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A Fresh Approach to Managed Care in NC and NY

Fresh Approach to Managed Care in NY and NC THE VBP Blog We’ve navigated you through 8 of the ten states with a managed care I/DD program and in this blog, we will cover the final two. We have learned a lot about the different approaches, the successful and not as successful programs, and the work that is still left to do. In our next blog, we will recap everything we have learned and what it means moving forward. North Carolina has been working with a form of managed care since 2005, but in 2015 committed to move towards a whole-person managed care approach. Their shift towards a new program has been halted due to legislation struggles and COVID-19, but… Read More »A Fresh Approach to Managed Care in NC and NY

older couple hugging

Local Engagement in IDD Managed Care with AZ and MI

Local Engagement in IDD Managed Care in Arizona and Michigan THE VBP Blog [5/26/2020] – As promised, this blog will examine the last 4 states that offer I/DD managed care programs to their consumers. This week, we take a look at Arizona and Michigan. Arizona built a completely different structure than we have seen before with a state-run Division of Developmental Disabilities as the managing entity. Michigan’s managed care program is similar to that of North Carolina, focusing on county-based programs. These two contrasting styles have both found success and both have created unique solutions to manage the I/DD and MLTSS population. Arizona’s Managed Care Program Arizona’s Long-Term Care System (ALTCS) was established in 1998 for the management of Long-Term… Read More »Local Engagement in IDD Managed Care with AZ and MI

Let’s Jump Back in to Managed Care in I/DD

Let’s Jump Back in to Managed Care in I/DD THE VBP Blog [5/14/2020] – For the past 8 months, we have touched on managed care in the individuals with intellectual and developmental disabilities (I/DD) population. While the world has been coping with COVID-19, this expansion of managed care has not slowed down. With the estimated 1.5 million Medicaid consumers with an I/DD, over 358,500 consumers with I/DD were enrolled in a managed long-term services and supports (MLTSS) program over 10 states as of May of 2020. This means approximately 2.1% of the total Medicaid population and 25.4% of I/DD consumers enrolled in a Medicaid program. This population has 45% with three or more chronic conditions and 35% always have a… Read More »Let’s Jump Back in to Managed Care in I/DD

Is Telehealth the TSA of COVID-19?

Break Through Value-Based Payments Is Telehealth the TSA of COVID-19? THE VBP Blog For those of you who know me personally, you know that being an optimist is my downfall. In times of crisis, the ability to look forward to the forthcoming changes can be challenging.  Mandy, my co-author brings her creativity and technology-savvy perspective to our discussions. Together, we look ahead to the elements we want learn from.  Our starting point for this blog was the major change that came out of 9/11.  We jointly concluded that technology changed significantly because of that crisis. We also saw the TSA in our airports as one of the manifestations of the change.  So, could telehealth be the TSA of the COVID-19… Read More »Is Telehealth the TSA of COVID-19?

elderly man in a wheelchair with a dog in his lap

Onward Means Consumer Protections

Onward Means Consumer Protections THE VBP Blog Over the last few decades, advocates and regulators have worked tirelessly to build in significant protections in the way services are delivered. We’ve been fighting for things such as independent living in the community, smaller group homes, privacy in each room, and community integration. In the current COVID-19 crisis, we see many of these regulations being waived, in the name of emergency flexibility and the ability to provide services efficiently.  We’re also seeing individuals with disabilities being pushed to the back of the line in some states. We see three ways to look at this abrupt change. One, there are a number of burdensome regulations we should reconsider. The pandemic is just exposing… Read More »Onward Means Consumer Protections

Onward Takes on New Meaning!

ONWARD Takes On A New Meaning THE VBP Blog Our blog has focused on the quality of services and how you can leverage measuring performance to continuously improve satisfaction, support our consumers, and keep you ahead of the game.  Today, the challenges you face are monumental, so we will focus on supporting you and live by our mantra, ONWARD! With hourly updates on the COVID-19 situation, having resources you can rely on is paramount. We want to make sure that you have resources for not only your consumers, but your staff and your business to ensure you make informed decisions. With that in mind, we have compiled both news articles and resources for you to reference. Here are a few… Read More »Onward Takes on New Meaning!

Pay for Performance – An Opportunity for Self-Direction in HCBS

Break Through Value-Based Payments Pay for Performance – An Opportunity for Self-Direction in HCBS THE VBP Blog Roughly a year ago we did a blog on Payment for Performance that took a look at the second step in the Value-Based Continuum. Pay for Performance (P4P) is the model that sets metrics to incentivize providers to achieve, advance, and exceed through their quality of care. We talked about the pros – sustainable metrics can lead to higher quality care – and the cons – lower social-economic status areas will have inevitable bad outcomes and thus receive less funding. The P4P model is undoubtedly the longest standing and fastest growing[2] above its counterparts in shared savings, bundling, and shared risk models.  In… Read More »Pay for Performance – An Opportunity for Self-Direction in HCBS

Looking at States’ Managed Care Programs: Kansas and Texas

Break Through Value Based Payments Looking at States’ Managed Care Programs: Kansas and Texas THE VBP Blog Happy New Year! Let’s start 2020 where we left off in our last blog. We will review two of the ten states that currently are supporting the I/DD population with managed care programs. Using the Ancor 2018 White Paper, combined with our own research, we opted to break down Texas and Kansas. Both contract with Multi-state Commercial MCOs to administer their programs. Kansas’ fully capitated, MCO-based, state-wide program is called KanCare, started in 2013 with the I/DD enrollment portion starting in 2014. As of the end of 2017 there were 8954 people on the KanCare I/DD Waiver program. The initial goals for KanCare… Read More »Looking at States’ Managed Care Programs: Kansas and Texas