McCall N, Wrightson CW, Korb J, Crane M, Weissert W, Wilkin J.

AHSR FHSR Annu Meet Abstr Book. 1996; 13: 70.

Laguna Research Associates, San Francisco, CA 94105, USA.

RESEARCH OBJECTIVES: This paper presents findings from a recently completed evaluation of the Arizona Long-term Care System (ALTCS), Arizona's capitated Medicaid program for long-term care beneficiaries. ALTCS is studied with respect to its implementation and operation, and program outcomes. STUDY POPULATION: The study focuses on the approximately 20,000 enrollees in the ALTCS program. Approximately two-thirds of these beneficiaries are elderly and physically disabled and one-third are mentally retarded/developmentally disabled. STUDY DESIGN: The implementation and operation analysis focuses on five issues: (1) effectiveness of program contractors; (2) method of setting capitation payments; (3) preadmission screening, level of care determination, and use of home and community-based services; (4) administrative costs; and (5) management information system. Outcome assessments include: (1) utilization of medical services; (2) incidence of specific indicators associated with quality of care; and (3) cost. PRINCIPAL FINDINGS: The implementation of the ALTCS program has generally met with success. Arizona beneficiaries have fewer hospital days, fewer procedures, and more evaluation and management services than traditional fee-for-service Medicaid programs. Cost of the ALTCS program as compared to a traditional Medicaid program is 16% less per year for its first five years and is increasing 4.6% slower per year. CONCLUSIONS: ALTCS, a capitated Medicaid program, successfully delivers integrated acute and long-term care services to long-term care Medicaid beneficiaries. RELEVANCE TO POLICY AND HEALTH CARE DELIVERY: With increased pressure on public programs to decrease costs while maintaining a safety net of service use for beneficiaries, Medicaid managed care can be an important component of an improved and more cost-effective delivery system.

Publication Types:

• Meeting Abstracts

Keywords:

• Aged
• Arizona
• Disabled Persons
• Fee-for-Service Plans
• Health Expenditures
• Humans
• Long-Term Care
• Managed Care Programs
• Medicaid
• Medicare
• economics
• hsrmtgs

Other ID:

• HTX/97604307

UI: 102222209

From Meeting Abstracts