New Resources for CBOs from the SCAN Foundation

New resources are available from the SCAN Foundation, which recently released a suite of resources for CBOs seeking partnerships with the health care sector.

Resources include:

Proposed Medicaid Managed Care Regulations: Guide to Implications for the Aging and Disability Network

Aging and Disability Partnership Guide to Medicaid Managed Care Proposed Rule

Prepared by: Justice in Aging, National Disability Rights Network, and Disability Rights Education and
Defense Fund.

For the first time in over a decade, the Centers for Medicare and Medicaid Services (CMS) is proposing to update the regulations for Medicaid services delivered by managed care organizations (MCOs).1 The long-term services and supports (LTSS) landscape continues to change, as more states are utilizing managed care for LTSS than ever before. The proposed regulations could introduce sweeping changes to the managed care delivery system and significantly impact community-based programs that provide LTSS services.
While there is extensive coverage of the proposed regulations in the general health policy world, a focus on the particular impact to community-based organizations is missing. This guide attempts to fill that gap, zeroing in on the potential changes to community-based programs under the proposed rule.

The guide focuses on eight key areas of importance to community-based organizations (CBOs) in the Aging and Disability Network:
1) Medical Loss Ratio and LTSS
2) Beneficiary Support System
3) Stakeholder Engagement
4) Enrollment and Disenrollment
5) Coverage and Continuation of Benefits Pending a Fair Hearing
6) Grievances and Appeal
7) Network Adequacy
8) Disability Accessibility

How Community-Based Organizations Can Support Value-Driven Health Care

How Community-Based Organizations Can Support Value-Driven Health Care

By: Anand Parekh and Robert Schreiber

July 10, 2015

Anad Parekh, Deputy Assistant Secretary for Health at HHS, and Robert Schreiber, MD, of the Hebrew SeniorLife Medical Group, have published an article in the Health Affairs Blog that explains how vital it is to connect patients with community-based organizations, such as Area Agencies on Aging. The article includes real-world examples as well as data that support the effectiveness of this approach:

“As our health care system transforms more quickly than ever from paying for volume to paying for value, providers have strong incentives to ensure that their patients‚Äô care plans are reinforced and supported outside the clinical setting in people‚Äôs homes and communities.”

“This is particularly important for older adults with multiple chronic conditions, who comprise 66 percent of Medicare fee-for-service beneficiaries and account for 93 percent of total Medicare expenditures. In addition, it is well known that individuals with both chronic conditions and functional limitations requiring long-term services and supports are at highest risk for poor outcomes and high health care expenditures.”