Wisconsin’s “Elder Boom” Kitty Rhoades, Secretary Department of Health Services.

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Presentation transcript:

Wisconsin’s “Elder Boom” Kitty Rhoades, Secretary Department of Health Services

Wisconsin’s Aging Population

Wisconsin’s Aging Population

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 SavingsAnnual Savings $ $ $33.40$1,082,227 Aging Population Projections , ,810900,1701,060,6201,234,6001,402,9001,485,570

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