According to the U.S. Bureau of the Census, the 60 and over population has steadily increased each year. Many of our elders participate in Medicare and/or Medicaid programs. With escalating health care costs, spending for this population has significantly increased. And the need for services, particularly in the area of long-term services and supports (LTSS), will continue to rise as our aging population grows.
We can help public programs and health care organizations ensure elderly beneficiaries receive the most clinically appropriate and cost-efficient package of services.
- Assisting public agencies by identifying and maximizing payments from Medicare and other third-party insurers
- Guiding service delivery reform for individuals eligible for both Medicare and Medicaid
- Working with public agencies to identify opportunities to access other Medicaid funding mechanisms, including state plan amendments, waiver and demonstration programs, which may help states access additional federal revenue like the Balancing Incentive Program
- Helping clients develop appropriate models of care including designing clinical assessment tools and processes to evaluate needs, developing eligibility and authorization approaches, as well as training providers on new initiatives
In one particular innovative approach, we collaborated with the Massachusetts Executive Office of Elder Affairs to develop the LTSS Policy Lab, a business intelligence solution. This helped deliver a more comprehensive view of the state’s elder population, and the connection between LTSS and the length of time elders are able to remain living in the community.
Other examples of our work with the Executive Office of Elder Affairs include:
- Helping local communities develop resident registries for the Silver Alert Community Resource Program, which contains information on individuals who have dementia, and are a resource for police departments if one of those individuals goes missing
- Providing operational support for the Massachusetts Prescription Advantage program, a pharmaceutical assistance program serving 57,000 members
- Supporting the MassOptions program – a 7-day a week, free resource for the elderly, individuals with disabilities and their caregivers, aimed at simplifying access to LTSS