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The Next Revolution: The Role of Informatics in Improving Health Care
State of Maine Long-term Care Reform
Slide Presentation by Mollie Baldwin (Text Version)
On July 26, 2001, Mollie Baldwin made a presentation during the Web-assisted teleconference, The Next Revolution: The Role of Informatics in Improving Health Care entitled "State of Maine Long-term Care Reform."
This is the text version of Ms. Baldwin's slide presentation. Select to access the PowerPoint® slides (155 KB).
State of Maine Long-term Care Reform
Presented by Mollie Baldwin
Bureau of Elder and Adult Services
July 26, 2001
- Budgetary crisis forces Legislature and policymakers to examine State's
long-term care (LTC) system:
- Department must commit savings toward State budget.
- Medical & financial eligibility took up to 90 days.
- Consumers and Advocates Want:
- Long-term care choices/options.
- Help in navigating complex eligibility system .
- Fewer barriers in eligibility process and accessing services.
Long-term Care Reform
- Improve access to information about long-term care options:
- Free assessment available to give consumers LTC advice.
- Improve home and community based care.
- Better allocate resources across care settings.
- Improve consumers' understanding of their options.
- Reduce reliance on costly institutional care.
Blueprint for Reform
- Universal pre-admission screening regardless of funding source:
- Legislatively mandated pre-admission screening for nursing home placement.
- Screening must include recommended community based care plan.
- Single entry point for eligibility determination:
- Ease of access for consumer.
- Forces collaboration between agencies & providers.
- To quickly determine medical and financial eligibility for long-term care
- To communicate between different parts of system and link information to
work efficiently and effectively for the consumer:
- State bureaus.
- Agencies, providers.
- Consumers, families.
Development of Technology Solution
Develop user-friendly, expandable and portable system with the following
- Calculate eligibility based on medical & financial information provided
- Portable—may be moved to a different agent who serves as single entry
- Track referrals, assessments.
- Interfaces with medical & financial legacy information systems via
- Daily feeds with statewide home care coordination agency.
- Assessors use untethered laptops.
This slide shows what the computer screen looks like where financial and
eligibility information is kept.
- Linked data across care settings improves policy decisions and resource
- Data shows system serving people in different settings with same characteristics.
- Data allows development of acuity based reimbursement systems as mandated
by the Legislature.
- Development of quality indicators for home care programs now underway.
- Maine's LTC system has changed and grown rapidly between 1995 and 2000:
- Total persons served has increased from 19,803 to 26,767.
- 52% of consumers received home care in FY 2000 compared to 32% in 1995.
- Significant new funding appropriated for home care & residential alternatives:
- Spending for home and community care,
- up from 16% to 35%.
- Responsiveness, accountability for providers delivering services to consumer.
Long-term Care State and Medicaid Spending
This slide shows two pie
charts displaying total State expenditures for long-term care in 1995 and
- Total Expenditures = $248,715,157.
- 6% ($16,711,742) for Residential Care.
- 10% ($28, 434,251) for Home Care.
- 84% ($239,569,164) for Nursing Facilities.
- Total Expenditures
- 14% ($43,198,380)
for Residential Care.
- 21% ($65,921,949)
for Home Care.
- 65% ($200,535,349)
for Nursing Facilities.
- Consumers find single entry point simplifies application process.
- Consumers receive eligibility decision on the spot & home and community-based
options at time of assessment.
- Improved consumer interaction with nurse assessors freed up from paper
- Assessment outcome data transmitted electronically to improve access and
expedite services care getting started.
- Financial resources have been diverted to home care programs.
Current as of August 2001
Baldwin, M. State of Maine Long-term Care Reform. Slide Presentation (Text Version) presented at The Next Revolution: The Role of Informatics in Improving Health Care, Web-Assisted teleconference, July 26, 2001. Agency for Healthcare Research and Quality, Rockville, MD.
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