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Descriptive Study of Three Disability Competent Managed Care Plans For U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation Office of Disability, Aging and Long-Term Care Policy DESCRIPTIVE STUDY OF THREE DISABILITY COMPETENT MANAGED CARE PLANS FOR MEDICAID ENROLLEES January 2014 Office of the Assistant Secretary for Planning and Evaluation The Office of the Assistant Secretary for Planning and Evaluation (ASPE) is the principal advisor to the Secretary of the Department of Health and Human Services (HHS) on policy development issues, and is responsible for major activities in the areas of legislative and budget development, strategic planning, policy research and evaluation, and economic analysis. ASPE develops or reviews issues from the viewpoint of the Secretary, providing a perspective that is broader in scope than the specific focus of the various operating agencies. ASPE also works closely with the HHS operating agencies. It assists these agencies in developing policies, and planning policy research, evaluation and data collection within broad HHS and administration initiatives. ASPE often serves a coordinating role for crosscutting policy and administrative activities. ASPE plans and conducts evaluations and research--both in-house and through support of projects by external researchers--of current and proposed programs and topics of particular interest to the Secretary, the Administration and the Congress. Office of Disability, Aging and Long-Term Care Policy The Office of Disability, Aging and Long-Term Care Policy (DALTCP), within ASPE, is responsible for the development, coordination, analysis, research and evaluation of HHS policies and programs which support the independence, health and long-term care of persons with disabilities--children, working aging adults, and older persons. DALTCP is also responsible for policy coordination and research to promote the economic and social well-being of the elderly. In particular, DALTCP addresses policies concerning: nursing home and community- based services, informal caregiving, the integration of acute and long-term care, Medicare post-acute services and home care, managed care for people with disabilities, long-term rehabilitation services, children’s disability, and linkages between employment and health policies. These activities are carried out through policy planning, policy and program analysis, regulatory reviews, formulation of legislative proposals, policy research, evaluation and data planning. This report was prepared under contract #HHSP23320095642WC between HHS’s ASPE/DALTCP and Mathematica Policy Research. For additional information about this subject, you can visit the DALTCP home page at http://aspe.hhs.gov/office_specific/daltcp.cfm or contact the ASPE Project Officers, Hakan Aykan and Jhamirah Howard, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201. Their e-mail addresses are: [email protected] and [email protected]. DESCRIPTIVE STUDY OF THREE DISABILITY COMPETENT MANAGED CARE PLANS FOR MEDICAID ENROLLEES Vanessa Oddo Angela Gerolamo David R. Mann Catherine DesRoches Mathematica Policy Research January 2014 Prepared for Office of Disability, Aging and Long-Term Care Policy Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services Contract #HHSP23320095642WC The opinions and views expressed in this report are those of the authors. They do not necessarily reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. TABLE OF CONTENTS ABSTRACT .................................................................................................................... iv ACRONYMS ................................................................................................................... vi EXECUTIVE SUMMARY .............................................................................................. viii I. INTRODUCTION ..................................................................................................... 1 II. BACKGROUND AND METHODS .......................................................................... 3 A. Care Coordination for People with Disabilities ................................................ 3 B. Overview of the Disability Competent Health System ..................................... 4 C. Overview of the Medicaid Managed Care Plans ............................................. 6 D. Evaluation Methods ....................................................................................... 11 III. COMMONWEALTH CARE ALLIANCE--BOSTON'S COMMUNITY MEDICAL GROUP ................................................................................................ 13 A. Context .......................................................................................................... 13 B. Organizational Features ................................................................................ 14 C. Processes of Care ......................................................................................... 16 IV. COMMONWEALTH CARE ALLIANCE--SENIOR CARE OPTION ...................... 20 A. Context .......................................................................................................... 20 B. Organizational Features ................................................................................ 21 C. Processes of Care ......................................................................................... 24 V. COMMUNITY HEALTH PARTNERSHIP .............................................................. 28 A. Context .......................................................................................................... 28 B. Organizational Features ................................................................................ 29 C. Processes of Care ......................................................................................... 32 VI. INDEPENDENCE CARE SYSTEM ....................................................................... 36 A. Context .......................................................................................................... 36 B. Organizational Features ................................................................................ 37 C. Processes of Care ......................................................................................... 40 VII. SIMILARITIES AND DIFFERENCES ACROSS PLANS ...................................... 45 A. Context .......................................................................................................... 45 B. Organizational Features ................................................................................ 46 C. Process Features .......................................................................................... 52 i VIII. DISCUSSION AND CONCLUSIONS .................................................................... 60 A. Plans Share Four Key Features .................................................................... 60 B. Three Key Features Distinguish the Plans .................................................... 62 C. Conclusions ................................................................................................... 63 REFERENCES .............................................................................................................. 65 APPENDICES APPENDIX A. Discussion Guide Topics. ................................................................ A-1 APPENDIX B. Site Profiles ..................................................................................... A-2 ii LIST OF FIGURES AND TABLES TABLE II.1. Program and Member Characteristics ....................................................... 7 TABLE VII.1. Organizational Features ........................................................................... 47 TABLE VII.2. Clinical Information System ..................................................................... 50 TABLE VII.3. Initial Assessment and Care Planning ..................................................... 53 TABLE VII.4. Ongoing Monitoring ................................................................................. 54 TABLE VII.5. Communication and Coordination with Providers .................................... 55 TABLE VII.6. Care Transitions and Medication Management ....................................... 58 iii ABSTRACT This report describes the organizational features of three disability competent health systems: Commonwealth Care Alliance (CCA) in Massachusetts; Community Health Partnership (CHP) in Wisconsin; and Independence Care System (ICS) in New York City. These programs integrate health and social services to deliver patient- centered care to Medicaid and Medicare beneficiaries with particularly complex chronic care needs. To provide program operators with useful information about these programs, we detail how staff deliver services and coordinate care for people with disabilities. We conducted two-day site visits to each program and discussed service delivery with program administrators and direct care staff. The disability competent managed care plans in this study are committed to promoting independence and individualized care among their members, and to ensuring that members have the appropriate balance of medical and social supports. The plans also share four key features: (1) high-touch clinical interventions; (2) interdisciplinary teams to deliver care; (3) a strong emphasis on managing care transitions; and (4) investment
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