On March 27, 2012 at a California Senate information hearing on In Home Supportive Services Integration into Medi-Cal Managed Care, Stephen Kaye presented a paper on the outcome measurements for managed LTSS.

Read Managed Long-Term Services and Supports in California: The Importance of Outcome Measurement

Read background information to the hearing

Transparency and public access to evaluation data are essential both for individuals to be able to make choices among plans and for stakeholders to evaluate the success of the demonstration.

Plan performance on plan performance, including member satisfaction and outcome measures, should be publically available and easy to access.  Particularly because these models are demonstrations, information about costs, savings and medical loss ratios also should be made public.

• Ohio has proposed to post monthly enrollment figures and other operational reporting (e.g., utilization data, incident reporting, nursing facility census) on Ohio’s Medicaid website.  For all data collected from plans, the state will present the information by plan and region.  (Ohio proposal at 24)

• Getting an amendment to your state’s Freedom of Information statute that explicitly makes demonstration plans subject to FOIA requirements also supports transparency.  In Connecticut, litigation interpreting the state’s FOIA statute resulted in a finding that Medicaid managed care contractors perform a “governmental function” and thus are bound by FOIA requirements.  As a result, the RFP for state Medicaid managed care companies states that companies are bound by FOIA.  The court decision is Health Net of CT v. FOIC, available at 2006 WL 3691796, 42 Conn. L. Rptr. 441 (Conn.Super.)  The Connecticut statute is Conn. Gen. Stat. §1-200(11), which must be read in conjunction with Conn. Gen. Stat. §1-218.