263419 Dual Eligibles: Impact at the Intersection of Federal and State Health Care Reform

Sunday, October 28, 2012

Dennis Heaphy, MEd, MPH , Disability Policy Consortium, Boston, MA
Massachusetts is one of 15 states receiving a CMS grant to reform healthcare delivery to dual eligibles ages 21-64; approximately 115,000 residents in MA. The Demonstration Project, part of the ACA, is meant to improve quality and decrease cost through integrated care. Integrated Care Organizations will be responsible for providing comprehensive person-centered medical home services that include both medical and Long-Term Support Services (LTSS). More broadly, building on previous healthcare reform measures, Massachusetts is undertaking "Payment Reform," the next step in healthcare reform. Under Payment Reform the fee-for-service system as it is currently understood will over time disappear and be replaced by a global payment system comprised of Accountable Care Organizations (ACOs) and other to be determined entities. These measures will result in system wide changes to health care delivery for all residents of the state and possibly the nation.

This presentation will describe the impact of both the duals initiative and Payment Reform on people with disabilities in MA. It will also describe the role of disability and other advocates in shaping both efforts. Participants will receive detailed information about how Massachusetts forms global payments, ACOs, risk adjustment, data collection and quality measurements. Particular attention will be placed on LTSS delivery and the role of community based organizations (Independent Living Centers, Recovery Learning Communities) in shaping and protection of LTSS. The presentation will also go into detail about the recovery model of mental health and the unique opportunities that will be made available through peer support and peer respite.

Learning Areas:
Diversity and culture
Provision of health care to the public
Public health or related public policy

Learning Objectives:
1. Will discuss efforts being undertaken in Massachusetts to develop and implement the Dual Eligibles Demonstration Project. 2. Discuss broader health care reform efforts being undertaken in Massachusetts. 3. Describe the impact to date of both the Dual Eligibles Demonstration Project and broader health care reform efforts in Massachusetts impact people with disabilities as a demographic with particular focus on people with disabilities between the ages of 21 and 64. 4. Identify areas of learning useful for stakeholders and policymakers in other states.

Keywords: Disability Policy, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm a public health practitioner and disability advocate with over 15 years of experience in the field. My background includes serving as ADA Project Coordinator for the Massachusetts Department of Public and Health Care Analyst for Disability Policy Consortium. I am a lead advocate impacting of the Dual Eligibles Demonstration Project in Massachusetts as well as broader healthcare policy in the state.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.