National Senior Services Data Survey · 2/16/2011 · • A desire to integrate information across...
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www.nasuad.org November 2, 2016 National Senior Services Data Survey National Information & Referral Support Center Webinar Damon Terzaghi Senior Director NASUAD
Transcript of National Senior Services Data Survey · 2/16/2011 · • A desire to integrate information across...
www.nasuad.org
November 2, 2016
National Senior Services Data Survey National Information & Referral Support Center Webinar
Damon Terzaghi Senior Director
NASUAD
Senior Services Data Study Project Background
Project Description: The National Association of States United for Aging and Disabilities (NASUAD) in collaboration with the Colorado State Unit on Aging (SUA) will partner on a study of data and outcome measures that improves the SUA’s ability to report on the impact and value of services provided to older adults.
– Identify data points – Methods of data collection – Necessary data systems
• Two parts to the project: – Colorado-specific interviews and analysis; – National Data Study on outcomes measurements
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Why Study Data Systems Now? • Demographics shifting and fast growing senior population • Increased focus on pre-eligible for Medicaid population and
in prevention • Increasing Medicaid Budget as Proportion in State Budgets • U.S. Assistant Secretary on Aging’s challenge to states to
diversify funding streams • New models of care through the Affordable Care Act
including health care homes, medical homes, Accountable Care Organizations.
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Overview of National LTSS Survey
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Methodology
• Survey drafted by NASUAD staff with input from the Colorado Aging Data Outcomes Advisory Committee (CADOAC) and multiple partners
• Survey was beta-bested with three states • Survey administered from June 22nd through July 31st
2016 • 42 state responses
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Core finding: Close to 60 percent of states lack reports on outcome measures
Yes 42.5%No 57.5%
Suggestions for Measuring Outcomes
• Administering consumer satisfaction surveys • Charting services and progress to a baseline and when
services are provided compare ER visits, length of stay in own home, or good community engagement
• Interviewing people every few months about quality and their ability to stay in their own homes
• Using National Core Indicators—Aging and Disabilities (NCI—AD)
• Monitoring health outcomes as in PACE model • Starting services with a more robust assessment of
wellbeing with periodic follow up assessment • Surveying consumers on progress for 2 to 5 years after
first contact
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Mediware PeerPlace State created Other, please explain
Which Data System(s) or Application Does Your State Use to Collect, Store, and Analyze
Information on Consumers in Your OAA system?
Num
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When asked what functions states would like to add to their OAA data systems, states mentioned the following:
• A desire to integrate information across multiple HHS
programs, including OAA, Medicaid, and Medicare; • The need to include additional information within the agency’s
database, including data regarding service authorizations, assessments, eligibility, claims data, and participation in other HHS programs;
• Additional reporting capacity and functionality, such as the ability to analyze caregiver characteristics or to stratify data by specific geographic regions; and
• Increased ability to track the provision of OAA unregistered services.
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Most states do not have a common database that includes information
from multiple programs
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0
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States that have Integrated Databases include the Following Programs
Num
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0
2
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6
8
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14
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Participantassessment
Servicesauthorized
Services provided Service rate Claimsinformation
Types of data stored in single IT system
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Close to 40 percent of states reported having an integrated system that collects and stores assessment data, services data, and/or payment data for multiple programs
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Does Your States Information System Share Data with Other State Health and Human Service Programs?
YesNoOther, please explain
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Programs Included in Data Sharing N
umbe
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0 5 10 15
Participant program eligibility (i.e. which programs the personis eligible for)
Participant eligibility information
Provider enrollment information
Provider licensure information
Provider claims and/or payment information
Provider sanctions or citations
Person-centered care plan
Other, please specify:
Types of Data Shared Number of states
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5
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15
20
25
30
35
Yes No
Does your state have a comprehensive statewide, web-based database that consumers can use to locate a provider?
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Yes No
If yes, does your database contain information on quality of care or beneficiary satisfaction?
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Num
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30
States with Access to Medicare Encounter/Claims Data
Yes No
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States that Link Medicare Data to Participants in Medicaid and/or OAA
Yes No
7
2
Programs with Medicare Data Linked to Participants
Medicaid OAA
www.nasuad.org
Differences in System Design Cause Challenges with Data Comparison
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30
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Single Entry Point No Wrong Door ADRC None
State Establishment of SEP, NWD, and ADRC N
umbe
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1 1
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States with all threemodels
States wityh NWD andADRC
States with SEP andNWD
States with SEP andADRC
States with only onemodel
States with none of themodels
Status of Multiple Intake Models N
umbe
r of s
tate
s
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
5
10
15
20
25
AAA ADRC CIL Countyeligibility/welfare office
State Medicaid Agency State Human ServicesOffice
Other
Number and Percent of LTSS Entry Systems Operating in Selected Locations
SEP NWD ADRC SEP (Percent) NWD (Percent) ADRC (Percent)
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
5
10
15
20
25
30
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Older adults (age60+)
Adults (age 18-64)with physicaldisabilities
Adults (age 18-64)with intellectual
and/ordevelopmental
disabilities
Children withphysical disabilities
Children withintellectual and/or
developmentaldisabilities
Individuals withbehavioral health
conditions
Individuals withtraumatic brain
injuries
Other
Number and Percent of LTSS Entry Point Systems Serving Selected Populations
SEP NWD ADRC SEP (Percent) NWD (Percent) ADRC (Percent)
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
5
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20
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Number and Percent of LTSS Entry Systems that Include Selected Programs
SEP NWD ADRC SEP (Percent) NWD (Percent) ADRC (Percent)
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10
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Only 25 Percent of States Have a Shared HCBS Taxonomy for OAA and Medicaid
Yes 24.4%No 75.6%
Measuring Quality Over half of states (64 percent) indicated that they are participating in one or more HCBS quality initiatives, including TEFT, NCI, NCI-AD, or state consumer surveys.
State responses indicated a strong focus on participant satisfaction, with less of an emphasis on quantitative analysis.
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18 Medicaid consumer satisfaction
Medicaid quality of life
Medicaid quality of care
States Collect Data on Medicaid Consumer Satisfaction, Quality of Life, and/or Quality of Care
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5
10
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20
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30Non-Medicaid LTSS consumer satisfaction
Non-Medicaid LTSS quality of life
Non-Medicaid LTSS quality of care
States That Collect Data on Non-Medicaid LTSS (including OAA) Consumer Satisfaction, Quality of Life, and/or Quality of Care
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0
2
4
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8
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Total inpatienthospitalization
Avoidablehospitalizations
Placements in long-term care facilities
Length of stay inLTC facilities
Chronic diseasemanagementparticipation
Clinical utilization datafor Medicaid LTSS
Clinical utilization datafor Non-Medicaid LTSS
Number of States Indicating They Collect Clinical Utilization Data for Medicaid and Non-Medicaid LTSS Services
Num
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Does Your Agency Have the Following Data Available for Medicaid Waiver and/or Non-Medicaid LTSS Services?
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Information Collected Available for Medicaid Available for OAA
Waiting list (number of individuals) 27 25
Waiting list (time between application and eligibility determination) 23 14
Average wait time between application and enrollment 22 14
Number of persons who received services within 30 days of applying or enrolling 24 15
Number of persons with a wait time for services exceeding 30 days from application/enrollment
24 16
Close to 60 percent of State
Respondents Report Using Information on Licensing, Citations,
or Sanctions to Monitor Participant
Safety, Health Outcomes, and/or
Quality of Care
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Yes 51.4%
No 48.6%
50 percent of states use these data for quality improvement efforts
Key Takeaways 1. A Number of States and Federal Entities are Seeking to
Improve Outcomes Measurement 2. Current State Data Collection Efforts are Driven by
Mandates and Funding Sources/Constraints 3. Lack of Integrated Systems Limits the Ability to Track
Outcomes Across the Country 4. Definitions of Systems and Services Vary, Causing
Challenges with Information Comparison 5. Additional Effort is Required to Measure Outcomes instead
of Process 6. Further Investment in Data Collection Systems is
Necessary to Improve Outcome Measurement
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For more information, please visit: www.nasuad.org
Or call us at: 202-898-2578
Damon Terzaghi [email protected]
