Capitated Payment Approaches for Medicaid-Financed Long-Term Care Services
نویسندگان
چکیده
In the following analysis, the authors examine the capitated payment approaches for long-term care (LTC) services of five programs: the Program of All-Inclusive Care for the Elderly (PACE), the Arizona Long-Term Care System (ALTCS), the Texas STAR + PLUS, the Minnesota Senior Health Option (MSHO), and the Monroe County Continuing Care Networks (CCNs) in New York. The authors describe key aspects in the design of these programs, with an emphasis on Medicaid reimbursement, and discuss differences and commonalities in the approaches taken by the programs in setting capitation rates.
منابع مشابه
Utilization of Services in Arizona's Capitated Medicaid Program for Long-Term Care Beneficiaries
The Arizona Long-Term Care System (ALTCS), Arizona's Medicaid program for long-term care (LTC) beneficiaries, capitates contractors to provide a full range of acute and LTC services to financially-eligible beneficiaries determined to be at risk of institutionalization. This article compares the acute care utilization experience of LTC beneficiaries in ALTCS with those in a fee-for-service (FFS)...
متن کاملMedicaid payment mechanisms: impact on medication adherence and health care service utilization in type 2 diabetes enrollees.
The purpose of this retrospective cohort study was to examine the impact of the type of health plan (capitated vs. fee for service [FFS]) on outcomes (medication adherence and health care service utilization) in type 2 diabetes Medicaid enrollees. Subjects were 8581 Medicaid enrollees with type 2 diabetes who newly started oral pharmacotherapy and were followed for 6 months before and 12 months...
متن کاملPACE (Program of All-Inclusive Care for the Elderly): innovative care for the frail elderly. Comprehensive services enable most participants to remain at home.
PACE--the Program of All Inclusive Care for the Elderly--provides integrated comprehensive healthcare services to the frail elderly on a capitated basis. Begun in the early 1970s in San Francisco's Chinatown, PACE today comprises many individual programs across the nation. PACE's goal is to provide participants with the healthcare services they need for the highest possible level of functioning...
متن کاملEnd-of-life care in the United States: policy issues and model programs of integrated care
BACKGROUND End-of-life care financing and delivery in the United States is fragmented and uncoordinated, with little integration of acute and long-term care services. OBJECTIVE To assess policy issues involving end-of-life care, especially involving the hospice benefit, and to analyse model programs of integrated care for people who are dying. METHODS The study conducted structured intervie...
متن کاملThe cost-effectiveness of noninstitutional long-term care services: review and synthesis of the most recent evidence.
There has been significant expansion and change in the financing, coverage, and delivery of home- and community-based services during the past decade. This article reviews the cost-effectiveness of Medicaid waiver programs, consumer-directed care, capitated models that blend acute and long-term care services, and case management and subsidized community services for individuals with dementia. G...
متن کامل