TY - JOUR
T1 - Comprehensive home-based care coordination for vulnerable elders with dementia
T2 - Maximizing Independence at Home-Plus—Study protocol
AU - Samus, Quincy M.
AU - Davis, Karen
AU - Willink, Amber
AU - Black, Betty S.
AU - Reuland, Melissa
AU - Leoutsakos, Jeannie
AU - Roth, David L.
AU - Wolff, Jennifer
AU - Gitlin, Laura N.
AU - Lyketsos, Constantine G.
AU - Johnston, Deirdre
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This reserach was funded by Grant Number 1C1CMS331332 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services (US) and by Grant Number R01AG046274 from the National Institute on Aging, National Institutes of Health (US).
Funding Information:
The project described is supported by Grant Number 1C1CMS331332 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. The authors sincerely thank the study participants and their families, the community partners, and the project’s supporters and funders.
Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Introduction: Despite availability of effective care strategies for dementia, most health care systems are not yet organized or equipped to provide comprehensive family-centered dementia care management. Maximizing Independence at Home-Plus is a promising new model of dementia care coordination being tested in the U.S. through a Health Care Innovation Award funded by the Centers for Medicare and Medicaid Services that may serve as a model to address these delivery gaps, improve outcomes, and lower costs. This report provides an overview of the Health Care Innovation Award aims, study design, and methodology. Methods: This is a prospective, quasi-experimental intervention study of 342 community-living Medicare–Medicaid dual eligibles and Medicare-only beneficiaries with dementia in Maryland. Primary analyses will assess the impact of Maximizing Independence at Home-Plus on risk of nursing home long-term care placement, hospitalization, and health care expenditures (Medicare, Medicaid) at 12, 18 (primary end point), and 24 months, compared to a propensity-matched comparison group. Discussion: The goals of the Maximizing Independence at Home-Plus model are to improve care coordination, ability to remain at home, and life quality for participants and caregivers, while reducing total costs of care for this vulnerable population. This Health Care Innovation Award project will provide timely information on the impact of Maximizing Independence at Home-Plus care coordination model on a variety of outcomes including effects on Medicaid and Medicare expenditures and service utilization. Participant characteristic data, cost savings, and program delivery costs will be analyzed to develop a risk-adjusted payment model to encourage sustainability and facilitate spread.
AB - Introduction: Despite availability of effective care strategies for dementia, most health care systems are not yet organized or equipped to provide comprehensive family-centered dementia care management. Maximizing Independence at Home-Plus is a promising new model of dementia care coordination being tested in the U.S. through a Health Care Innovation Award funded by the Centers for Medicare and Medicaid Services that may serve as a model to address these delivery gaps, improve outcomes, and lower costs. This report provides an overview of the Health Care Innovation Award aims, study design, and methodology. Methods: This is a prospective, quasi-experimental intervention study of 342 community-living Medicare–Medicaid dual eligibles and Medicare-only beneficiaries with dementia in Maryland. Primary analyses will assess the impact of Maximizing Independence at Home-Plus on risk of nursing home long-term care placement, hospitalization, and health care expenditures (Medicare, Medicaid) at 12, 18 (primary end point), and 24 months, compared to a propensity-matched comparison group. Discussion: The goals of the Maximizing Independence at Home-Plus model are to improve care coordination, ability to remain at home, and life quality for participants and caregivers, while reducing total costs of care for this vulnerable population. This Health Care Innovation Award project will provide timely information on the impact of Maximizing Independence at Home-Plus care coordination model on a variety of outcomes including effects on Medicaid and Medicare expenditures and service utilization. Participant characteristic data, cost savings, and program delivery costs will be analyzed to develop a risk-adjusted payment model to encourage sustainability and facilitate spread.
KW - Care coordination
KW - Dementia
KW - Medicaid
KW - Medicare
KW - caregivers
KW - payment
UR - http://www.scopus.com/inward/record.url?scp=85038392870&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038392870&partnerID=8YFLogxK
U2 - 10.1177/2053434517744071
DO - 10.1177/2053434517744071
M3 - Article
C2 - 29607051
AN - SCOPUS:85038392870
SN - 2053-4345
VL - 20
SP - 123
EP - 134
JO - International Journal of Care Coordination
JF - International Journal of Care Coordination
IS - 4
ER -