VCU to lead evaluation of program for Medicaid members who require long-term services, support

The Virginia Department of Medical Assistance Services has selected Virginia Commonwealth University to lead a five-year evaluation of the state’s new Commonwealth Coordinated Care Plus program.

CCC Plus is a Medicaid-managed long-term services and support program designed primarily for people 65 and older who have both Medicaid and Medicare coverage, as well as adults and children with disabilities who require long-term care services and supports. The program, which started in the Tidewater region in August 2017, has been implemented across the state in phases. As of January 2018, the program is operational statewide and currently serves more than 200,000 Virginians.

“The CCC Plus program seeks to improve the care of Medicaid members who have the most complex and costliest care needs,” said Peter Cunningham, Ph.D., professor in the VCU School of Medicine’s Department of Health Behavior and Policy.

Cunningham will lead the evaluation with Andrew Barnes, Ph.D., also from the Department of Health Behavior and Policy, and E. Marshall Brooks, Ph.D., from the School of Medicine’s Department of Family Medicine and Population Health. The VCU team is also leading an evaluation of the Addiction and Recovery Treatment Services program, which increases access to addiction treatment services for Medicaid members who have substance use disorders.

The objectives of CCC Plus are to improve the quality, access and efficiency of long-term services and provide support for Virginia’s Medicaid population. The program achieves the objectives primarily by coordinating medical and long-term care needs through managed-care organizations, which use care coordinators to work directly with members to address their needs. By better coordinating care, as well as utilizing innovative care delivery and payment models, a key goal of CCC Plus is to increase the ability of Medicaid members requiring long-term services and supports to live at home or in other community-based residential settings, rather than in nursing facilities or other institutions.

“Fragmentation of care services and the lack of care coordination has been a major problem in the past for this population because their medical and long-term care needs are covered by different payers — Medicare and Medicaid,” Barnes said. “CCC Plus seeks to bridge that gap and, in the process, improve both the quality of care and quality of life for these members.”

The new program is expected to better manage the costs of care for the target population and increase budget predictability for state policymakers and legislators. While people who are eligible for CCC Plus comprise 28 percent of the state’s Medicaid population, they account for 68 percent of state Medicaid expenditures, according to DMAS.

“When policymakers worry about the impact of the Medicaid program on the state budget, it is the population eligible for CCC Plus that they are most concerned about because their care needs are the most costly and have been the most difficult to manage historically,” Cunningham said.

The VCU evaluation team will use member surveys and focused interviews with care coordinators and other health care providers, as well as analysis of Medicaid claims data, to determine if CCC Plus reaches its goals of improving quality of long-term care services, reducing nursing facility admissions, and controlling program costs.