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Social and Behavioral Sciences Commons

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Full-Text Articles in Social and Behavioral Sciences

Massoptions Transforms The Way Elderly And People With Disabilities Get Much Needed Long-Term Services And Supports In Massachusetts, Jeff A. Auger, Kerrie Topi Jun 2018

Massoptions Transforms The Way Elderly And People With Disabilities Get Much Needed Long-Term Services And Supports In Massachusetts, Jeff A. Auger, Kerrie Topi

Commonwealth Medicine Publications

Some of the Commonwealth’s most underserved populations—the elderly, people with disabilities, and their caregivers— now have simplified access to the long-term services and supports (LTSS) they need, thanks to MassOptions, an innovative collaboration between UHealthSolutions, the nonprofit business affiliate of UMass Medical School, and the Massachusetts Executive Office of Elder Affairs.


Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman Aug 2017

Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman

Commonwealth Medicine Publications

This poster highlights the results of a UMass Medical School partnership with MassHealth, the Massachusetts Medicaid program, to integrate third party liability (TPL) activities across all aspects of the Medicaid program. By embedding TPL at all stages of Medicaid operations and interfacing with all Medicaid systems, the partners optimized identification of and access to TPL sources for all Medicaid members.

The TPL activities include eligibility coordination, coverage coordination, payment coordination and recovery coordination. The partnership has achieved over $40 million in cost avoidance through the identification of missed Medicare benefits, over $64 million in cost avoidance over enhanced coordination of ...


Determination Of Massachusetts’ Respite Policies And The Potential Impact Of Unpaid Family Care Giver Support On Home And Community Based Services, Leanne Winchester, Kate Russell, Kelly Love Jul 2017

Determination Of Massachusetts’ Respite Policies And The Potential Impact Of Unpaid Family Care Giver Support On Home And Community Based Services, Leanne Winchester, Kate Russell, Kelly Love

Commonwealth Medicine Publications

Direct care workforce shortages, increasing health care costs, and limited access to services force many families to make life-changing decisions to care for family members with long term disabilities or who are chronically ill at home. For this project, the authors conducted an environmental scan of current policies and programs for state and federally funded respite services across Massachusetts’ state agencies.

The results of this project demonstrate the variability in Massachusetts’ state policies and program practices in four primary areas:

  • The types of respite services offered by state agencies

  • The agencies definition of respite services

  • Variability in the ability of ...


Evaluation Of Progesterone Agent Utilization And Birth Outcomes In A State Medicaid Plan, Tasmina Hydery, Mylissa K. Price, Bonnie C. Greenwood, Mito Takeshita, Rose Mauro, Parag Kunte, Kimberly J. Lenz, Paul L. Jeffrey Feb 2017

Evaluation Of Progesterone Agent Utilization And Birth Outcomes In A State Medicaid Plan, Tasmina Hydery, Mylissa K. Price, Bonnie C. Greenwood, Mito Takeshita, Rose Mauro, Parag Kunte, Kimberly J. Lenz, Paul L. Jeffrey

Commonwealth Medicine Publications

An analysis of medication adherence and birth outcomes among members receiving progesterone for the prevention of preterm birth in a state Medicaid program. Data is also used to evaluate the association between member characteristics and medication adherence and birth outcomes as well as whether there was a change in the cost of care.


The Pediatric Behavioral Health Medication Initiative, Neha Kashalikar Sep 2016

The Pediatric Behavioral Health Medication Initiative, Neha Kashalikar

Commonwealth Medicine Publications

How the Massachusetts Medicaid Pharmacy Program, which is managed by UMass Medical School, developed the Pediatric Behavioral Health Medication Initiative. The initiative was created in response to studies and reports that found pediatric behavioral health medication polypharmacy regimes had been increasing. Compared to the rest of the country, the prevalence was highest among the MassHealth pediatric population.

A prior authorization requirement, guidelines, case review and a prescriber outreach process were established as part of the initiative to ensure MassHealth pediatric members were being prescribed appropriate behavioral health medication.


Improving The Direct Care Workforce Through Core Competency Training, Leanne Winchester, Lauren Bercaw Apr 2016

Improving The Direct Care Workforce Through Core Competency Training, Leanne Winchester, Lauren Bercaw

Commonwealth Medicine Publications

This report provides a comprehensive overview of the MA Personal and Home Care Aide State Training (PHCAST) Grant Project funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing. The grant aimed to improve existing training for home care aides, offer training for personal care attendants, increase transferability of the workforce, and reduce turnover. The state also sought to standardize core competencies and training facilitation for direct care workers who provide long-term care in community‐based settings for diverse populations.

The accomplishments of the grant project include ...


Stories From The Frontline: Patient-Centered Medical Home Care Transitions, Anita Morris, Joan Johnston, Sai Cherala, Ruth Aboagye, Pam Senesac, Judith L. Steinberg, Jaime Vallejos Mar 2016

Stories From The Frontline: Patient-Centered Medical Home Care Transitions, Anita Morris, Joan Johnston, Sai Cherala, Ruth Aboagye, Pam Senesac, Judith L. Steinberg, Jaime Vallejos

Commonwealth Medicine Publications

The Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI) was a three-year multi-payer demonstration designed to promote clinical model transformation in practices across the state and prepare the practices for PCMHI recognition. It was a partnership between MassHealth, the Massachusetts Medicaid program, and UMass Medical School. An analysis of the project at 46 participating practices finds that primary care practice transformation takes time; care transitions, including emergency room and post-discharge follow-up care, require the development of new clinical workflows; and the processes of care are more likely to improve before outcomes are affected. These lessons learned can aid provider organizations nationwide ...


Using Pdsas To Optimize Surgical Screening, Wesley Klein, Joan Johnston, Anita Morris Mar 2016

Using Pdsas To Optimize Surgical Screening, Wesley Klein, Joan Johnston, Anita Morris

Commonwealth Medicine Publications

This poster describes a project that used a patient-centered medical home model to improve cervical cancer screening for patients at Duffy Health Center in Hyannis. Lessons learned include: identifying existing opportunities to provide whole-person care may provide revenue enhancement opportunities; practice workflow tools require user input in their development to be accepted and effective; buy-in from all team members is crucial and it is important for the team to agree on the process; and data collection is essential, along with ongoing quality improvement and practice transformation coaching.


The Healthy People 2020 Roadmap For Massachusetts Children & Youth With Asd/Dd: Understanding Needs And Measuring Outcomes, Elaine Gabovitch, Courtney Dutra, Emily Lauer Nov 2015

The Healthy People 2020 Roadmap For Massachusetts Children & Youth With Asd/Dd: Understanding Needs And Measuring Outcomes, Elaine Gabovitch, Courtney Dutra, Emily Lauer

Commonwealth Medicine Publications

The Massachusetts Autism Commission 2012 report identified “a critical need to develop a comprehensive statewide approach” to respond to the needs of the rapidly increasing population of people with autism spectrum disorder and developmental disabilities (ASD/DD). In response, UMass Medical School has been conducting a needs assessment to inform efforts to establish a state-level data collection and surveillance plan for systems of services for children and youth with ASD/DD.

Although Massachusetts is a resource rich state, through a review of secondary data analysis, key informant interviews, focus groups, and surveys, the needs assessment has identified certain gaps in ...


Massachusetts Eligibility Data Platforms: Integrating State And Federal Data Sets To Maximize Benefits And Savings, Jenifer Hartman, Yuping Su Aug 2015

Massachusetts Eligibility Data Platforms: Integrating State And Federal Data Sets To Maximize Benefits And Savings, Jenifer Hartman, Yuping Su

Commonwealth Medicine Publications

This poster presentation shows how UMass Medical School works with state Medicaid programs to customize and implement business methodologies to maximize benefits for individuals and savings for states. The medical school’s collaboration with state and federal agencies has resulted in two national corrections of federal benefits systems in the past five years that led to increased benefits for individuals and increased Medicaid savings and revenue in all states.

Presented at the Medicaid Enterprise Systems Conference 2015.


Massachusetts Expert Panel On End Of Life Report: Looking Forward: 2014 And Beyond, Linda J. Cragin Mar 2015

Massachusetts Expert Panel On End Of Life Report: Looking Forward: 2014 And Beyond, Linda J. Cragin

Commonwealth Medicine Publications

This report provides a brief snapshot of end of life care activity in Massachusetts, identifies related themes and trends in Massachusetts health care institutions, and conveys current concerns and priorities for improving end of life care in the Commonwealth.


One State's Perspective On The Management Of Hepatitis C Drugs, Pavel Lavitas Feb 2015

One State's Perspective On The Management Of Hepatitis C Drugs, Pavel Lavitas

Commonwealth Medicine Publications

This presentation provides an overview of the hepatitis C virus monitoring program implemented for state Medicaid to contain costs and to promote optimal member care. Key clinical and economic outcomes of the monitoring program are highlighted and formulary management strategies for novel hepatitis C virus agents identified.

Presented at the American Drug Utilization Review Society 2015 Conference.


Massachusetts Hospital Profiles: Data Through Fiscal Year 2013, Michael Chin Jan 2015

Massachusetts Hospital Profiles: Data Through Fiscal Year 2013, Michael Chin

Commonwealth Medicine Publications

An industry overview and chartbook that provides a comprehensive look at the Massachusetts' hospital system.


Overview Of A Hepatitis C Medication Monitoring Program In A State Medicaid Program, Pavel Lavitas, Kimberly J. Lenz, Tasmina Hydery, Mark Tesell, J. Gagnon, Paul L. Jeffrey Oct 2014

Overview Of A Hepatitis C Medication Monitoring Program In A State Medicaid Program, Pavel Lavitas, Kimberly J. Lenz, Tasmina Hydery, Mark Tesell, J. Gagnon, Paul L. Jeffrey

Commonwealth Medicine Publications

This presentation outlines a successful hepatitis C medication monitoring program instituted by Clinical Pharmacy Services for MassHealth, the Massachusetts Medicaid program. The program used outreach and education strategies to communicate with prescribers about regimens that were the most effective in treating the virus and containing costs. Member adherence to the regimen was monitored and hepatitis C cure rates were tracked through the program.


Implementing Integrated Clinical Care Management In The Patient-Centered Medical Home, Jeanne Z. Cohen, Christine Johnson, Judith Steinberg, Sai Cherala Mar 2014

Implementing Integrated Clinical Care Management In The Patient-Centered Medical Home, Jeanne Z. Cohen, Christine Johnson, Judith Steinberg, Sai Cherala

Commonwealth Medicine Publications

Clinical Care Management (CCM) of the highest risk, most complex and costly patients is a key element of the Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI), and is a new service for most primary care practices. There is much confusion about the role of the Care Manager (CM), and a lack of awareness of key foundational elements critical to successful implementation of CCM. This poster describes the shared approach to implementation of CCM in the MA PCMHI, use of care management and care coordination clinical quality measures to monitor implementation progress, and shared lessons learned in the implementation process.


Meeting Massachusetts' Growing Demand For Home And Community-Based Supports, Leanne Winchester, Kate Russell Mar 2014

Meeting Massachusetts' Growing Demand For Home And Community-Based Supports, Leanne Winchester, Kate Russell

Commonwealth Medicine Publications

This presentation provides an overview of the innovative approaches and lessons learned from the Massachusetts Personal and Home Care Aide State Training (PHCAST) grant, a project managed by UMass Medical School for the Executive Office of Health and Human Services. PHCAST defined core competencies for direct care workers, and developed a standardized training in those competencies


Health Needs Assessment Of People With Disabilities In Massachusetts, 2013, Mitra Monika, Christine J. Clifford, Lauren Smith, Bridget Landers, Rachel Tanenhaus, Georgia Simpson Jan 2014

Health Needs Assessment Of People With Disabilities In Massachusetts, 2013, Mitra Monika, Christine J. Clifford, Lauren Smith, Bridget Landers, Rachel Tanenhaus, Georgia Simpson

Commonwealth Medicine Publications

The Disability, Health and Employment Policy Unit at UMass Medical School conducted an assessment of the health needs of people with disabilities on behalf of the Health and Disability Program (HDP), Office of Health Equity, Massachusetts Department of Public Health. The assessment was conducted to meet the Centers for Disease Control and Prevention (CDC) funding requirements of the Health and Disability Program and provided an in-depth examination of the health needs of people with disabilities in Massachusetts. This assessment provides comprehensive information on the unmet public health needs and priorities of the disability community in Massachusetts to enable HDP to ...


Implementing Integrated, Interdisciplinary Clinical Care Management In The Patient-Centered Medical Home, Jeanne Z. Cohen, Christine Johnson, Judith Steinberg, Sai Cherala Nov 2013

Implementing Integrated, Interdisciplinary Clinical Care Management In The Patient-Centered Medical Home, Jeanne Z. Cohen, Christine Johnson, Judith Steinberg, Sai Cherala

Commonwealth Medicine Publications

Clinical care management (CCM) of the highest risk, most complex, and costly patients is an integral component of the patient-centered medical home (PCMH) but a new service for many primary care practices. The Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI) is a 3-year, multi-payer demonstration with 45 participating practices. Support for CCM implementation is provided through learning collaboratives and practice facilitation. Techniques for shared learning include developing a CCM interdisciplinary team workflow utilizing process mapping and modeling care plan development. MA PCMHI practices have found these techniques valuable for clarifying what a care plan is and visualizing existing workflows, so ...


Economic Wellbeing And Life Satisfaction Among Working And Non-Working Adults With Disabilities, Alexis D. Henry, Monika Mitra, John Gettens, Jianying Zhang Nov 2013

Economic Wellbeing And Life Satisfaction Among Working And Non-Working Adults With Disabilities, Alexis D. Henry, Monika Mitra, John Gettens, Jianying Zhang

Commonwealth Medicine Publications

Working-age adults with disabilities in the US are more than twice as likely to live in poverty as those without disabilities; poverty rates are greater among non-working people with disabilities compared to those who work. Poverty-associated stress compounds the challenges faced daily by people living with disability.

We examined satisfaction with finances, worries about meeting monthly expenses, and overall life satisfaction among working and non-working adults with disabilities using a 2010 Massachusetts Behavioral Risk Factors Surveillance System (BRFSS) follow-up survey of working-age adults with disabilities (n=882). The MA BRFSS Disability and Employment Follow-Up Survey gathered information on work participation ...


Accountable Care As A Health Reform Tool In Oregon And Massachusetts, Julia Feldman, Rachel Gershon Oct 2013

Accountable Care As A Health Reform Tool In Oregon And Massachusetts, Julia Feldman, Rachel Gershon

Commonwealth Medicine Publications

Over the past few years, Oregon and Massachusetts both established accountable care programs to help improve health care quality and reduce costs. However, some analysts remain skeptical regarding the ability of Accountable Care Organizations (ACOs) or other accountable care entities to rein in costs. Oregon and Massachusetts provide a laboratory for evaluating whether ACOs deliver the outcomes desired, which is especially important as millions of Americans gain access to health insurance under the Affordable Care Act (ACA) next year. This analysis examines each state’s approach.

As the nation grapples with health care policy challenges, accountable care emerged as a ...


Massachusetts Department Of Developmental Services Medication Review, Alexandra Bonardi, Gail Grossman, Emily Lauer Aug 2012

Massachusetts Department Of Developmental Services Medication Review, Alexandra Bonardi, Gail Grossman, Emily Lauer

Commonwealth Medicine Publications

This presentation by Alixe Bonardi goes over the use of pharmaceutical drugs among adults with developmental disabilities, touching on why adults use drugs, when, and the situations that lead pharmacists to prescribe certain drugs.

Presented at the National Association of State Directors of Developmental Disabilities Services (NASDDDS) Reinventing Quality Conference 2012.


Masshealth: The Basics - Facts, Trends And National Context, Robert W. Seifert Jun 2012

Masshealth: The Basics - Facts, Trends And National Context, Robert W. Seifert

Commonwealth Medicine Publications

This updated June 2012 report provides an overview of MassHealth, the Massachusetts state Medicaid program, eligibility and enrollment information, spending growth statistics, and cost drivers analysis.

Client/Partner: Blue Cross Blue Shield of Massachusetts Foundation


Masshealth Hospice Program: Overview And Analysis Final Report, Teresa E. Anderson, Debi Lang, Heather Posner Jun 2012

Masshealth Hospice Program: Overview And Analysis Final Report, Teresa E. Anderson, Debi Lang, Heather Posner

Commonwealth Medicine Publications

The MassHealth Hospice Program: Overview and Analysis study employed mixed methods to conduct a descriptive analysis of primary and secondary data, using document review, key informant interviews, and MassHealth claims and enrollment data. This report explains the structure and implementation of the hospice benefit, examines the increase in hospice benefit utilization and expenditures, assesses member and family satisfaction with the benefit, and describes end of life services provided by Medicaid programs in five states.

Client/Partner: MassHealth


Massachusetts Medicaid Pediatric High-Risk Asthma Bundled Payment Pilot, Katharine London Sep 2011

Massachusetts Medicaid Pediatric High-Risk Asthma Bundled Payment Pilot, Katharine London

Commonwealth Medicine Publications

This presentation provides an overview of the Massachusetts Pediatric Bundled Payment Pilot. The presentation includes the goals and objectives of the pilot, eligibility requirements, scope of services, implementation plans, and outcome measures.


Massachusetts Medicaid: Innovative Fiscal Strategies, The Public Partnership Model, Marc A. Thibodeau Jun 2011

Massachusetts Medicaid: Innovative Fiscal Strategies, The Public Partnership Model, Marc A. Thibodeau

Commonwealth Medicine Publications

This report provides a snapshot of the innovative programs UMass Medical School’s Center for Health Care Financing has initiated and conducted on behalf of the Commonwealth of Massachusetts.

You will see how we have been able to generate revenue and achieve cost avoidance totaling $26 billion over the past 15 years. And while the numbers are impressive, especially in increasingly difficult fiscal times, the more important story is what can be accomplished when the family of state agencies in Massachusetts collaborate and combine their strengths to better serve the public.

The public partnership model offers states the flexibility to ...