Ready, Fire, Aim: Does Integrating Acute and Long-Term Services Work?

Friday, November 4, 2022

8:00 AM – 9:30 AM ET

Location: 208 CC

CE: 1.5

Chair(s)

RA

Robert Applebaum, PhD

Professor
Department of Sociology and Gerontology
Miami University
Oxford, Ohio, United States

Slides

Discussant(s)

RB

Richard Browdie, MBA (he/him/his)

Principal
none
Browdie Consulting
Alexandria, Virginia, United States

Individual Symposium Abstract First Author(s)

RA

Robert Applebaum, PhD

Professor
Department of Sociology and Gerontology
Miami University
Oxford, Ohio, United States

Slides
JB

John Bowblis, PhD

Professor
Department of Economics
Miami University
Oxford, Ohio, United States
Jennifer Heston-Mullins, PhD, LISW

Associate Director of Research & Senior Research Scholar
Scripps Gerontology Center
Scripps Gerontology Center, Miami University
Oxford, Ohio, United States
Katherine Abbott, PhD, MGS, FGSA

Executive Director, Scripps Gerontology Center Professor, Department of Sociology & Gerontology
Sociology & Gerontology
Miami University
Oxford, Ohio, United States

Due to the increasing costs of Medicaid and Medicare and concerns about how these two programs fail to work together to deliver quality care, there has been a growing enthusiasm for integrated care programs. The Financial Alignment Initiatives (FAI), implemented by the Centers for Medicare and Medicaid Services (CMS) in 2011 and tested in 13 states were designed to test the impacts of a program that offers Medicare and Medicaid services under one organization to individuals who are dually eligible for both programs. Previous studies of the expansion of managed long-term services have generated considerable interest over the last two decades however, research results have been mixed. There is also limited information about the implementation of these efforts, as demonstrations have served varying target populations with very different intervention strategies. The lack of conclusive results means that states, now faced with decisions about continued implementation of these initiatives do not have good information to make sound policy decisions. The national evaluation of the FAI states did not include Medicaid costs. Our study is designed to gain a better understanding of Ohio’s FAI MyCare Demonstration. This symposium provides data from a comprehensive impact analysis that examined both Medicaid and Medicare claims data using a difference- in- differences treatment and comparison analysis (n= 390,000) and an in-depth process evaluation (using interviews with 487 participants) to gain an understanding of program effects. After reviewing results the symposium will discuss the future of these and other reform efforts to integrate Medicaid and Medicare services.

Learning Objectives:

After attending participants will have a better idea of the integrated care research results generated over the last two decades.
After attending participants will been exposed to the the evaluation design issues and results of a large scale study evaluating integrated care.
After attending the participants will have been exposed to a large scale process evaluation and will have gained a better perspective on the importance of linking process and impact evaluation results.

Presentations:

8:00 AM – 9:30 AM ET

When You Get to a Fork in the Road, Take It: Should States Follow Yogi's Advice on Managed Long-Term Services?
Individual Symposium Abstract First Author: Robert Applebaum, PhD – Miami University
8:00 AM – 9:30 AM ET

Evaluating Expenditures and Utilization of Ohio's Integrated Medicare and Medicaid Program
Individual Symposium Abstract First Author: John Bowblis, PhD – Miami University
8:00 AM – 9:30 AM ET

Program Theory Versus Implementation: The Importance of Process in Understanding Program Impact
Individual Symposium Abstract First Author: Jennifer Heston-Mullins, PhD, LISW – Scripps Gerontology Center, Miami University
8:00 AM – 9:30 AM ET

The Black Box of Care Management in Managed Long-Term Services and Supports
Individual Symposium Abstract First Author: Katherine M. Abbott, PhD, MGS, FGSA – Miami University