Implementation of Medicaid Managed Long-Term Services and Supports for Adults With Intellectual and/or Developmental Disabilities in Kansas

Williamson, Heather J.; Perkins, Elizabeth A.; Levin, Bruce; Baldwin, Julie A.; Lulinski, Amie; Armstrong, Mary I.; Massey, Oliver T.

doi:10.1352/1934-9556-55.2.84

Cited by 14 publications

(4 citation statements)

References 24 publications

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“…As of July 2014, 55 million people in the United States were enrolled in Managed (Centers for Medicare & Medicaid, n.d.). Yet, there is conflicting research about the benefits of managed care for people with disabilities in the United States, particularly the cost‐effectiveness and quality (Burns, ; Caswell & Long, ; Duggan & Hayford, ; Wegman et al, ; Williamson et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, participants in our study who had managed care were less likely to have opportunities to self‐manage their own health care, compared to those not on managed care. The relationship between managed care and self‐management of health is an important topic for future study; this is especially pertinent as this service delivery model is relatively new for people with IDD, yet is rapidly growing in frequency in the United States (Williamson et al, ). People with IDD are a unique population that, in many instances, require a different set of services and supports than nondisabled people or even people with other types of disabilities.…”

Section: Discussionmentioning

confidence: 99%

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Self‐management of health by people with intellectual and developmental disabilities

Friedman

Rizzolo

Spassiani

2018

Research Intellect Disabil

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Background Self‐management of health includes people with intellectual and developmental disabilities (IDD) playing a key role in health management in collaborating with healthcare professionals. Methods This study analysed data from Personal Outcome Measures® surveys (n = 1,341) to explore self‐management of health. We had the following research questions: Who is most likely to be supported to self‐manage their health? How does being supported to self‐manage impact different areas of health? and How does being supported to self‐manage impact other health‐related organizational supports? Results Findings revealed the impact of self‐management of health can be wide‐ranging, regardless of impairment severity. When supported to self‐manage their health, healthcare professionals were more likely to address healthcare issues, and interventions were more likely to be effective. Conclusions Self‐management represents a paradigm shift for people with IDD because it transforms people from passive recipients to active directors of their health.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Self‐management of health by people with intellectual and developmental disabilities

Friedman

Rizzolo

Spassiani

2018

Research Intellect Disabil

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“…Both models attended to key contextual factors of residential setting, health disparities, and the heterogeneity of people with IDD, as each implemented care coordination and had positive qualitative findings regarding quality of care for participants, including participants’ increased confidence in self-management, timeliness of care, and medication safety. By providing personalized care, they could address unique issues such as improving access to preventive care (Williamson, Perkins, & Acosta, 2016), managing comorbid conditions (Williamson, Perkins, & Levin, 2017), and supporting family members (Williamson, Perkins, Lulinski, et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Care Coordination Models Improve Quality of Care for Adults Aging With Intellectual and Developmental Disabilities

Ruiz

Giuriceo

Caldwell

et al. 2019

Journal of Disability Policy Studies

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A significant gap remains between existing evidence-based care coordination techniques for the general population and those that have been successfully translated for people with intellectual and developmental disabilities (IDD). Two models funded through the Health Care Innovation Awards have dedicated resources to the translation of evidence-based practices in community or clinical settings. This study analyzes quasi-experimental mixed-methods evaluation data, including Medicaid/Medicare claims on more than 600 beneficiaries who participated in the two models and survey data, site visits, and focus groups with participants and caregivers. Qualitative data suggest that both models address key contextual factors, considering residential setting, health disparities, and heterogeneity of the population. We identify key improvements in health care quality related to timeliness, patient safety, and medication reconciliation. In addition, both models show some evidence of reduced claims utilization. This study represents the first step to understand the potential of care coordination to improve the lives of adults aging with IDD. As health systems continue to struggle to manage the cost of their most expensive users and deliver high quality care, these models hold promise as vehicles to reduce utilization and cost among adults who have lived long-term with disability by addressing their unique health care and social needs.

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“…Kansas is one state that recently transitioned their Medicaid programs to a managed care (MLTSS) approach referred to as KanCare (). This paper reports the results of one portion of a larger case study focused on the overall KanCare implementation experience (Williamson, Perkins, Levin, Baldwin, Armstrong, Lulinski, & Massey, ). The study's overall objective was to describe the current implementation of MLTSS for adults with IDD and their family caregivers in a state (Kansas) that recently implemented MLTSS.…”

Section: Specific Aimsmentioning

confidence: 99%

Family Caregivers as Needed Partners: Recognizing Their Role in Medicaid Managed Long‐Term Services and Supports

Williamson

Perkins

Massey

et al. 2018

Policy Practice Intel Disabi

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Adults with intellectual and/or developmental disabilities (IDD) in the United States are supported by both formal Medicaid‐funded long‐term services and supports and family caregivers. Lack of alternative housing options and wait lists for long‐term services and supports means the role of the family caregiver is and will continue be critical. Rising long‐term services and supports costs combined with goals to improve care coordination and access to services are driving more states to change the design of their long‐term services and supports systems to a Medicaid‐Managed Long‐Term Services and Supports (MLTSS) approach. Best practices for implementing MLTSS for individuals with IDD include acknowledging the family caregiver role. The current study's aim is to understand how family caregivers and their roles are recognized in MLTSS for adults with IDD in Kansas. Kansas was selected given their unique approach to MLTSS for adults with IDD, referred to as KanCare. In‐depth semi‐structured telephone interviews were completed with 31 stakeholders in Kansas, including statewide/regional representatives (N = 13), service coordination providers (N = 7), and family caregivers (N = 11). Additional family support services were available in KanCare, but families had difficulty accessing them. No formal processes were reported for assessing the needs of family caregivers in KanCare and families found communications with managed care entities challenging. Families reported difficulties with taking on responsibility of managing in‐home supports and there were concerns about being paid to provide care as a guardian. Family caregivers play a critical role in MLTSS, including assisting with care coordination and access to services. However, their role was not formally acknowledged in KanCare. Future research, practice, and policy efforts should focus on promoting family caregiver assessments and identifying best practices for supporting family caregivers in MLTSS.

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Implementation of Medicaid Managed Long-Term Services and Supports for Adults With Intellectual and/or Developmental Disabilities in Kansas

Cited by 14 publications

References 24 publications

Self‐management of health by people with intellectual and developmental disabilities

Self‐management of health by people with intellectual and developmental disabilities

Care Coordination Models Improve Quality of Care for Adults Aging With Intellectual and Developmental Disabilities

Family Caregivers as Needed Partners: Recognizing Their Role in Medicaid Managed Long‐Term Services and Supports

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