Part II: ATI's Fred Bentle sits down with Dr. Charles T. Pu to ask him about his experience operating a unique SNF at Home Model. Dr. Pu shares learnings from his SNF at Home trial, recently published in the Journal of Applied Gerontology.
Policymakers are calling attention to nursing home regulations clearly identifying owners and operators. We reviewed capital market dynamics, the role of private capital in the industry, and included policy implications for future reform.
Part I: ATI's Fred Bentle sits down with Dr. Charles T. Pu to ask him about his experience operating a unique SNF at Home Model. Dr. Pu shares learnings from his SNF at Home trial, recently published in the Journal of Applied Gerontology.
The long-term care insurance market has been on a downward spiral due to several factors. Some carriers have exited the industry, and remaining carriers' policies are at much higher premium levels. This presents challenges to downstream policy.
Future Medicare Advantage policy must consider more deliberate opportunities to support person-centeredness, to recognize the outsized role that family caregivers play, and to integrate with Medicaid to promote equitable access and health outcomes.
Medicare Advantage is positioned to integrate and coordinate services more effectively than in fee-for-service environments. We organized our insights into a tool that explores key data on related topics to expand MA plans and value-based care.
Over 12 million people in the United States are enrolled in Medicare and Medicaid. Dual eligible beneficiaries are more likely than Medicare-only population to experience numerous health and social markets.
Inequities experienced by diverse Medicare beneficiaries were exposed during the pandemic. Research shows that Black and Latinx MA enrollees experience greater clinical complexity, while receiving receive more preventive services at a lower cost.
LTC provider-led SNPs combine primary care with residential long-term care to reverse the revolving door between nursing homes and assisted living and emergency rooms and inpatient hospitalizations, benefiting residents, families, and Medicare plans.
MA plans were allowed to make midyear supplemental benefits changes to address beneficiaries’ needs during the pandemic. Early lessons plan experiences suggest supplemental benefits can help meet member needs and enable home-based care.
Non-primarily health benefits are now available through Medicare Advantage programs. With support from partners, we developed principles to guide stakeholders in developing, offering, delivering, and using these new benefits.
As CMS sunsets the MMP model, it will be important to preserve lessons that benefited stakeholders. CMS has authority to maintain MMP model attributes, and should preserve those that are in statute through a refined, innovative financial model.
Impactful policymaking requires understanding individuals’ holistic health. This chartbook provides insights into the dual eligible population, supporting efforts to provide meaningfully integrated programs to all dual eligible beneficiaries.
With no current requirements ensuring that Medicaid programs serving dual eligible individuals integrate with Medicare, CMS has an opportunity to achieve greater integration for these individuals, and improving access to integrated programs.
The shortage of worforce capacity to deliver services to beneficiaries limits the ability of state Medicaid agencies to provide services. States have three core options to encourage managed care entities to support HCBS capacity building efforts.
Medi-Cal allows managed care plans to provide flexible person-centered services and address social drivers of health. Other states across the country can look to California’s experience to explore opportunities to leverage ILOS more broadly.
CA's Medicare Innovation Office is the first dedicated office within a state Medicaid agency focused on program design for dual eligibles. Understanding the growing Medicare population is important for CA to identify opportunities to support them.
This report outlines strategic recommendations for the California Department of Aging to explore in its effort to improve quality, equity, and cultural competence. Other states and their SHIPs might also consider these recommendations.