Center For Long-Term Care Reform
In 2010, 29.9% of African American Medicare beneficiaries in Chicago who were hospitalized were readmitted within 30 days of discharge, more than 50% higher than the national average readmission rate of 19.2%. The stark disparity in this statistic led our Health & Medicine Center for Long-Term Care Reform team to dig deeper on readmissions-related statistics and learn about any best practices to address the gaps that could lead to such a disparity. We are pleased to share our findings this report.
Health & Medicine’s Center for Long-Term Care Reform responds to the Rauner Administration’s plans for a major Medicaid managed care “re-boot.” This Critical Issues Policy Brief raises three questions for the Medicaid managed care re-boot and calls on State policy makers to work with stakeholders, including MCOs, Medicaid providers, and Medicaid members to address these issues to set a stronger foundation for a new managed care program in Illinois.
Health & Medicine and our Center for Long-Term Care Reform have long been committed to improving the way older adults in Illinois live and enjoy their final years with dignity in their homes and communities. With a new administration in place, Health & Medicine intends to take action to ensure that aging issues are prioritized by the new Pritzker administration, as well as advocating nationally for adequate funding and rational policies to support home and community-based services and supports. To that end, we are pleased to share our Aging in Illinois: 2019 Agenda for Change. The Agenda highlights five issues—workforce,Medicaid managed care, nursing home safety and accountability, livable communities for all, growing population of aging immigrants—based on their overall importance and potential for immediate impact.
The Center for Long-Term Care Reform has been monitoring and responding to the roll out of managed care in Illinois Medicaid since the launch of the managed long-term services and supports in 2010. Early in the process of transitioning to managed care, we advocated for transparency, consumer protections, and quality assurance. As managed care has matured and expanded to new areas and populations, notably to include newly eligible ACA enrollees, we have turned our attention to the capacity of managed care to reduce disparities and achieve health equity. This paper describes one managed care plan's experience with addressing health equity based reform.
The Medicare Hospital Readmissions Reduction Program began four years ago, and has attracted both support for its overall efficacy and criticism for its impact on safety net hospitals. Meanwhile, state Medicaid programs are using readmissions as a performance measure for hospitals and for managed care plans. This paper compares the federal HRRP with Illinois Medicaid’s Potentially Preventable Readmissions Program, and asks what Illinois can learn from the successes and shortcomings of the federal program.