Hearing the consumer voice in managed long-term care programs in Wisconsin

The PEONIES approach is a unique method of assessing the quality of community-based long-term services and supports, which is now being development and implemented in Wisconsin's Medicaid managed long-term care programs. It is based on consumer-specific outcomes in 12 quality of life domains. This unique approach gives control to each individual to define their desired outcomes (dreams, wishes, goals) in each domain. Quality is measured as the extent to which desired outcomes are achieved and are supported by managed long-term care programs. Quality also includes supporting individuals to recognize options and possibilities beyond their current situations.

Historically, individuals have received long-term care supports and services using a formulaic approach to hours and types of services based on an assessment of functional abilities and health. The PEONIES approach uses a semi-structured interview and reflective listening techniques to elicit and reflect back the outcomes identified by the individuals. Supports and services are identified to support the achievement of these outcomes.

In this presentation, we will share findings from PEONIES interviews with 144 individuals, with particular attention given to (1) the range of outcomes identified; (2) the percent of desired outcomes that are achieved versus in progress; (3) the percent of outcomes that are fully supported; and (4) the ways these findings differ by population group (adults with physical disabilities, adults with developmental disabilities, and elders). We also will discuss the ways that individuals responded to the interviews, and implications for how this approach can change the nature of long-term care programs.