dual eligibles planning grant SB 12-023 (Boyd) Require RCCOs to inform enrollees about PACE, if they are eligible

Person-Centered Payments in Long-Term Care Redesign care planning tool and assessment form for community based long term care services In future could create person-centered “budget” for each enrollee Care plans would lead to less subjective decision making by care managers. Request included in HCPF’s FY 2012-13 budget proposal

The state (HCPF/DHS) currently has multiple HCBS waivers Waiver Consolidation The state (HCPF/DHS) currently has multiple HCBS waivers Upcoming legislation to move all waivers to HCPF First step in process to consolidate waivers Problem: Waiver participants can’t get services outside their designated waiver Concerns: Individuals do not want to lose services

Managed Care Models Medicaid Managed LTSS What’s needed Careful design Institution to Community/ Home Focus Little evidence to support What’s needed Careful design Expertise Financial resources

“Boomers are just the beginning." - Rich Umbdenstock, President, American Hospital Association Amy Downs 720.382.7091 downsa@coloradohealthinstitute.org