Addressing the Challenge: Public and Private Solutions for Long-Term Services & Supports Long-Term...

Addressing the Challenge: Public and Private Solutions for Long-Term Services & Supports

Long-Term Care Financing Advisory Committee Meeting

October 15, 2009For Advisory Committee

Policy Discussion Purposes

University of Massachusetts Medical School EBD Consulting

Services, LLC 2

Outline of the Presentation

Public Awareness Campaign Informal Caregiver Supports Setting the Stage for Comprehensive Reform

Goals and Principles Review of the Challenge

Solutions that hold Promise for Massachusetts The Long-Term Care Partnership Program (LTCP) The Contribution Program Cost & Impact Analysis MassHealth Data & Analysis

Committee Business

10/15/09 For Advisory Committee Policy Discussion Purposes

Public Awareness CampaignA public awareness campaign to increase

understanding of LTS options & financing

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For Advisory Committee Policy Discussion Purposes

Why Encourage Adults to Plan for LTS?

Complement other statewide I&R activities Address public concern that the demand for

LTS will exceed available resources• Educate about shared public/private responsibility

Improve quality of life in later years• Support individual preferences, choice and dignity• Enable families to support aging relatives

• Encourage proactive LTS planning• Help future generations to maintain financial security • Avoid/reduce Medicaid costs

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Elements of CMS Campaign

State role Solicit Governor’s buy-in Pay for initial mailing of

letter/brochure Issue press release/ hold

press conference Other activities as desired

TV, radio ads Educational sessions Website-800AGEINFO

CMS role Print Governor’s letter/

brochure Arrange initial mailing Produce toolkit (booklet/CD) Staff call center Distribute toolkit to callers

(including mailing charges) Provide technical

assistance & other materials

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Campaign Materials

Governor’s Letter

Brochure

Booklet and CD

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Chapters of Campaign Booklet Introduction Embrace the future! Where should I start? Lifestyle planning Legal and estate issues Staying at home Financial Planning for

LTS

LTC Insurance Reverse Mortgages Additional options

available in Mass Planning for your Care For more information

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Planned activities

Initial Mailing • Approximately 450,000 households

Other components• TV/radio ads• Educational sessions• Website

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Next Steps & Timetable Finalize campaign materials 10/23/09 Solicit Governor’s Buy-in 11/01/09 Print materials 12/15/09 Update 800AGEINFO Website 12/30/09 Launch campaign 1/15/10

Governor’s press conference Public service ads Initial mailing & responses

Regional educational sessions 4/10-6/10 Campaign funding ends 9/30/10

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Informal Caregiver Support

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Informal Caregivers provide an immense amount of LTS in Massachusetts Informal Caregivers provide about 36% of the LTS received by

elders nationally1

In Massachusetts, there are about 690,000 informal caregivers of people of all ages at any given time, and about 1,040,000 at any time during the year2

These caregivers provide the equivalent of $8.9 billion worth of care Nationally, 17% of informal caregivers provide 40+ hours per week

of care, 8% provide 21-39 hours, 23% provide 9-20 hours, and 48% provide 8 hours or less3

1 Hagen, S. Financing Long-Term Care for the Elderly, Congressional Budget Office, April 2004.2 National Family Caregivers Association & Family Caregiver Alliance. (2006). Prevalence, Hours and Economic Value of Family

Caregiving: Updated State-by-State Analysis of 2004 National Estimated by Peter Arno, PhD. Kensington, MD & San Francisco, CA: FCA.

3 National Alliance for Caregiving and AARP. Caregiving in the U.S. Bethesda: National Alliance for Caregiving, and Washington, DC: AARP, 2004.

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The majority of Informal Caregiver supports are currently offered through Elder Affairs

* Respite is also disparately available through MRC and its SHIP program, MCB, and DDS

Types of Program Program Agency

Training and Support including counseling, support groups, and training

Family Caregiver Support Program

Elder Affairs

Information and Assistance, programs that assist caregivers in accessing supports in the community


800-AGE-INFOMADIL

Elder Affairs

Elder AffairsEOHHS

Respite* programs that provide informal caregivers with a break from their caregiving responsibilities


Home Care Respite ProgramHCBS Waivers

Elder Affairs

Elder AffairsMassHealth with Elder Affairs, DDS, MRC

Other Programs that can provide support to informal caregivers including financial assistance

Adult Day Health and Supportive Day

PCA (by paying family members)AFC (by paying family members)

Elder Affairs & MassHealth

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Given the number of Informal Caregivers in the state, very few are receiving publicly-funded services

Sources: Executive Office of Elder Affairs and MassHealth.1 Family Caregiver Support program expenditures include federal Title III-E, state and local funds. 2 FCSP utilization numbers are the only ones that are unduplicated. 3 Does not include DDS Expenditures

Programs that offer Caregiver-Specific Services

State Expenditures

Utilization2

Family Caregiver Support Program1

In-Home & Other Respite $611,500 1,046

In-home counseling, Support Groups, & Caregiver Training

$1,960,000 7,049

General Information and Referral $1,300,000 13,449

Home Care Respite Program $6,800,000 30,696

Elder & TBI Waiver $41,4443 134

Totals $10,712,944 52,889

Additionally, DDS provided 515 “respite opportunities” in 2009.

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There are other services that support Informal CaregiversAdult Day Health: provides daily respite for caregivers. No data

collected by MassHealth on how many participants have caregivers. FY08: $62,700,000 6,998 MassHealth clients in FY’09 - 923 in Complex level of care, which

means they meet NF LOC, and are therefore likely to have caregivers at home

Adult Foster Care: allows family members to be providers, paying them for providing care for individuals who live in their home. No data collected on how many providers are family members.

Personal Care Attendants (PCA): Allows clients to hire family members as PCA. In the past year, 5,005 PCAs were hired family members, which is 19% of

all PCAs hired.

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Training Informal Caregivers reduces other LTS costs

In one key study, training and support programs created a median delay in nursing facility placement of 577 days, or 1.5 years*

A randomized 17-year-long study of 406 spouse caregivers of individuals with Alzheimer’s Disease

Intervention was two individual and four family counseling sessions tailored to specific situation, encouragement of support group participation, and the availability of ad hoc telephone consultation.

* Mittelman, M.; Haley, W.; Clay, O.; Roth, D. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology 2006;67(9):1592-9.

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Paying Informal Caregivers could address a number of issues related to LTS financing

Decrease other LTS costs1

Increase pool of possible workers Expand access to LTS for rural areas Raise questions about familial responsibility and

substitution of care

1 Dale, S., and Brown, R. Reducing Nursing Home Use Through Consumer-Directed Personal Care Services. Medical Care. 44(8):760-767, August 2006. Brown, R., Carlson, B., Dale, S., Foster, L., Phillips, B., and Schore, J. “Cash & Counseling: Improving the Lives of Medicaid Beneficiaries Who Need Personal Care or Home and Community-Based Services.” Princeton, NJ: Mathematica Policy Research, Inc., August, 2007

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Possible Short-Term Actions to improve Informal Caregiver Supports Increase awareness, and therefore utilization, of existing

supports through increased outreach and education

Understand whether and why many caregivers do not get information they need and can use about available supports

Encourage implementation of evidence-based programs for caregivers of people with disabilities across the lifespan

Press for full funding of the National Lifespan Respite Care Act

Press for increased funding for National Family Caregiver Support Act

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Setting the Stage for Comprehensive Reform


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CF Olmstead Plan goals1. Help individuals transition from institutional care.

2. Expand access to community-based long-term supports.

3. Improve the capacity and quality of community-based long-term supports.

4. Expand access to affordable and accessible housing with supports.

5. Promote employment of people with disabilities and elders.

6. Promote awareness of long-term supports.

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LTC FAC Advisory Committee goalTo identify and prioritize short-term and long-term strategic

options for reforming the financing system for LTS for elders and individuals with disabilities in Massachusetts to support a range of LTS and a sustainable mix of personal and familial responsibility, private financing mechanisms and public assistance in a manner that:

maximizes independence; and assures access to the necessary continuum of LTS.

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CF Olmstead Plan principles1. People with disabilities and elders should have access to community

living opportunities and supports.

2. The principle of “community first” should shape policy development and funding decisions.

3. A full range of long-term supports, including HCBS, housing, employment opportunities and nursing facility services, are needed.

4. Choice, accessibility, quality, and person-centered planning should be the goals in developing LTS.

5. Systems of community-based care and support must be strengthened, expanded and integrated to ensure access/efficiency.

6. Public and private mechanisms of financing LTS must be expanded.

7. LTS must address the diversity of individuals with disabilities and elders in terms of race, ethnicity, language, ability to communicate, sexual orientation, and geography.

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LTS Financing Principles (Draft 2)The reformed LTS financing system will:

1. Ensure a strong public safety net for the poor and most vulnerable.

2. Limit financial pressure on the state financing system so that state funds are preserved for those most in need.

3. Encourage personal responsibility for financing LTS to the maximum extent possible.

4. Enable middle income people of all ages to access the LTS they need without becoming impoverished.

5. Ensure appropriate participation of and support for informal caregivers.

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Other Olmstead Plan and Community First Activities

Olmstead Plan objectives available online at www.mass.gov/hhs/communityfirst

December meeting will include discussion of related activities around the following topics: Transportation Employment Housing Workforce Development Care Integration Information and Awareness Consumer Choice / Self-Direction

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People with LTS Disabilities who need assistance with Self-Care or Every Day Tasks

*Does not include persons who were: institutionalized, in military group quarters or college dormitories, or unrelated individuals < age 15. Source: 2007 American Community Survey (ACS), US Census Bureau, tabulations by authors.

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Need for LTS Resources (Informal and Financial) Depends on Time in Need AND Type of Services UsedSimulated Distribution of Years of LTSS Need at 65

Kemper (2005)10/15/09 25


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Distribution of LTSS SpendingSimulated for 65-year-old (2004)

Kemper (2005)10/15/09 26


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Low High

FINANCIAL RESOURCES

High

LTSNEED

Low

Medicaid & Other State

Programs Personal Resources(includes Informal Caregivers)

Medicaid Spend-down

Current LTS Financing System

LTC Insurance

State Programs

10/15/09


Zero in on the Challenges

The Elderly Substantial Need: 68% of the Elderly Need Care Medicaid is the Only Option for Many Private LTC Insurance is Unaffordable for Low/Middle Incomes Middle Income Spend Down to Medicaid Upper Income fare best today Limited community-based care

The Under 65 Disabled Private LTC Insurance is an option only before become disabled Limited community-based care MassHealth CommonHealth is only option for many

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Solutions That Hold Promise For Massachusetts





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Today’s Presentation for the LTC FAC

Responds to the Goals of the Advisory Committee Responds to the LTS Financing Principles of the Committee Introduces Public & Private Models to Finance LTS Recommends a Model for Massachusetts

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How to Evaluate Each Model

Target Population How many people will benefit from the model? Who will not benefit?

Benefit Coverage What benefit does the model offer? Does it meet the need? How much long-term services & support coverage does it provide?

Costs (Costs and Savings Impact Analysis) Who bears the costs? Is it cost effective?

Is this a solution for today or tomorrow?

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Cut to the Chase: There is No Silver Bullet!

Each existing model leaves someone out

Existing models offer partial solutions

Our Challenges: How can we design our model to achieve our goals? Can we combine models to improve coverage? How can we improve upon existing models?

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Preview: Where we might end up

A Complementary approach Private Insurance:

Expand to Middle Income people Public Insurance:

Meet the Challenge of Covering Disabled & Middle Income people Medicaid: Adjust to fill gaps

Massachusetts as a State Laboratory Massachusetts embraces its role as a State Laboratory for Change Take what exists and improve upon it Start small

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Two Models that Hold Promise for Expanding Coverage

Two Models to Insure the Elderly & Disabled Privately sponsored: The LTC Partnership Program Publicly sponsored: The Contribution Program

“Walk-Through” of Each Model Background Key Bullets The Pros & Cons of Each Model Changes for Massachusetts Where does it leave us?

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Privately Sponsored: The LTC Partnership

Private Insurance for Long-Term Care (or LTS) Focused on currently healthy people planning for future LTS need Represents an alliance between State Government & Private Industry RWJF 1988 grants to states

Goals of the LTC Partnership Program Reduce Medicaid LTC Costs Protect Consumers from Impoverishment & Protect some/all assets Offer Consumers “back-end” protection: “Asset Disregard Incentive” Connecticut Case Study: An Early Pioneer in the LTC Partnership

Handout: “Connecticut Case Study: 101,”Prepared for Committee Meeting, 10/15/09

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The Connecticut Case Study: Key Bullets

Who wins? Upper Income Persons Lower out of pocket costs for those who use care

Who loses? Middle Income and Disabled Persons Left Out

What about the costs and savings? The Verdict is Out on Medicaid Savings Program is solvent, so far

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Long Term Care Insurance Participation

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More people in Connecticut have LTC Insurance than in Massachusetts (includes group policies)

Connecticut MassachusettsPartnership 33,450 Non-Partnership 74,000 Total w LTC Insurance 107,450 152,051

% Adult Population (21+) with LTC Insurance 4.3% 3.2%

% Population 55-74 with LTC Insurance 17.5% 13.6%



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The Connecticut Case Study: Pros & Cons

The Pros of the Model Long-running program, 17 years & an experienced Director Great Consumer Protections Great Insurance for Upper Income

Comprehensive Care Policies (high premium cost) “Dollar for Dollar” Coverage/Asset Protection Lower out-of-pocket costs

The Cons of the Model Low rate of participation (unaffordable to many) Benefits accrue to Upper Income Elderly Persons Middle Income & Disabled left out of the program Consumers find the purchase decision to be a complex one Limited Portability

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Premiums Must be More Affordable for Middle Income

Higher income people buy LTC insurance (green) We need to make LTC insurance affordable for middle income (yellow)

A % FPL 100% 200% 300% 400% 500% 600% 1000% 2000%FPL (1) 10,836$ 21,672$ 32,508$ 43,344$ 54,180$ 65,016$ 108,360$ 216,720$ FPL (2) 21,672$ 43,344$ 65,016$ 86,688$ 108,360$ 130,032$ 216,720$ 433,440$

B AgeCT Premium for 1 Policyholder Connecticut Annual Premium as a Percentage of Annual Household Income:

25 2,122$ 19.6% 9.8% 6.5% 4.9% 3.9% 3.3% 2.0% 1.0%35 2,410$ 22.2% 11.1% 7.4% 5.6% 4.4% 3.7% 2.2% 1.1%45 2,662$ 24.6% 12.3% 8.2% 6.1% 4.9% 4.1% 2.5% 1.2%55 3,129$ 28.9% 14.4% 9.6% 7.2% 5.8% 4.8% 2.9% 1.4%62 4,280$ 39.5% 19.7% 13.2% 9.9% 7.9% 6.6% 3.9% 2.0%

67 6,079$ 56.1% 28.1% 18.7% 14.0% 11.2% 9.4% 5.6% 2.8%72 9,496$ 87.6% 43.8% 29.2% 21.9% 17.5% 14.6% 8.8% 4.4%77 15,323$ 141.4% 70.7% 47.1% 35.4% 28.3% 23.6% 14.1% 7.1%82 22,589$ 208.5% 104.2% 69.5% 52.1% 41.7% 34.7% 20.8% 10.4%85 28,848$ 266.2% 133.1% 88.7% 66.6% 53.2% 44.4% 26.6% 13.3%

C MA Population est'd 9% 12% 13% 66% ========================================>MA Population est'd 34% ==================> 26% ==================> 40% =========>

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Low High

FINANCIAL RESOURCES

High

LTSNEED

Low

Medicaid & Other State

Programs

Medicaid Spend-down

LTS Financing System With LTC Partnership Program

Personal ResourcesConsumer ProtectionsInformal Caregiver Support

LTC InsuranceLTC Partnership

State Programs

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Where does the LTC Partnership Program Leave Us?

It will not meet everyone’s needs Those with current LTS needs or current chronic conditions Low income people who cannot afford to pay premiums

But with changes, it can be effective: Middle to Upper Income Individuals who can afford to pay premiums over a long period of time Healthy individuals who may need LTS in the future

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The Connecticut Case Study: Changes for Massachusetts

Prerequisite: Must enact NAIC Model Act Implement consumer protections

What would we want to do differently? Target middle income persons who are at risk to spend down

Question to FAC: Are these the design features we want to work on? Target middle income population Encourage more people to buy, and at a younger age Create an affordable benefit package Make purchase decision easy for consumers Consider incentives?

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Publicly Sponsored: The Contribution Program

Public Model for LTS A contributory program for paying for the cost of LTS Everyone included (large risk pool) Federal Plan Supported by Senator Kennedy, AAHSA Federal plan included in 2 out of 3 National Health Care Reform bills

(House & HELP; CBO scores as a savings)

Goals Provide some coverage in affordable way Offer consumers a life-time benefit for some of their future LTS needs Meets some – not all – of a person’s needs Spread the risk broadly across all persons, no health screen Example: The CLASS Act

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The CLASS Act: Key Bullets

Cash benefit

Everyone is included, with voluntary opt out

Vested in 5 years: People with current needs can begin drawing benefit in 5 years.

Portability from state to state

Big commitment on the part of the government to provide LTS financing over the long-term

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The CLASS Act: “Skinny” might be OK for some

Age 55 in 2009 Premiums = $65/Month = $780/Year Premiums are very likely to be raised over time Benefit = $50/day or $100/day (used $75, here)

Age 75 in 2029 Benefit = Assumes $75 cash daily/benefit in 2009 at 5% compounded

inflation

Premium Payments from 2009-2029

CLASS Benefit in 2009

CLASS Benefit in 2029

Monthly/Daily $ 65 $ 75 $ 199

Annual $ 780 $ 27,375 $ 72,635

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The CLASS Act: Solvency of a Contribution Program

Premiums must be sufficient to fund the program

Questions about the Solvency of the Program $65 may not be sufficient in the long run AAHSA: Yes, program is solvent CBO: Maybe, in the middle American Academy of Actuaries: No

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The CLASS Act: Pros & Cons

The Pros of the Model Everyone gets something Cash benefit based on need Complements other plans for LTC Benefits do not count against Medicaid eligibility Great way to provide some coverage for middle income individuals Great way to provide some coverage for disabled individuals

The Cons of the Model Concerns about sustainability over long-term Younger persons and/or upper income persons may opt out Lower rates of participation lead to adverse selection Program is viewed as serving “all” the needs Benefit too “skinny”

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Low High

FINANCIAL RESOURCES

High

LTSNEED

Low

Medicaid (Enhanced)& Other State Programs

LTS Financing System with Contribution Program Only

Contribution Program

Personal Resources(includes Informal Caregivers)

State Programs

LTC Insurance

Medicaid Spend-down

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Where does the Contribution Program Leave Us?

It will not meet everyone’s needs Those with current LTS needs or current chronic conditions Low income people who cannot afford to pay premiums

But with changes, a Limited Cash Benefit can: Address the need for home- and community-based care Individually-tailored needs that are not presently covered by insurance

or Medicaid Support the informal care network

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The CLASS Act: Changes for Massachusetts

What would we want to do differently? Ensure solvency over many years Ensure high participation levels

Question to FAC: Are these the design features we want to work on? Lower premium contribution for low income individuals Portability for individuals who move to another state Pair benefit with Medicaid Asset Protection? Consider other incentives? Consider a mandatory program?

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Model Comparisons (Part 1 of 2)

Title: Partnership for Long-Term Care

Title: The CLASS Act

“Enhance Private Insurance” “Create Contribution Program”

Description Private Insurance Public Insurance Trust, could serve as a complement to Private

Insurance and/or MedicaidParticipation

Voluntary purchase Voluntary (opt out)

Target Population

Those who can afford a long-term care insurance policy and with assets to protect, meet health

screen

Workers age 18+ eligible to enroll; Can continue to be in the plan after retired (need to keep

paying premiums)Covered Covers Elderly and Adults

who buy before become disabledCovers both Elderly and <65

DisabledUniversity of Massachusetts

Medical School EBD Consulting Services, LLC 5110/15/09


Model Comparisons (2 of 2)

Title: Partnership for Long-Term Care

Title: The CLASS Act

“Enhance Private Insurance”

“Create Contributory Program”

Excluded Low income who cannot afford premiums, middle income whose out of pocket costs

would erode asset protection; disabled and others who fail to

meet the health screen

Persons too poor to pay “regular” premiums or too

“rich” for “subsidized” premium; also, persons with certain cognitive functional

limitations that fail to meet the test (triggers follow HIPAA

rules)

Health Screen Yes NoRisk/Selection Potential for “cherry picking” Potential for “adverse

selection”

Benefit 99% of policies are comprehensive, including both

NF and HC

$50 or $100 per day




A Complementary Public-Private Model

A Complementary approach Private Insurance:

Expand to Middle Income people Public Insurance:

Meet the Challenge of Covering Disabled & Middle Income people Medicaid: Adjust to fill gaps

Massachusetts as a State Laboratory Massachusetts embraces its role as a State Laboratory for Change Take what exists and improve upon it Start small

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Low High

FINANCIAL RESOURCES

High

LTSNEED

Low

Medicaid (Enhanced)& Other State Programs

Medicaid Spend-down

LTS Financing System with LTC Partnership AND Contribution Program

Contribution Program

Personal ResourcesConsumer ProtectionsInformal Caregiver Support

LTC InsuranceLTC Partnership

State Programs

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Next Steps & Timeline

Cost & Impact Methodology

MassHealth Data

November Meeting

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Highlights of Cost & Impact Methodology

Population Benefits Premiums/Costs Assumptions Assessment

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Cost & Impact Methodology & AnalysisMethodology for Analyzing and Costing out the Long-term services and support options

Step 1 Develop Baseline Costs of Current & Future Need, including Medicaid and State Programs

Population

Benefit Coverage

Step 2 Define Population Assumptions

Target Populations & Participation Rates

Step 3 Define Benefit/Programmatic Assumptions

Define Benefit

Establish Rules of the Program, e.g. no drop outs, all healthy at start of program,

Outline details, e.g. Number of years to compute, balance, benefit trigger, daily benefit

Step 4 Calculate Premium Collections

Step 5 Assess Impact on Other Financing Sources

Consumer Out of Pocket

State Programs, including Medicaid

Informal Care

Step 6 Perform Sensitivity Analysis by modifying assumptions

Modify Participation rates, e.g. changing benefits, introducing other incentives

Modify Risk Pool (range of risk - from cherry picking to adverse selection)

Step 7 Assess Model in terms of Meeting Goals

Burden on Medicaid Budget & Role of Government Programs

Effect on Consumers (Spend down/Asset Protection)

Adequacy of Benefit to Meet Needs of Consumer

Step 8 Confirm Solvency of Program

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MassHealth Data & Analysis

Review Population and Spending What we know about the Populations What we know about MassHealth Spending

How to Collect & Analyze MassHealth Data Examine populations by income, etc. Examine costs by type of LTS

External Data Sources

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A Quick Review of the Challenge:LTS Cost Pressures in Massachusetts

Numbers Illustrate Cost in 20 Years from Today MetLife Survey

Average Annual Nursing Home

Average Annual Assisted Living Costs

Home

Home Care Average Annual rate (5 hrs/week)

Home Care Average Annual rate

(20 hrs/week)

2008

Massachusetts 110,230$ 50,304$

National Average 77,380$ 36,372$ 5,200$ 20,800$

2028 (in 20 years)

Massachusetts 292,473$ 133,471$

National Average 205,312$ 96,506$ 13,797$ 55,189$

Source: The MetLife Mature Market Institute Survey of Nursing Home and Assisted Living Costs in 2008

Notes: Massachusetts is compared to the National Average, and also to Connecticut, since we

examine the Connecticut Insurance Partnership for Long-Term Care in this presentation.

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LTS Costs Unaffordable for Many

Massachusetts - 3 years in a Nursing Home in 2029 will run close to $900K

The Cost of Care in Massachusetts Home Care Nursing Facility Care

Age 55 Today (2009), daily rates 151$ 302$ Annual Cost 55,115$ 110,230$

Age 75 20 years (2029), daily rates 401$ 801$ Annual Cost 146,237$ 292,473$

In 20 years time, at age 75, if you need LTC care:

1 year 365 146,237$ 292,473$ 2 years 730 292,473$ 584,946$ 3 years 1,095 438,710$ 877,419$

4 years 1,460 584,946$ 1,169,892$ 5 years 1,825 731,183$ 1,462,365$

Can you afford the care? 25,000$ 100,000$

Age Year 5.0% 5.0%55 2009 25,000$ 100,000$ 75 2029 66,332$ 265,330$

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MassHealth Data: Members

Summary of MassHealth Population with Long-Term Stay, in FY 2008

Average MembershipDual Medicaid Only Total

21 - 59 2,404 1,371 3,775 60 - 64 908 515 1,423 65 + 28,879 710 29,589 Total 32,191 2,596 34,787 Ratio Dual:Medicaid Only 93% 7% 100%

65+ 90% 27% 85%Under 65 10% 73% 15%Total Member Months

Source: EOHHS data run June 11, 2009.

Notes: Data includes all MassHealth members on Standard FFS who had a long-term stay defined as 90+ days in a particular facility.

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MassHealth Data: Spending

Summary of MassHealth Spending for Persons with Long-Term Stay in FY 2008

FFS Data Only Total

SpendingLTC 113,258,546$ NF 1,564,288,526$ Chronic IP 243,329,977$ ICF-MR 236,079,079$ Acute 83,476,468$ Exclude 8,143,770$ Psych IP 16,108,241$ Semi-Acute IP 6,657,513$ All spending 2,271,342,120$

Source: EOHHS data run June 11, 2009.Notes: Data includes all MassHealth members on Standard FFS who had a long-term stay defined as 90+ days in a particular facility.Chronic & Psych facilitites may be underreported, if state owned/operated data is missing.

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Committee Business




Committee Business

Public input process Save the Date:

Wednesday, November 18th 12 PM – 2:30 PM, MetroWest Area Monday, November 23rd 5:30 PM – 8 PM, Holyoke

Next meeting: Date: Thursday, November 12th, 2009 from 9:00 -11:30am Location: One Beacon Street, MassHousing Board Room

Future meeting reminder Additional meeting scheduled for Thursday, December 10th

10/15/09University of Massachusetts

Medical School EBD Consulting Services, LLC


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