A major policy concern for state Medicaid programs is a rapidly aging population that is poorly positioned to pay for long-term care needs without public assistance. When an individual can no longer live independently and meets criteria for nursing facility admission, Medicaid will pay for long-term care once other assets are spent down.
To help stem these rising costs, UMass Medical School partnered with the Massachusetts Executive Office of Elder Affairs (EOEA) in 2012 to develop a customized data solution to analyze longitudinal data sets with the goal of determining the value of home and community-based services provided to an elderly population. We are integrating Medicaid data with six years of Medicaid Waiver, state home care program, and Title III service delivery data. Data sources contain enrollment, case management, assessment, claims, financial, and census data. Through this work, we are able to:
- Provide operational data to improve decision-making on the part of independent agencies responsible for case management.
- Develop a set of analytical reports that can be used to determine the value of home and community-based services and inform policy-makers.
In July 2014, the Massachusetts state legislature authorized and funded a Home and Community-Based Services Policy Lab to study the outcomes and effectiveness of public investment in the system. Early results indicate that linking multiple data streams can give stakeholders a better understanding of population health and costs.
It is essential for fiscal health nationwide for states to have the capacity to aggregate medical, diagnostic, demographic, functional assessment, and community services data to make informed policy decisions that both improve health outcomes and manage rising costs. This project highlights the important role Academic Medical Centers play by leveraging their knowledge of clinical care, health care systems, analytics, training, and research to develop and improve Medicaid policies and programs and solve health systems issues.