Brooke Hollister1, Jason D Flatt1, Susan A Chapman2. 1. Institute for Health and Aging, University of California, San Francisco. 2. Department of Social and Behavioral Sciences, UCSF School of Nursing, San Francisco, California.
Abstract
Background and Objectives: This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid beneficiaries. Research Design and Methods: Data came from contracts, policy documents, and 24 semistructured key informant interviews with national experts and leaders from community-based organizations, advocacy organizations, researchers, federal and state government, and health plans in the seven states. Results: Contracts included language mandating care coordination practices deemed dementia-capable, including workforce qualifications, training, and experience; dementia screening; involvement of a caregiver in the care planning process; and education, support groups, and referral resources for people with dementia and their caregivers. There was little consistency across states in their dementia capable requirements and informants questioned the dementia capability of the care coordination workforce and practice. However, promising practices and areas for improvement were identified. Discussion and Implications: The variability of the duals demonstrations made it difficult to compare across states. The three-way contracts were often the starting point of a process to more clearly define policies and practices in each state including workforce requirements. Efforts should be made to further adopt and translate evidence-based practices into health systems and evaluate promising practices.
Background and Objectives: This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid beneficiaries. Research Design and Methods: Data came from contracts, policy documents, and 24 semistructured key informant interviews with national experts and leaders from community-based organizations, advocacy organizations, researchers, federal and state government, and health plans in the seven states. Results: Contracts included language mandating care coordination practices deemed dementia-capable, including workforce qualifications, training, and experience; dementia screening; involvement of a caregiver in the care planning process; and education, support groups, and referral resources for people with dementia and their caregivers. There was little consistency across states in their dementia capable requirements and informants questioned the dementia capability of the care coordination workforce and practice. However, promising practices and areas for improvement were identified. Discussion and Implications: The variability of the duals demonstrations made it difficult to compare across states. The three-way contracts were often the starting point of a process to more clearly define policies and practices in each state including workforce requirements. Efforts should be made to further adopt and translate evidence-based practices into health systems and evaluate promising practices.
Authors: Joan Weiss; Nina Tumosa; Elyse Perweiler; Mary Ann Forciea; Toni Miles; Ellen Blackwell; Susan Tebb; Daniel Bailey; Scott A Trudeau; Mary Worstell Journal: J Am Geriatr Soc Date: 2020-01-22 Impact factor: 5.562