Perspective
Ongoing quality management and review of disability benefit evaluation processes and procedures is critical for state and municipal retirement systems. Working with a partner skilled in assisting organizations with all aspects of medical review needs can ease the burden, says Jody Simpson of Disability Evaluation Services.
Building a successful Long Term Services and Support program starts with creating strong clinical guidelines, says Jessica Carpenter, Senior Director of Disability and Community Services. The goal is ensuring individuals receive the right service, in the right setting, and at the right time.
Robert Seifert of the Center for Health Law and Economics discusses the Indiana Medicaid Waiver, which was recently approved for a three year extension by the federal government.
Extensive evidence shows that Community Health Workers (CHWs) can help health systems meet the triple aim: improve population health, improve quality of care and contain costs, while also promoting health equity and community engagement. Katharine London discusses how new payment methods and delivery system reforms give health care providers flexibility to provide sustainable funding for CHWs.
Kentucky’s 1115 Medicaid Waiver, approved by CMS on January 12, 2018, uses small financial incentives and punishments to try to change the behavior of enrollees. Rebecca Laes-Kushner explains this new Medicaid setup.
Disability evaluation can be a challenge for state and municipal retirement system administrators. Jody Simpson of Disability Evaluation Services explains how Commonwealth Medicine, UMass Medical School is uniquely equipped to help support systems through all components of the medical review process.
Jessica Carpenter discusses why states should guarantee contracts for Managed Long-Term Care plans include requirements for policies, guidelines, and processes that will provide the appropriate services to members, manage utilization, and ensure the state’s funding is used appropriately.
As the elder population continues to grow, it becomes more important to consider the future of health care. By 2050, the population over the age of 65 will double and the population over the age of 85 will triple; and many will need long-term services and supports (LTSS).
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