3110.0: Monday, November 13, 2000 - 2:30 PM

Abstract #11876

Continuing Care Networks Demonstration: building a disability -based payment model

Katie Smeenk, MPA, Community Coalition for Long Term Care, 10 Gibbs Street, Suite 410, Rochester, NY 14604, 716-325-1991, N/A and Helena Temkin-Greener, PhD, Community & Preventive Medicine, University of Rochester Medical Center, 601 Elmwood Ave, P.O. Box 644, Rochester, NY 14642.

The New York State Department of Health, in a partnership with the Community Coalition for Long Term Care, Unity Health System, ViaHealth and BlueCross BlueShield of the Rochester Area, is implementing a new demonstration program (CCN) which combines Medicare and Medicaid financing and a comprehensive benefit package of primary, acute, and long term care services. The State has received demonstration waivers from the Health Care Financing Administration and enrollment will begin in May 2001.

Over the course of the demonstration, we expect to enroll at least 10,000 older (age 65+) persons in Monroe County. The demonstration will serve as the prototype for possible state-wide replication. The CCN demonstration will enroll both Medicare-only and dually eligible elderly who reside either in the community or in nursing homes. The goal is to combine all aspects of services for older persons so as to decrease the use of hospitals and to prevent or delay the using of nursing home care. The CCN demonstration employs a risk-adjusted payment model for Medicare and for Medicaid, based on enrollees’ functional status.

This presentation will cover the development of the demonstration with special emphasis on the payment, organization and service delivery models. The challenges of implementing a waiver-based demonstration program will also be discussed.

Learning Objectives: At the end of this session, the participants will: 1) Be familiar with the New York State CCN demonstration model. 2) Understand the challenges of implementing waiver-based programs

Keywords: Medicare/Medicaid,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA