This Chartbook is an update to the Chartbook: Older Adults and Adults with Physical Disabilities: Population and Service Use Trends in Maine 2010. With the aging of Maine’s population and its status as the “oldest” state in the nation, the use of long term services continues to be a critical public policy issue in the State and nationally. The information in this Chartbook is provided to help inform state policy makers, legislators, providers, advocates and others with an interest in this subject.
Outline of the Chartbook:
Sections 1-4 of this Chartbook provide general demographic information on historical and projected change in the population of older adults in Maine, by county and compared with other states. These sections also provide an overview of the number of older adults who live in poverty, have a disability and live in rural areas.
Sections 5 and 6 provide comparisons of the characteristics of people who live in nursing facilities, residential care facilities and at home.
Sections 7-10 examine the trends in the use and “case mix” of people in nursing facilities and residential care facilities.
Section 11 provides an overview of the supply of nursing and residential care facilities and beds.
Section 12 includes a summary of selected quality indicators across long term care settings.
Section 13 provides a comparison of the use of services across long term care settings and
Section 14 provides comparative expenditure data.
When referencing or using any of the charts or other materials in the Chartbook, please use the following recommended citation:
Fralich, J. et al., Older Adults and Adults with Disabilities: Population and Service Use Trends in Maine, 2012 Edition. (Chartbook). Portland, ME: University of Southern Maine, Muskie School of Public Service; 2012. Available at: http://muskie.usm.maine.edu/Publications/DA/Adults-Disabilities-Maine-Se...
This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. This first report provides a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008-2010. This report provides baseline data on the characteristics of Medicare-MaineCare members who are dually eligible, the distribution of expenditures across categories of service for MaineCare and Medicare, and the cost of care for people with select chronic conditions. The report includes information on members considered full benefit as well as those who are partial benefit members. Partial benefit members are also know as Qualified Medicare Beneficiaries, Specified Low Income Medicare Beneficiaries; Qualified Individuals; and Qualified Disabled and Working Individuals. Individuals who are dually eligible for MaineCare and Medicare typically have multiple chronic conditions, high medical and long term care costs, and low income. Medicare covers hospital, medical, skilled long term care and pharmacy services while Medicaid pays for behavioral health, community based long term services and supports and nursing home services. The integration of services and benefits for people who are dually eligible is a challenge for states and the federal government. As states move to introduce value based purchasing initiatives through health homes, accountable care communities and other managed care efforts, the need to coordinate services and align incentives between the Medicaid and Medicare programs becomes increasingly critical. Many states are involved in dual eligible demonstrations to improve the integration of services, benefits and care.
Suggested Citation: McGuire C, Gressani T, Bratesman S, Fralich J, Griffin E. Members Dually Eligible for MaineCare and Medicare Benefits: MaineCare and Medicare Expenditures and Utilization, State Fiscal Year 2010. (Chartbook). Portland, ME: University of Southern Maine, Muskie School of Public Service; October 2012.
Behavioral Risk Factor Surveillance System is one of Maine’s standard health behavior surveillance systems, data from which informs policy development, program planning, and other public health interventions for chronic disease prevention. This project will assist the Maine BRFSS coordinator and the Maine CDC to achieve BRFSS objectives. Muskie School staff will update the BRFSS interactive web query as well as maintain multiple-year standardized datasets, add the most recent year of data, and update documentation. Muskie staff will also perform other analyses as necessary, including multivariate and trend analyses to help the Maine CDC better understand prevalence, risk factors and disease management for health behaviors and conditions (such as diabetes, asthma, and cardiovascular disease) that impose a heavy burden on the residents of Maine and its health care system.
Established in 1992, the mission of the Maine Rural Health Research Center is to inform health care policy making and the delivery of rural health services through high quality, policy-relevant research, policy analysis and technical assistance on rural health issues of regional and national significance. The Center's core funding is provided by the federal Office of Rural Health Policy.
The Office of MaineCare Services and the New Hampshire Medicaid Program have observed a trend in the conversion of physicians from private practice to other practice arrangements including Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), hospital-owned practices, and hospital outpatient departments. The extent and consequences of these changes are largely unknown; however, reimbursement is higher for Medicaid patients when care is provided within these facilities rather than physician offices. This project will result in an understanding of changes to the organization and finance of physician practice in Maine and New Hampshire, the contribution of the federal process for approving FQHCs / RHCs on these trends, and potential policy options for mitigating the impact to Medicaid.
The project includes a literature review, interviews with state Medicaid officials and practice administrators, and analysis of claims data.
Maine Primary Care Association; Maine-Dartmouth Family Practice Residence; Women's Health Initiative; Maine CDC Cardiovascular Program; Physical Activity and Nutrition Program; Office of Elder Services Living Well Program; Office of Minority Health-Tribal Invitation; Maine Women's Health Campaign, OAMHS/DHHS;
Abstract:
CVD is the leading cause of death in Maine. Project will focus on developing a gender-based approach to two Healthy People 2010 objectives concerning high blood pressure and action taken to control high blood pressure by increasing the proportion of adults who engage in moderate physical activity and consume health fruits and vegetables. Project will embed gender-based approaches to managing chronic conditions into primary care and family medicine systems of care via existing care model collaboratives. Develop a strategic plan to share outcomes and resources for spread to other chronic conditions within Maine's health care systems. Project will incorporate mental health screenings and analyze data by gender.
In 2005, the Department of Health and Human Services, (DHHS) and Muskie School jointly developed a proposal for the DHHS to enter into a five-year agreement wit the Centers for Disease Control and Prevention (CDC). The purpose of the grant is to develop a coordinated, strategic approach to reduce the incidence, and morbidity of injury through surveillance and prevention efforts. More specifically, this agreement will enable the Maine Injury Prevention Program (MIPP) to: Build a solid infrastructure for injury prevention; collect and analyze injury data; design, implement, and evaluate interventions through collaboration with partners; provide technical support and training; and reduce the burden of injury in Maine through public policy. The purpose of the one-year agreement is to fund program management to carry out the following activities: strategic, data-driven program planning and development, facilitated stakeholder involvement, technical report development using new surveillance data, grants management, technical assistance to organizations implementing injury prevention and control programs, stakeholders and staff on conducting evaluation; selecting best-practice interventions, program development (using logic models), using new injury surveillance data, reviewing progress towards project goals and objectives, and preparing and submitting reports to CDC.
This Cooperative Agreement covers a set of activities that are designed to enhance the Department?s use of performance data for management and quality improvement, including (a) conducting performance measurement, surveys and other evaluative activities at the Department level; (b) building management capacity for using and reporting existing data in at least two DHHS Offices; (c) facilitating processes for collecting and reporting stakeholder input into Department decisions.
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