The Next Revolution: The Role of Informatics in Improving Health Care

State of Maine Long-term Care Reform

Slide Presentation by Mollie Baldwin (Text Version)

On July 26, 2001, Mollie Baldwin made a presentation during the Web-assisted teleconference, The Next Revolution: The Role of Informatics in Improving Health Care entitled "State of Maine Long-term Care Reform."

This is the text version of Ms. Baldwin's slide presentation. Select to access the PowerPoint® slides (155 KB).

Slide 1

State of Maine Long-term Care Reform

Presented by Mollie Baldwin
Bureau of Elder and Adult Services
July 26, 2001

Slide 2

History

• Budgetary crisis forces Legislature and policymakers to examine State's long-term care (LTC) system:
  • Department must commit savings toward State budget.
• Medical & financial eligibility took up to 90 days.
• Consumers and Advocates Want:
  • Long-term care choices/options.
  • Help in navigating complex eligibility system .
  • Fewer barriers in eligibility process and accessing services.

Slide 3

Long-term Care Reform

Governor's initiative:

• Improve access to information about long-term care options:
  • Free assessment available to give consumers LTC advice.
• Improve home and community based care.
• Better allocate resources across care settings.
• Improve consumers' understanding of their options.
• Reduce reliance on costly institutional care.

Slide 4

Blueprint for Reform

• Universal pre-admission screening regardless of funding source:
  • Legislatively mandated pre-admission screening for nursing home placement.
  • Screening must include recommended community based care plan.
• Single entry point for eligibility determination:
  • Ease of access for consumer.
  • Forces collaboration between agencies & providers.

Slide 5

Systems Challenge

• To quickly determine medical and financial eligibility for long-term care services.
• To communicate between different parts of system and link information to work efficiently and effectively for the consumer:
  • State bureaus.
  • Agencies, providers.
  • Consumers, families.

Slide 6

Development of Technology Solution

Develop user-friendly, expandable and portable system with the following features:

• Calculate eligibility based on medical & financial information provided to assessor.
• Portable—may be moved to a different agent who serves as single entry point.
• Track referrals, assessments.
• Interfaces with medical & financial legacy information systems via daily feeds.
• Daily feeds with statewide home care coordination agency.
• Assessors use untethered laptops.

Slide 7

Financial Information Tab

This slide shows what the computer screen looks like where financial and eligibility information is kept.

Slide 8

Data Benefits

• Linked data across care settings improves policy decisions and resource allocations:
  • Data shows system serving people in different settings with same characteristics.
• Data allows development of acuity based reimbursement systems as mandated by the Legislature.
• Development of quality indicators for home care programs now underway.

Slide 9

State Benefits

• Maine's LTC system has changed and grown rapidly between 1995 and 2000:
  • Total persons served has increased from 19,803 to 26,767.
  • 52% of consumers received home care in FY 2000 compared to 32% in 1995.
• Significant new funding appropriated for home care & residential alternatives:
  • Spending for home and community care,
  • up from 16% to 35%.
• Responsiveness, accountability for providers delivering services to consumer.

Slide 10

Long-term Care State and Medicaid Spending

This slide shows two pie charts displaying total State expenditures for long-term care in 1995 and 2000.

In 1995:

• Total Expenditures = $248,715,157.
• 6% ($16,711,742) for Residential Care.
• 10% ($28, 434,251) for Home Care.
• 84% ($239,569,164) for Nursing Facilities.

In 2000:

• Total Expenditures = $309,655,678.
• 14% ($43,198,380) for Residential Care.
• 21% ($65,921,949) for Home Care.
• 65% ($200,535,349) for Nursing Facilities.

Slide 11

Consumer Benefits

• Consumers find single entry point simplifies application process.
• Consumers receive eligibility decision on the spot & home and community-based options at time of assessment.
• Improved consumer interaction with nurse assessors freed up from paper burden.
• Assessment outcome data transmitted electronically to improve access and expedite services care getting started.
• Financial resources have been diverted to home care programs.

Current as of August 2001

Internet Citation:

Baldwin, M. State of Maine Long-term Care Reform. Slide Presentation (Text Version) presented at The Next Revolution: The Role of Informatics in Improving Health Care, Web-Assisted teleconference, July 26, 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/informat/baldwintxt.htm

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