Work

ATI Advisory identifies what sets apart individuals with Long Term Care (LTC) needs from the rest of the Medicare population. This work examines the demographic profiles, care complexity, medications, and medical and pharmacy spending for Medicare beneficiaries receiving LTC in different settings, as well as for Medicare beneficiaries who do not receive LTC.

With support from Arnold Ventures, ATI Advisory conducted listening sessions, focus groups, and interviews with diverse stakeholders to better understand the unique needs and experiences of individuals who are dual eligible for Medicare and Medicaid, and their caregivers. Through these conversations, ATI gained insights on the potential role that integrated coverage and care experiences can play in addressing the concerns of individuals who are dual eligible and their caregivers. Central to what we heard: individuals who are dual eligible and their caregivers seek a person-centered and seamless consumer experience.

With support from West Health Institute, ATI Advisory created a compendium of more than 40 innovative models and programs that can help meet the behavioral health needs of the older adult population. ATI’s analysis includes policy and financing considerations to help identify and translate attributes that support scale and enable sustainability for stakeholders. These include state, community-based organizations and managed care plans looking to develop or implement integrated behavioral health strategies for older adults.

ATI Advisory in partnership with UnitedHealthcare Community & State, developed a report highlighting the health equity considerations faced by Medicaid beneficiaries with complex care needs. Findings from ATI's analysis show substantial disparities and intersectional needs among individuals dually eligible for Medicare and Medicaid, individuals with long term services and supports (LTSS) need, and individuals with intellectual and developmental disabilities (I/DD).

Four years into implementation, nearly 40% of Medicare Advantage plans are offering nonmedical supplemental benefits in 2023. This latest report examines why benefits that help members stay in their homes – specifically in-home support services (IHSS), caregiver supports, and social needs benefits – have experienced significant growth and adoption despite the challenges in providing a human-powered service.

On February 1, 2023, CMS released the Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) that proposed several changes to the Hierarchical Condition Category (HCC) model.