Value-Based Payments: Intellectual and Developmental Disabilities Quality Indicators Associated With Billing Expenditures

2021 ◽  
Vol 59 (4) ◽  
pp. 295-314
Author(s):  
Carli Friedman ◽  
Mary C. Rizzolo
Keyword(s):  
Developmental Disabilities ◽  
Cost Savings ◽  
Service Organizations ◽  
Hierarchical Regression ◽  
Intellectual And Developmental Disabilities ◽  
Billing Data ◽  
Cost Variance ◽  
Hierarchical Regression Model ◽  
Services And Supports

Abstract Although managed care is expanding into the intellectual and developmental disabilities (IDD) service system, there is little agreement about measurable and meaningful outcomes for people with IDD, including for use in value-based payments (VBP). In this study, we examined potential VBP metrics for people with IDD—relationships between quality and costs. We analyzed Basic Assurances data and long-term services and supports billing data from 68 human service organizations that supported 6,608 people with IDD. Our final hierarchical regression model predicted 66.40% of the variance of annual long-term services and supports (LTSS) billing per person. Our findings suggest quality assurance indicators can account for a significant portion of cost variance—quality metrics represent a potential for cost savings and efficient service delivery.

Families of Individuals With Intellectual and Developmental Disabilities: Policy, Funding, Services, and Experiences

2013 ◽  
Vol 51 (5) ◽  
pp. 349-359 ◽  
Author(s):  
Amy Hewitt ◽  
John Agosta ◽  
Tamar Heller ◽  
Ann Cameron Williams ◽  
Jennifer Reinke
Keyword(s):  
Developmental Disabilities ◽  
Research Priorities ◽  
Future Research ◽  
Intellectual And Developmental Disabilities ◽  
Policy Makers ◽  
Home Support ◽  
The Status ◽  
Services And Supports ◽  
At Home

Abstract Families are critical in the provision of lifelong support to individuals with intellectual and developmental disabilities (IDD). Today, more people with IDD receive long-term services and supports while living with their families. Thus, it is important that researchers, practitioners, and policy makers understand how to best support families who provide at-home support to children and adults with IDD. This article summarizes (a) the status of research regarding the support of families who provide support at home to individuals with IDD, (b) present points of concern regarding supports for these families, and (c) associated future research priorities related to supporting families.

Day Habilitation Services for People With Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services Waivers

2016 ◽  
Vol 41 (4) ◽  
pp. 244-255 ◽  
Author(s):  
Carli Friedman
Keyword(s):  
Developmental Disabilities ◽  
Service Utilization ◽  
Fiscal Year ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Total Spending ◽  
Day Habilitation ◽  
Services And Supports ◽  
Community Based Services

Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are one of the largest providers of long-term services and supports for people with intellectual and developmental disabilities (IDD). HCBS waivers also play a prominent role in providing day habilitation services for people with IDD. The purpose of this study was to examine how HCBS waivers allocate day habilitation services for people with IDD. HCBS waivers providing day habilitation services for people with IDD were analyzed to determine service utilization and projected expenditures. In fiscal year 2014, HCBS waivers projected US$5.62 billion of funding for day habilitation services; however, there was wide variance across services in terms of projected total spending, spending per participant, and reimbursement rates.

A National Analysis of Medicaid Home and Community Based Services Waivers for People With Intellectual and Developmental Disabilities: FY 2015

2017 ◽  
Vol 55 (5) ◽  
pp. 281-302 ◽  
Author(s):  
Carli Friedman
Keyword(s):  
Developmental Disabilities ◽  
National Level ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Day Habilitation ◽  
Services And Supports ◽  
National Analysis ◽  
Regulation Changes ◽  
Community Based Services

Abstract Medicaid Home and Community Based Services (HCBS) 1915(c) waivers are the largest source of funding for the long term services and supports of people with intellectual and developmental disabilities (IDD). National-level analyses of HCBS IDD waivers are crucial because of the large variance across states, the recent CMS rule and regulation changes (CMS 2249-F/2296-F), and the ever changing economic and political landscape. Therefore, the aim of this study was to examine state waiver priorities for people with IDD. In FY 2015, 111 waivers projected spending $25.6 billion for approximately 630,000 people with IDD. The services with the most funding were residential habilitation, supports to live in one's own home, and day habilitation. However, our analysis revealed large discrepancies across states and services.

Fiscal Stewardship, Choice, and Control: The Context of Self-Directed Services for People With Intellectual and Developmental Disabilities (IDD) in the United States

2019 ◽  
Vol 57 (2) ◽  
pp. 158-171 ◽  
Author(s):  
Matthew D. Bogenschutz ◽  
Matthew DeCarlo ◽  
Jennifer Hall-Lande ◽  
Amy Hewitt
Keyword(s):  
United States ◽  
Developmental Disabilities ◽  
Cost Savings ◽  
Data Interpretation ◽  
The United States ◽  
Intellectual And Developmental Disabilities ◽  
Political Climate ◽  
Services And Supports ◽  
High Level ◽  
And Control

Abstract Self-directed home and community based services (HCBS) waiver services and supports for people with intellectual and developmental disabilities (IDD) have become a viable and widely used method of service provision in the United States. Grounded in theories of self-determination, previous literature on self-direction has suggested high satisfaction and positive outcomes for people who use self-directed programs as well as cost savings for state IDD service systems. This study explored the ways in which state IDD service administrators think about how self-direction may be used as a method of achieving cost savings while providing opportunities for people with IDD and their families to exercise choice and control. Informed by 54 high-level IDD service administrators in 34 states, and guided by a thematic analysis approach to data interpretation, the study found evidence that administrators typically see strong potential for self-direction to have cost-savings benefits, while also fostering choice. In the current political climate, the need for cautious fiscal stewardship may become a stronger driving force behind self-direction for people with IDD in the United States.

scholarly journals Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

2018 ◽  
Vol 30 (1) ◽  
pp. 11-21 ◽  
Author(s):  
M. P. DeCarlo ◽  
M. D. Bogenschutz ◽  
J. A. Hall-Lande ◽  
A. S. Hewitt
Keyword(s):  
Developmental Disabilities ◽  
The United States ◽  
Support Staff ◽  
Self Determination ◽  
Intellectual And Developmental Disabilities ◽  
Thematic Map ◽  
Human Service Delivery ◽  
State Administrators ◽  
Services And Supports

Self-direction is an approach to human service delivery within long-term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with intellectual and developmental disabilities. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships, as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

scholarly journals Implementation of Self-Directed Supports for People With Intellectual and Developmental Disabilities in the United States

2019 ◽  
Author(s):  
Matthew Peter DeCarlo ◽  
Matthew D. Bogenschutz ◽  
Jennifer Hall-Lande ◽  
Amy Hewitt
Keyword(s):  
Developmental Disabilities ◽  
The United States ◽  
Support Staff ◽  
Self Determination ◽  
Intellectual And Developmental Disabilities ◽  
Thematic Map ◽  
Human Service Delivery ◽  
State Administrators ◽  
Services And Supports

Self-direction is an approach to human service delivery within long term services and supports that aims to provide greater control for individuals with disabilities and their closest supporters. The purpose of this study was to understand the implementation of self-directed supports for individuals with IDD. Researchers interviewed state developmental disabilities administrators in 34 of 42 states that currently operate self-directed service options and used qualitative analysis to arrive at a thematic map of the strengths and challenges currently experienced by state administrators. Common strengths identified by state administrators were increased opportunities for participant self-determination and improved relationships with support staff. Common challenges included restructuring case management relationships as well as rulemaking and enforcement. Administrators’ suggestions for the future of self-direction focused on increasing program size and streamlining services using technology.

Trauma-informed care in the context of intellectual and developmental disability services: Perceptions of service providers

2020 ◽  
pp. 174462952091808
Author(s):  
Amanda J Rich ◽  
Nikki DiGregorio ◽  
Carla Strassle
Keyword(s):  
Developmental Disabilities ◽  
Service Providers ◽  
Well Being ◽  
Service Organizations ◽  
Intellectual And Developmental Disabilities ◽  
Mental Health Providers ◽  
Health Providers ◽  
Trauma Informed Care ◽  
High Staff Turnover ◽  
Trauma Informed

Traumatic life events have pervasive impacts on health and well-being. A growing body of literature shows that people with intellectual and developmental disabilities are disproportionately impacted by trauma. Trauma-informed care (TIC) is a philosophy of service provision that is committed to preventing traumatization and re-traumatization and promoting healing. This study explores the perceptions of 130 leaders in the field of intellectual and developmental disabilities services on the adoption and practice of TIC through the analysis of quantitative data. Results indicated a disconnect between the level of TIC integration and perceptions detailing how well organizations are currently performing in aspects of TIC. Barriers to TIC included high staff turnover, lack of accessible mental health providers, lack of affordable training, stigma, and restrictive funding structures. Implications and recommendations for service organizations and educators are provided.

scholarly journals Evaluating the Availability and Quality of HIV/AIDS Services and Supports for Individuals with Intellectual and Developmental Disabilities

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 435-440
Author(s):  
Andrew T. Roach ◽  
Franco Dispenza ◽  
Melissa Zeligman ◽  
Anne Stair ◽  
Breanna Kelly
Keyword(s):  
Developmental Disabilities ◽  
Community Based Participatory Research ◽  
Intellectual And Developmental Disabilities ◽  
Persons With Disabilities ◽  
Three Phase ◽  
Acquired Immunodeficiency ◽  
Services And Supports ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

We used a community-based participatory research (CBPR) framework to conduct a needs assessment of the availability and quality of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) services for persons with intellectual and developmental disabilities (PWIDD) in the Atlanta metropolitan area. We present the findings of a three-phase research project. Findings from the research informs organizations and policymakers on how to provide persons with disabilities better access to HIV/AIDS care. Ethn Dis. 2019;29(Suppl 2):435-440; doi:10.18865/ed.29.S2.435

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