George Mason University will conduct a 1-year study of cost, utilization and survey data to analyze the short- and mid-term outcome of coordinated, patient-centered care for working-age Medicaid beneficiaries with physical disabilities (NOT-HS-06-32). This study extends existing work and capitalizes upon a prospectively-designed program evaluation to deliver important answers about providing care to one of our country's most vulnerable and costly populations. Our overall goal is to measure the business case for disability care coordination from the perspective of the payer (e.g., a state Medicaid program), by showing that the additional expenses of paying for care coordination are offset in the form of reduced total program expenditures.
Our specific aims are: (1) Determine if total program expenditures decline, and - if so - do they decline for all people or just certain groups? (2) If expenditures decline, how much do they decline, and are the cost reductions sustainable over four years? (3) If expenditures decline, is that at the expense of satisfaction, perceived access and quality? (4) How does utilization of preventive care compared to national averages as presented in Healthy People 2010? ? ? The setting is the Minnesota Disability Health Options (MnDHO) program, offered since September 2001 to Medicaid adults of working age with physical disabilities residing in the Minneapolis-St. Paul community. The population is 548 MnDHO enrollees. Use a retrospective pretest-posttest design, we will complete a multivariable analysis of three years of comprehensive satisfaction, cost, and utilization data, and a time-series analyses of four years of monthly cost and utilization data. ? ? This study meets multiple AHRQ objectives: using local data sets; participatory action research; research on people with disabilities; and research on the short- and long-term outcomes of care coordination. If we make a successful business case, the public and private sectors will be encouraged to invest in DCCO formation, which in turn would move the country toward achieving goal #6-10 for people with disabilities expressed in Healthy People 2010, Chapter 6: making sure that people with disabilities have full access to health and wellness treatment programs and facilities. ? ? ? ?
| Palsbo, Susan E; Diao, Guoqing (2010) The business case for adult disability care coordination. Arch Phys Med Rehabil 91:178-83 |
