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Evaluation of the managed community care demonstration project
Susan L Hughes1, Sanford Finkel, Kathryne Harter
1University of Illinois at Chicago, USA.
Journal of Aging and Health
|March 5, 2003
Summary
Capitation in community care increased covered services and efficiency while maintaining client satisfaction and not affecting nursing home admissions. This model shows promise for home and community-based services.
Area of Science:
- Health Services Research
- Gerontology
- Public Health Policy
Background:
- Home and community-based services (HCBS) are crucial for aging populations.
- Traditional fee-for-service (FFS) models can lead to escalating costs.
- Innovative payment models are needed to balance service expansion and cost containment.
Purpose of the Study:
- To evaluate the impact of a capitated community-care demonstration in Illinois.
- To assess changes in service range, client satisfaction, agency costs, and nursing home admissions.
- To determine the feasibility of capitation for HCBS.
Main Methods:
- Pretest and posttest design with 752 demonstration clients (mean age 80, 2 ADL impairments).
- Measured client satisfaction, range of services, agency costs, and nursing home admissions.
- Compared outcomes to clients receiving services under fee-for-service (FFS).
Main Results:
- Covered services increased from 3 to 14; mean services used rose from 1 to 2.5.
- Client satisfaction remained stable; agency costs declined.
- No significant difference in nursing home admissions compared to FFS.
Conclusions:
- Capitation effectively expanded the range of covered HCBS.
- The model improved efficiency and maintained client satisfaction.
- Further testing of capitated HCBS is recommended in diverse settings and with various providers.