the ltss care management experience survey: a tool to
TRANSCRIPT
The LTSS Care Management Experience Survey: A Tool to Enhance Contracting between CBOs
and health care entities
Part of the Aging and Disability Business Institute Series- a collaboration of n4a and ASA
The “Business Institute”
The mission of the Aging and Disability Business Institute (Business Institute) is to successfully build and strengthen partnerships between community-based organizations (CBOs) and the health care system so older adults and people with disabilities will have access to services and supports that will enable them to live with dignity and independence in their homes and communities as long as possible.
www.n4a.org/businessinstitute
Partners and Funders
Partners:• National Association of Area Agencies on Aging• Independent Living Research Utilization/National Center for
Aging and Disability• American Society on Aging• Partners in Care Foundation• Elder Services of the Merrimack Valley/Healthy Living Center
of Excellence
Funders:• Administration for Community Living• The John A. Hartford Foundation• The SCAN Foundation
ACL Business Acumen Grants
• Learning Collaboratives for Advanced Business Acumen Skills (n4a)
• Organize and conduct 3-5 topically-based action learning collaboratives to address “next generation” issues; and to provide targeted technical assistance to networks of community-based aging and disability organizations.
• Trailblazers Learning Collaborative• Health Information Technology Learning Collaborative• Medicare Advantage Learning Collaborative
• Create knowledge and capture insights through these collaboratives to incorporate into future curriculum for national dissemination.
5
Trailblazers Learning Collaborative
• Purpose:1) Develop comprehensive strategies for approaching and engaging different health care payers and providers 2) Develop and test “road maps”
• 2 work groups – Health plans and health systems
6
Overall Change in Contracting Status
Most Common Health Care Partners for CBOs Contracting with Health Care Entities T2 and T1
8.9%
8.9%
12.7%
17.5%
17.9%
21.3%
26.5%
28.5%
41.6%
5.4%
4.0%
6.3%
16.1%
13.9%
19.3%
27.8%
12.6%
35.0%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Medicare Advantage Plan (including…
Medicare Fee for Service (e.g., we are a…
Accountable Care Organization (ACO)…
Medicare/Medicaid Duals Plan
Commercial health insurance plan
Veterans Administration Medical Center
Hospital or hospital system
State Medicaid that is not pass through…
Medicaid Managed Care Organization
RFI T1-2017 (n=223)
RFI T2-2018 (n=291)
Most Common Services Provided through Contracts by CBOs Contracting with Health Care Entities T2 and T1
20.2%
20.9%
22.3%
24.7%
25.8%
27.2%
27.9%
30.0%
30.3%
38.3%
50.2%
17.9%
20.6%
20.6%
14.3%
26.5%
22.0%
19.7%
26.0%
10.3%
29.1%
49.3%
0% 10% 20% 30% 40% 50% 60%
Caregiver support/training/engagement
Participant-directed care
Transportation (medical or non-medical)
Options/Choice counseling
Home care (e.g., homemaker, personal…
Person-centered planning
Evidence-based programs (e.g., fall…
Nutrition program (e.g., counseling, meal…
Assessment for long-term services and…
Care transitions/discharge planning
Case management/care…
RFI T1- 2017 (n=223)
RFI T2 -2018 (n=287)
First product: LTSS client experience survey
• Methods• Collect surveys currently in use within TLC• Scan other measures, especially those from
authorities (CMS CAHPS) and those recognized in the healthcare sector
• Map commonalities• Eliminate less crucial questions• Refine question order, wording and answer
sets (Scripps)• Pilot & revise• Roll out
Why?
• Growth of MLTSS—support “sales” by providing data about quality
• Supports LTSS NCQA accreditation• Three uses:
• Internal quality review—drive improvement efforts
• Benchmark quality—compare with other agencies doing similar work
• External reporting—provide reports to state LTSS agencies, MLTSS plans, etc.
CMS CAHPS CM questions for HCBS
• https://www.medicaid.gov/medicaid/quality-of-care/performance-measurement/cahps-hcbs-survey/index.html
• Getting needed services for ADLs/IADLs• Communication/treatment• Choice• Individual services like transportation• Community inclusion/empowerment
Results to date: LTSS – internal view
4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 5 5.1
Amber
Aureliana
Duane
Dulce
Gustavo
Hermione
Manuel
Maria A
Maria C
Maria L
Maria CM
Patricia
Richard
Sandra
Sandy
Shen
Overall Scores by CM
Results to date: LTSS comparative view
0% 20% 40% 60% 80% 100% 120%
How often does [CM] treat you the way you want them to?
In the last 3 months, how often did [CM] treat you with courtesy andrespect?
In the last 3 months, how often could you contact [CM] when youneeded to?
How often does [CM] explain things in a way that is easy tounderstand?
In the last 3 months, how often did [CM] listen carefully to you?
How often does [CM] consider your preferences when arrangingservices and other resources to meet your needs?
How would you rate the help you get from [CM NAME]?
In the last 3 months, did your service plan include ALL, MOST, SOMEor NONE of the things you need?
Overall how satisfied are you that [CM] helps you to remainindependent and safe in your home?
Would you recommend [CM] to your family and friends if theyneeded [PROGRAM]?
Would you recommend [PROGRAM] to your family and friends?
Percent of clients giving top rating; comparison of 2 sites
Site 2 - n=10 Site 1 - n=195
How often did CM consider your preferences?
How often does CM treat you as you want?
How satisfied that pgm keeps you safe and independent at home?
Comments in word cloud by frequency
Results to date: LTSS Overall
• Net promoter score for LTSS Medicaid waiver programs run by CBOs• 93%
• 7% neutral; no negatives• Would you recommend the program to
a friend or relative?• Would you recommend your care
manager to a friend or relative• 93% provide the top answer – Definitely
Yes!
Small print• Currently hosted in secure, HIPAA-
compliant SurveyGizmo• Currently hosted by Partners in Care
Foundation• Request data export/reports at frequency
of no more than monthly• Request benchmark report comparing
your data with others’ outcomes no more than monthly
• Note: Surveys are usually done in quarterly or annual batches, so comparative data may not change frequently
How you can use the tool
• TEST LINK:• https://www.surveygizmo.com/collab/441450
6/TLC-CM-Satisfaction-Survey• Request to use the full survey:
• [email protected]• Send names of case managers and name of
program to customize• Send questions/response sets you would like
to have ADDED• Beth will send the link to the live survey
Other products
• Care transitions outcomes and patient experience survey in final stage of word-smithing
• Includes outcomes• Readmissions• ED use• Behavior change• Medications• Confidence in ability to self-manage chronic illness
• Care transitions standard “product” description for those just getting started
Questions & Answers: Please Submit Using the “Questions”
Box
Please join us for future webinars in the Aging and Disability Business Institute Series
“Tools to Accelerate Cross-Sector Partnership Development” – Sept. 19
Learn more and pre-register here:http://www.asaging.org/series/109/aging-and-disability-business-institute-
series
