Blueprint for Health Plans: Integration of CBOs to Provide Social Services and Supports (Executive Summary)
The Blueprint for Health Plans (Executive Summary) highlights successful partnerships for delivering social services and helps identify future opportunities.
Blueprint for Health Plans: Integration of CBOs to Provide Social Services and Supports (Full Report)
The integration of community-based organizations (CBOs) into health plan networks, on both a formal and informal basis, can help meet the needs of older adults with complex medical and social needs. The Blueprint for Health Plans (Full Report) highlights successful partnerships for delivering social services and helps identify future opportunities.
The SCAN Foundation teamed up with Avalere Health to create an informative roadmap outlining best practices of sustainable business models for providing person-centered care to older adults with substantial health needs. Highlighting case studies from both public and private programs, this roadmap will help your organization demonstrate and communicate the value of your care delivery model.
Following on previous reports describing the population who uses Medi-Cal-funded long-term services and supports, the California Medicaid Research Institute has produced a report that describes key characteristics of the population using LTSS across each of the state’s 58 counties. This report describes spending and service use patterns across the 58 counties.
In this paper, the National Committee for Quality Assurance (NCQA) discusses prior integration efforts; introduces a model for integrated entities and a framework for assessing and promoting quality of integrated care; and explores the challenges to implementing and achieving the goals of person-centered, integrated care for Medicare-Medicaid beneficiaries. They use the word “framework” to describe the key concepts underlying the structure and process measures; it can also be expanded to include the content of performance measures as companions to the structure and process measures.
The California Medicaid Research Institute (CAMRI) developed an integrated and longitudinal database containing Medi-Cal and Medicare claims and assessment data of LTSS recipients in California in 2008. CAMRI's integrated database provides a unique opportunity to look at characteristics and program spending across the entire care continuum for beneficiaries with LTSS needs within Medi-Cal and for dual eligibles across Medicare and Medi-Cal. This report focuses on LTSS use and spending in the eight duals demonstration counties.
This is the third report coming from the California Medicaid Research Institute (CAMRI) project entitled: Comprehensive Analysis of Home- and Community-Based Services in California. The report describes Medicare and Medi-Cal spending for those beneficiaries using long-term services and supports funded by Medi-Cal.
Per capita Medicare spending is higher for seniors with chronic conditions and functional impairment than for seniors with chronic conditions alone. Seniors with chronic conditions and functional impairment require acute care and long-term services and supports (LTSS) from systems that are fragmented. The lack of coordination between acute care and LTSS may contribute to the unnecessary utilization of health services and higher spending on this population.
The California Medicaid Research Institute (CAMRI) compiled a report that identifies Californians who receive home-and community-based support and what services they receive. The brief brings together available information spread across multiple state and federal data systems.
In this brief, the California Medicaid Research Institute documents its process to acquire and link all the data sources necessary to evaluate long-term care services utilization, costs, and outcomes in California. This provides useful information about how data currently flows in the state and how system transformation can be supported.
The SCAN Foundation, in partnership with Avalere Health, released a web-based modeling tool that enables policymakers and the public to test the budgetary implications of a wide variety of federally run long-term care insurance programs. The model, called the Long-Term Care Policy Simulator, produces more than 2,500 unique outputs, each illustrating how public long-term care insurance program designs and benefits translate into estimated coverage, participation rates, and costs to participants and taxpayers. Read more in this report.