We Are Balanced in Ohio: What Shall Follow this Major Accomplishment?

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Presentation transcript:

We Are Balanced in Ohio: What Shall Follow this Major Accomplishment? Shahla Mehdizadeh, Ph.D. 39th Annual Conference of the Ohio Association of Gerontology and Education April 24th, 2015

What Am I Talking About? Through a continuous and persistent state policy, Ohio has reached a point that the Medicaid dollars spent on Long-Term Services and Supports (LTSS) provided in facilities and community has reached a balance for all people with a disability. The number of people cared for in community surpassed those receiving care in facilities in 2008. How have we achieved this? How do we compare with other states? What do we need to do to maintain this balance or improve upon it?

The Talk of the Town Columbus Dispatch Summer 2014

Medicaid LTSS Expenditures and Utilization by Settings Participants in 2013

How Do We Compare with Other States and U.S.? (For 2012, PACE included in HCBS) To make the comparison possible, mental health expenditures and LTSS “like” expenditures (not part of waivers) are excluded.

Per Member, Per Month for all LTSS Programs & Facilities in Ohio, 2005-2013 Almost all waivers’ and facilities’ PMPM has declined since 2011.

Comparing Total Medicaid LTSS Over Time (Not Adjusted), 2007-2013

Are We Adding to the Number of People Medicaid is Paying for Their LTSS Over Time? Yes the number But the proportion is Just keeping up with aging population. 34.6 31.8

Comparing Number of Participants Received LTSS, Paid by Medicaid, 2007-2013

Comparing the Number of Persons and Persons-Year Received LTSS

Can We Maintain this Trend? Projections of Ohio’s Populations with Disabilities Year Total Population Population with Severe Physical or Cognitive Disability Total Population with Physical Disability and up to 200% Poverty Income Threshold Population with Severe Developmental or Intellectual Disability Population with Severe Mental Illness 2015 11,638,998 197,247 62,235 66,285 509,575 2020 11,707,724 213,864 67,187 65,616 509,943 2025 11,749,993 235,783 73,782 64,708 506,047 2030 11,763,264 262,703 81,923 63,751 502,026

Have We Created a Sustainable Trend to Pursue in Future? Growth of the 60+ Population & the Patterns of Change in LTSS Exp.

How Ohio Achieved the Balance, and How to Sustain It? Increased availability of HCBS for all populations with disability and monitored and diverted facility-based care utilization Reduced Per Member, Per Month expenditures on HCBS and facility-based care To maintain this balance State needs to: Become continuously innovative by offering alternatives to facility-based care Help consumers remain independent by alleviating environmental barriers Educate them on availability of assistive devices and services so they can remain independent even when they have a disability.