As I noted in a previous post, UnitedHealthcare Community & State has a National Advisory Board (Board). The Board members are consumers, caregivers and advocates of individuals with special health care needs. They come together to help identify emerging trends and make program and policy recommendations. In my role, I have the great fortune of working with the Board to advance our collective goal of improving the quality of life for all individuals served by Medicaid, including the aging and disabled.
Over the last year and a half, the Board focused on the need to create a health care culture where access to care is foundational. Through this multi-year project, the Board explored available research and data in order to develop recommendations for benefit designs that support people with disabilities of all ages, as well as their caregivers, to live with improved health, dignity, and independence in their community. These recommendations, which I have recapped below, are captured in the Board’s recently released white paper, Culture of Access: Waiver Benefit Design Overview and Recommendations.
- Benefit designs should reflect that individuals are unique and come from a variety of backgrounds. As a result, states should make available the benefits and services noted in the paper to all individuals in need of long-term services and supports (LTSS) based on their needs and desires and in alignment with their person-centered care plan (and not solely on diagnosis).
- By streamlining and consolidating existing waivers, states can more effectively create program efficiencies that could reduce administrative complexity inherent when operating multiple waivers.
- There are several advantages for states opting to consolidate their waivers but in doing so they must also ensure that their program design recommendations simultaneously improve care and contain costs.
- Caregivers face a number of challenges including emotional and financial difficulties, high expectations, and balancing their own lives and ensuring that they are supported will positively affect the individuals they are caring for. Current Medicaid rules should be leveraged to strengthen caregiver supports and states should ensure that caregivers are aware of those available resources and how to access them.
- As states consider consolidating or streamlining their waivers to customize their programs and provide a defined set of HCBS to targeted populations, they must ensure that each individual has equal access to the services necessary to meet their unique needs and they must not limit services based on an individual’s population group. For instance, states cannot mandate that the Personal Emergency Response Systems (PERS) benefit is only for older adults or that individuals with intellectual and developmental disabilities can only access habilitation services.
UnitedHealthcare and our National Advisory Board are dedicated to ensuring that individuals of all ages with intellectual and developmental disabilities, physical disabilities, behavioral health diagnoses, cognitive impairments, or serious mental illness have access to the services they need to live healthier lives in the community as well as greater flexibility and control over their own lives.
We look forward to working in partnership with the federal government, states, consumers, and other stakeholders to discuss these recommendations and ultimately to design programs and provide benefits that are most appropriate for individuals with complex health needs.
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