Capitol Correspondence - 08.05.19

Big Picture Resources: Person-Centeredness, MFP, Dual Eligibles, Disability Inclusion ad Alternative Payment Models

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ANCOR is sharing these resources in case they are of interest to our members, who offer a broad range of supports and services for people with disabilities.

Evidence person-centered approaches work in blog post by Health Care Strategies: “An article in the May 2019 Journal of General Internal Medicine, summarized on the Better Care Playbook, reports on a comparative effectiveness study demonstrating that a transitional care intervention emphasizing post-discharge services for patients with complex needs can reduce some types of acute care costs. The transitional program studied here led to 42 percent fewer inpatient admissions over 180 days.

The Better Care Playbook recently spoke with Christine Schaeffer, MD, medical director of Northwestern Medicine Transitional Care, who described the core components of this transitional care program. She also shared important considerations for health systems interested in implementing person-centered transitional care to address gaps in care and reduce costs.”

Evaluating the impact of Money Follows the Person, presentation by Brandeis University: This PowerPoint presentation shares useful statistics on use of Money Follows the Person, including savings accrued, user demographics and the population that remains eligible for the program.

Primer on dual eligible special need plan look-alikes, by Justice in Aging: “Over the last few years, however, Medicare Advantage plans have emerged that are undermining the move toward integration. These plans, which have come to be called D-SNP look-alikes, are aggressively marketed almost exclusively to dual eligibles, but are not D-SNPs or integrated products. They are not subject to the regulations governing D-SNPs and have no responsibility to coordinate Medicare and Medicaid benefts. Unlike D-SNPs, they have no contracts with state Medicaid agencies that define their responsibilities to better integrate care for duals and no accountability. They draw dual eligibles away from coordinated options and place responsibility on the consumer to navigate two separate delivery systems. The Medicare Payment Advisory Commission (MedPAC) reports that in 2017, 44 look-alike plans operated in 16 states and enrolled over 200,000 benefciaries.2 MedPAC conservatively estimates that as of 2019 the number of look-alike plans has nearly doubled since 2017, and they are now available in 35 states. Enrollment is estimated to have increased to at least 220,000.3 Given the proliferation of look-alike plans, advocates working with dual eligibles need to be prepared to identify the impact of these plans on dual eligibles and report their experiences to Justice in Aging and CMS.”

Robert Wood Johnson Foundation calls for ideas for disability inclusion in LinkedIn post, shares links to upcoming grants organization: “In our work to help build a Culture of Health, we recognize the importance of working with people across many different sectors—including those working in health care, housing, transportation, economic and community development, education, and the faith community. We want to know how leaders across our nation are thinking about disability inclusion. What strides has your organization taken or could your organization take to increase inclusion for the full spectrum of people with disabilities, including those with physical, sensory, mental, cognitive, or intellectual disabilities? What can our field learn from others to become leaders in this work? I hope you share your thoughts in the comments.” [ANCOR note: in the same post, the author notes the Disability and Philanthropic Forum, which houses the Disability Inclusion Fund, which will in turn be sharing how to apply for disability inclusion grants later in 2019.]

Brief on outcomes-based contracts by the Urban Institute: “Outcomes-based contracts (OBCs) can be valuable tools for governments to link payments to desired improvements in service delivery. Defined as any contract structure in which payment is wholly or partially based on the achievement of predefined outcomes, OBCs are part of a broader family of performance based procurement strategies. Though they present various benefits to governments, including incentivizing improved performance and facilitating greater use of data in decision-making, OBCs also present various challenges and risks to governments and the service providers with whom they contract. This brief discusses the benefits and challenges from the OBC field, collected through interviews with practitioners and researchers, and provides practical recommendations for government practitioners interested in OBCs.”