Managed Care

This interactive session, from n4a’s 2016 annual conference, helped participants learn how to tell their organization’s story and package their “products” in ways that will help them get noticed and appreciated by health care payers. Presenters included representatives from health plans who discussed what they look for in a “pitch” from a community-based organization seeking to market its services.

This resource offers narrative considerations along with helpful tools to develop pricing for integrated care and community-based services. It covers pricing structures, how to set a price, and other pricing strategies.

This is a technical report about the supports and services that people with IDD receive through the State IDD agency. In addition to the report, there are state profiles, which describe status and trends for each state in the country, and a chart gallery, which is an interactive tool to view detailed data by state, year, and funding authority. Topics include ICF/IID and Medicaid Waiver recipients, expenditures and expenditures per person from 1977 to 2015.

This report reviews federal health and housing policies, noting the barriers created that seniors with clinically-driven housing insecurity must navigate. It also reviews a series of initiatives that ACAP members are undertaking to address housing as a social determinant for this vulnerable population, with examples from California, Ohio, and North Carolina.

The AAHD Health Promotion Resource Center for People with Disabilities is intended to provide visitors with current and valuable information about multiple aspects of health promotion and wellness for people with disabilities.

This paper discusses the long-term services and supports landscape; individuals who work with a direct service worker; the direct service worker profession; the direct service worker shortage; challenges for individuals served by direct service workers; and pathways to improvements.

This paper provides direct insights from managed care leaders about family caregiver supports and provides examples of how progressive managed care plans are supporting family caregivers who are caring for plan members with LTSS needs. The paper discusses how it is important to understand and address family caregivers’ roles and their needs in order to have a high-performing LTSS system, because the family provides the lion’s share of LTSS to people who need help.

This fact sheet outlines strategies to help Medicaid stakeholders encourage partnerships between community-based organizations and health care organizations. States can provide: (1) financial support to build and sustain program capacity; (2) assistance in identifying metrics for evaluation; (3) incentives to providers to address social determinants of health; and (4) use of policy levers, including value-based contracts, managed care organization regulations, and state plan amendments.

This issue brief from the Kaiser Family Foundation discusses four key issues related to long-term services and supports (LTSS), including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years. The brief also includes data about LTSS providers and consumers, summarizes key federal laws and policies related to quality, and lists selected federal quality measures.

Presentation from the Aging and Disability Business Institute that provides practical strategies that can enable CBOs to establish positive working relationships with physician groups, hospitals and health plans.