Quality

This policy brief gives background information on what Managed Care is and how it can be used as a model that promotes Medicaid savings. The brief discusses the different factors for success and the quality standards for Medicaid Managed Care.

This report serves as a follow-up to the 1995 Institute on Medicine (IOM) report which argued for an ombudsman program to address the quality of care in long-term institutional settings. This study investigates the role and effectiveness of the State Long-Term Care Ombudsman Programs (LTCOPs) in improving care. Surveys with all states/territories reveal new findings on the structure of the program in different states as well as their own perceived effectiveness. Comprehensive data and analysis.

This document outlines recommendations from the Johnson Foundation's Wingspread Conference to ensure that individuals with I/DD are fully integrated into society and the recognition of their families' role in their lives. Review the action steps and accomplishments.

This resource for programs includes State Lifespan Respite Programs, that provide respite and are interested in developing & implementing participant-directed respite, especially through voucher programs. Included are: overview materials that provide content information regarding participant direction, examples from two states that currently implement participant-directed respite programs using a voucher system, important tax and financial information, & resources for additional materials.

This report describes the process of assembling and integrating Medicaid and Medicare data to study recipients of HCBS in California. Subsequent reports will describe disability levels and service use of HCBS users in Medi-Cal only and dual eligibles between 2005 and 2008.

Medicaid program integrity is among the highest priorities of the nation’s Medicaid Directors and is a key component of every initiative and program states conduct. Program integrity is about creating a culture where there are consistent incentives to provide better health outcomes within a context that avoids over-or underutilization of services. Directors seek to promote economy, efficiency, accountability, and integrity in the management and delivery of services.

Person- and family-centered care (PFCC) has gained attention in recent years as a mechanism for transforming health care and long-term services & supports (LTSS). Research shows that PFCC improves quality of care & quality of life. The current shift in payment reform & service delivery away from disease or provider-focused models and toward incentives that reward better coordination, communication, and continuity of care, is likely to promote wider adoption and effective implementation of PFCC.

Review the data products and publications from a new survey about Residential Care Facilities. Included are residential care facilities; assisted living residences; board & care homes; congregate care; enriched housing programs; homes for the aged; personal care homes; & shared housing establishments that are licensed, registered, listed, certified, or otherwise regulated by a state. NSRCF is designed to produce national estimates of facilities and their residents.

States serve a large number of people with dementia & caregivers in their Aging Networks & LTSS systems. This involves accommodating the needs of a population experiencing a variety of physical, cognitive, & behavioral symptoms from dementia, along with other medical conditions. This brief discusses why states should be concerned about dementia capability in their LTSS systems, describes the components of model dementia-capable systems, & reports how states have addressed dementia capability.

When assessing the needs of persons with dementia and caregivers in the community, it is important to understand the number of persons affected and their unique needs for services and programs. This toolkit complements the issue brief titled Making the Long-Term Services and Supports System Work for People With Dementia and Their Caregivers by identifying resources that states and communities can use to design initiatives to ensure that programs are dementia-capable.