June 2010
Prepared for: Genworth Financial
Lewin contact: Lisa Alecxih
A number of factors will likely result in dramatic changes to the financing and delivery of long-term care (LTC) services—an increasing population of older people and people with disabilities, a severe economic recession, the new national health reform law, and other recent developments. This study, conducted by The Lewin Group for Genworth Financial, synthesizes the latest available data on Medicaid and LTC trends; takes a new look at LTC financing challenges and possible solutions in light of these historic changes; and proposes guidelines for consideration in developing a comprehensive, national long-term care solution.
Client Area: Payers / Insurers
Expertise Area: Aging and Disability
May 2010
Prepared for the Congress of California Seniors
Lewin Contact: Lisa Alecxih
This study estimates the potential State revenue impacts associated with the proposed elimination of the Medi-Cal ADHC program. While the proposed elimination of the Medi-Cal ADHC program would save direct expenses on the program, policymakers should also consider the potential negative impacts of the elimination on cost-shifting to other more expensive care settings, loss of jobs among ADHC employees, reductions in family caregivers’ ability to work, loss of State tax revenue, forfeiting $164 million annually in federal Medicaid matching funds and economic impact on local businesses and other entities that would lose revenue from the elimination of adult day health care providers.
Client Area: Foundations, State and Local Governments
Expertise Area: Aging and Disability
February 2010
DHHS, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
Lewin contact: Lisa Alecxih
On January 28, the Engelberg Center for Health Care Reform at Brookings hosted a forum to discuss strategies for improving care for older Americans across a range of institutional and community-based settings. Experts and key stakeholders examined the components of health care reform most likely to influence older Americans; discussed promising models for payment, delivery-system reforms, and coordination across a continuum of care; and identified how quality and efficiency can be improved.
During the forum, Richard Frank, Deputy Assistant Secretary for Office of Disability, Aging, and Long-Term Care Policy for the Assistant Secretary for Planning and Evaluation, officially released a chartbook prepared by The Lewin Group. The chartbook takes a closer look at the health spending for individuals with chronic conditions and functional impairments living in the community. The Lewin Group analysis indicates that the combination of chronic conditions and functional limitations is a critical indicator and an improved targeting criteria for individuals with high health spending who could benefit from better coordination and management.
Client Area: Federal Government
Expertise Area: Aging and Disability
January 2010
Missouri Department of Social Services
The purpose of this report, prepared under contract to the Missouri Department of Social Services, is to present strategies for containing costs for long-term care services in Missouri's Medicaid program, MO HealthNet. This report focuses on short-term cost containment opportunities, but it also previews longer-term opportunities for improving the long term care system.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
July 2009
Minnesota Department of Human Services
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medical Assistance State Plan Personal Care Assistance (PCA) program. Lewin partnered with the University of Minnesota’s Institute on Community Integration on this study.
This final report analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to strengthen the program. While the study focuses primarily on PCA State Plan services, important considerations include how other Medical Assistance Programs (e.g., home and community-based waiver programs) provide PCA services, and the interaction between those program requirements and the PCA State Plan program.
Three interim reports were also developed for this project and are posted on this website as well:
- Interim Report #1 (dated March 31, 2009) provided a national scan of PCA programs, analyses of Minnesota PCA program enrollment and expenditure data, findings from interviews with State officials in Minnesota and other states with PCA programs, findings from stakeholder interviews, and preliminary recommendations for the State.
- Interim Report #2 (dated June 24, 2009) included findings from a series of 14 focus groups, conducted by the
University of Minnesota’s Institute on Community Integration, with recipients of PCA services and PCA workers in a variety of Minnesota Medical Assistance programs offering PCA services. The purpose of conducting these focus groups was to hear from workers about their experiences providing PCA services and from service recipients about their experiences receiving PCA services.
- Interim Report #3 (dated June 25, 2009) presented provider agency perspectives and related recommendations to strengthen and improve provider-related components of the program based on a survey of PCA provider agencies. This report also included analyses of the types of living arrangements .
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
June 2009
Minnesota Department of Human Services
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the last of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This report focuses on provider agency perspectives and related recommendations to strengthen and improve provider-related components of the program, and analyses of the types of living arrangements in which individuals receive PCA services and related recommendations.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
June 2009
Minnesota Department of Human Services
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the second of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This second report includes findings from a series of 14 focus groups, conducted by the University of Minnesota’s Institute on Community Integration, with recipients of PCA services and PCA workers in a variety of Minnesota Medical Assistance programs offering PCA services. The purpose of conducting these focus groups was to hear from workers about their experiences providing PCA services, and from service recipients about their experiences receiving PCA services. This report provides: a description of the methodology used to obtain this data (through the focus groups); findings from several topical areas such as services delivered/received, quality of services, wages/benefits, education/training, and family members as PCA workers; a summary of focus group participants’ recommended key changes to improve the Minnesota PCA program; and interim recommendations to improve and strengthen Minnesota’s PCA program.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
March 2009
Minnesota Department of Human Services
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the first of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This first report includes findings from a national scan of PCA programs, analysis of Minnesota PCA program enrollment and expenditure data, interviews with state officials in Minnesota and other states with PCA programs, stakeholder interviews, and initial recommendations for the State.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
March 2009
AARP
Lewin contact: Lisa Alecxih
AARP commissioned The Lewin Group to conduct research to help inform policy discussions about quality of care and litigation in Tennessee nursing homes. Specifically, the study addresses the following overarching policy questions: What are the factors driving litigation in Tennessee? What are the nursing home litigation trends in the state? What positive or negative outcomes does litigation have for nursing home residents? What steps have nursing facility operators in Tennessee taken to reduce the frequency and cost of litigation, and what are the implications for nursing home quality? What are the potential impacts of tort restrictions, based on the experiences of other states?
Based on the findings, the report discusses considerations and potential strategies for ensuring delivery of quality services in Tennessee nursing homes.
Client Area: Associations
Expertise Area: Aging and Disability
November 2006
Lewin contact: Lisa Alecxih
Over the past 20 years, a significant number of senior citizens, particularly among the “oldest old” – persons 85 and older - have been choosing to stay in their homes rather than move to nursing homes, according to a study by The Lewin Group.
The full report on this latest research by The Lewin Group was released at a news conference by Lisa Alecxih, Vice President at The Lewin Group, on Tuesday, November 21. The report takes an in-depth look at trends among America's large and growing senior population.
Expertise Area: Aging and Disability
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