Wisconsin’s “Elder Boom” Kitty Rhoades, Secretary Department of Health Services.
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Transcript of Wisconsin’s “Elder Boom” Kitty Rhoades, Secretary Department of Health Services.
Wisconsin’s “Elder Boom”
Kitty Rhoades, SecretaryDepartment of Health Services
Wisconsin’s Aging Population - 2015
Wisconsin’s Aging Population - 2035
Pay Sources for Long-Term Care
• Medicaid: 42% • Medicare: 25%• Private Pay– Out of Pocket: 22%– Private Insurance/Other: 11%
SFY 2012 Medicaid Costs for Individuals Relocating from a Nursing Home to a Home- or Community-Based Setting
Ave. Institutional Costs per Day
Ave. Community Costs per Day Ave. Daily Savings Annual Savings
$143.78 $110.38 $33.40 $1,082,227
Aging Population Projections
2005 2010 2015 2020 2025 2030 2035
726,280 782,810 900,170 1,060,620 1,234,600 1,402,900 1,485,570
Wisconsin Medicaid Long-Term Care Programs
• Fee-For-Service Nursing Home– Statewide
• Legacy Waiver Home- and Community-Base Services– 15 counties
• Managed Long-Term Care Programs (e.g. Family Care): nursing home and home- and community-based services– 57 counties
• IRIS: self-directed home- and community-based services– 57 counties
Strategies to Control Costs
• Aging and Disability Resource Centers• Reduce Nursing Home Utilization• Reduce Need for Higher Cost Services– Medication Compliance– Dementia Care– Falls Prevention– Employment/Vocational Programs– Residential and Natural Supports
• Reduce Administrative Burden on MCOs• IRIS Initiatives
Controlling Future Cost Growth: Capabilities of Managed Long-Term Care
• Payment structure that drives Managed Care Organizations to continuously improve and provide the most cost-effective care.
• Equal access to long-term care services in an individual’s home, community-based settings, or nursing homes, which assures that the level of service matches a member’s needs
• Efficiencies from MCO-developed regional and comprehensive provider networks that increase the variety of services available to member at negotiated, competitive rates.
Conclusion
• Family Care, and the entitlement of support in homes and community-integrated settings, allows Wisconsin residents to receive cost-effective long-term supports.
• Managed long-term care is the most effective strategy to meet the needs of Wisconsin’s residents.
Thank You