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Quality Improvement Measurement of Outcomes for People With Disabilities - Closing the Quality Gap: Revisiting the State of the Science

This report examines how health care outcomes for general medical care have been assessed for people with disabilities within the rubrics of care coordination and quality improvement. A total of 15,513 articles were screened; very few were direct examples of work conducted from the perspective of disability as a complicating condition. Capturing the disability perspective will require collaboration of measurement efforts across medical interventions, rehabilitation, and social support provision.

Short URL: http://www.advancingstates.org/node/53318

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Long-Term Care for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care

This report compares long-term care (LTC) for older adults delivered through Home and Community-Based Services (HCBS) with care provided in nursing homes (NHs) by evaluating (1) the characteristics of older adults served through HCBS and in NHs; (2) the impact of HCBS and NH care on outcome trajectories of older adults; and (3) the per person costs of HCBS and NH care, costs for other services such as acute care, and family burden.

Short URL: http://www.advancingstates.org/node/53317

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Development of Quality Indicators for Home and Community-Based Services Population: Project Methodology

This report details development of the Agency for Healthcare Research and Quality (AHRQ)’s Quality Indicators (QI) for the HCBS population. It includes key sections: 1) the introduction section providing background on the HCBS QI development project. 2) the methods section on an overview of the QI development process, 3) results of details of empirical analyses performed to support QI, 4) the concluding thoughts section providing a discussion of interpretation of the indicators.

Short URL: http://www.advancingstates.org/node/53316

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Assessing the Health and Welfare of the HCBS Population

The Agency for Healthcare Research and Quality (AHRQ) was assigned to develop outcome indicators to assess the "health and welfare" of recipients of Medicaid HCBS. AHRQ also was required to use the outcome indicators to describe the health and welfare of this population. The outcome indicators are presented by individual attributes and area characteristics. The health of the HCBS population is also described within the context of State policies and service availability.

Short URL: http://www.advancingstates.org/node/53315

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Driving HCBS Innovation through Data and Metrics

Presented at the 27th National Home and Community-Based Services (HCBS) Conference, this presentation discussed HCBS beginnings and momentum, including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP), data and metrics to build community-based services, and using metrics to move forward.

Short URL: http://www.advancingstates.org/node/53314

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Using Propensity Score Matching Techniques to Assess Medicare/Medicaid Service Use

This poster describes the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid LTSS via HCBS waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses.

Short URL: http://www.advancingstates.org/node/53313

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Pathways to Medicare-Medicaid Eligibility: A Literature Review

The purpose of this literature review is to better understand the various pathways to Medicare-Medicaid eligibility, how and why and individual becomes eligible for both programs. Also, this report presents examples of federal government- and state-sponsored programs and supports aimed at delaying or preventing a descent into functional decline and/or poverty. The ways to simplify the enrollment process for those who quality and need Medicare and Medicaid benefits are discussed as well.

Short URL: http://www.advancingstates.org/node/53312

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Long-Term Services and Supports: Challenges and Opportunities for States in Difficult Budget Times

This paper discusses the progress states have made in moving away from institutional care for Long-Term Supports and Services and toward home and community-based programs. It analyzes the opportunities available through the Affordable Care Act and other programs whereby states can continue that progress even in a challenging budget environment.

Short URL: http://www.advancingstates.org/node/53311

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New Medicare-Medicaid Enrollees in Maryland: Demographic and Programmatic Characteristics

This study focuses on new Medicare-Medicaid enrollees in Maryland and the circumstances that shaped their initial eligibility for both programs. This report details the demographic and programmatic characteristics of new enrollees. Specifically, it serves as the vehicle for establishing an initial operational definition of new enrollees and developing the terminology needed to describe the circumstances surrounding initial Medicare-Medicaid eligibility.

Short URL: http://www.advancingstates.org/node/53310

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New Medicare-Medcaid Enrollees in Maryland: Prior Medicare and Medicaid Resource Use

This report describes and analyzes chronic disease patterns and health care expenditures of persons in Maryland who in 2008 began to receive coverage from both Medicare and Medicaid. The analysis focuses on disease and expenditure patterns in the year before these individuals, most of whom had been enrolled in Medicare alone or Medicaid alone, became enrollees in both programs. The results can provide a better understanding of simultaneous enrollment in Medicare and Medicaid.

Short URL: http://www.advancingstates.org/node/53309

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