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Wisconsin’s “Elder Boom”

Wisconsin’s “Elder Boom”. Kitty Rhoades, Secretary Department of Health Services. Wisconsin’s Aging Population - 2015. Wisconsin’s Aging Population - 2035. Pay Sources for Long-Term Care. Medicaid: 42% Medicare: 25% Private Pay Out of Pocket: 22% Private Insurance/Other: 11%.

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Wisconsin’s “Elder Boom”

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  1. Wisconsin’s “Elder Boom” Kitty Rhoades, Secretary Department of Health Services

  2. Wisconsin’s Aging Population - 2015

  3. Wisconsin’s Aging Population - 2035

  4. Pay Sources for Long-Term Care • Medicaid: 42% • Medicare: 25% • Private Pay • Out of Pocket: 22% • Private Insurance/Other: 11%

  5. Wisconsin Medicaid Long-Term Care Programs • Fee-For-Service Nursing Home • Statewide • Legacy Waiver Home- and Community-Base Services • 15 counties • Managed Long-Term Care Programs (e.g. Family Care): nursing home and home- and community-based services • 57 counties • IRIS: self-directed home- and community-based services • 57 counties

  6. Strategies to Control Costs • Aging and Disability Resource Centers • Reduce Nursing Home Utilization • Reduce Need for Higher Cost Services • Medication Compliance • Dementia Care • Falls Prevention • Employment/Vocational Programs • Residential and Natural Supports • Reduce Administrative Burden on MCOs • IRIS Initiatives

  7. Controlling Future Cost Growth: Capabilities of Managed Long-Term Care • Payment structure that drives Managed Care Organizations to continuously improve and provide the most cost-effective care. • Equal access to long-term care services in an individual’s home, community-based settings, or nursing homes, which assures that the level of service matches a member’s needs • Efficiencies from MCO-developed regional and comprehensive provider networks that increase the variety of services available to member at negotiated, competitive rates.

  8. Conclusion • Family Care, and the entitlement of support in homes and community-integrated settings, allows Wisconsin residents to receive cost-effective long-term supports. • Managed long-term care is the most effective strategy to meet the needs of Wisconsin’s residents.

  9. Thank You

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