Figure 1. Logic Model for Centennial Care Evaluation Inputs Activities Outputs Outcomes -- Impact Short-Term Medium-Term Long-Term Federal Enroll individuals in Care coordinators Participants access Appropriate Improved overall government Centennial Care have responsibility to appropriate utilization of health status for – CMS and knowledge of physical outpatient, Centennial Care Determine care individual participants health, behavioral inpatient, participants State coordination level for each health, and LTSS institutional, and government participant by assessing Participants have HCBS services Decline in – NM HSD risks and health needs improved access even Continuity of care growth rate of when their health for participants Effective and Medicaid MCOs Improve access to physical needs are complex, across the spectrum use of expenditures health, behavioral health, requiring physical of services and the electronic health Providers and LTSS by providing health, behavioral duration of their records and Health service (including care coordination and health, and LTSS needs telemedicine provider payment physical health, Patient-Centered Medical services reform behavioral Homes Efficient provider Provider network health, and Providers have credentialing adequacy across all LTSS) Integrate care across responsible point of domains of service Delivery system physical health, behavioral contact for Improved claims (physical health, clients’ reform Enrollees health, and LTSS by needs and can obtain adjudication behavioral health, giving MCOs full necessary supports and LTSS) NM citizens and responsibility for all Improved advocacy services Providers receive grievance and Satisfaction among groups better compensation appeals processing all providers of Ensure quality of services for delivering quality care (physical delivered under services health, behavioral Centennial Care to health, and LTSS) Medicaid recipients and Citizens and advocates their providers through receive better value for Participant monitoring and incentive Medicaid expenditures satisfaction systems Improve infrastructure to streamline health service delivery
Figure 1. Logic Model for Centennial Care Evaluation Inputs Activities Outputs Outcomes -- Impact Short-Term Medium-Term Long-Term Federal government – CMS State government – NM HSD MCOs Providers (including physical health, behavioral health, and LTSS) Enrollees NM citizens and advocacy groups Enroll individuals in Centennial Care Determine care coordination level for each participant by assessing risks and health needs Improve access to physical health, behavioral health, and LTSS by providing care coordination and Patient-Centered Medical Homes Integrate care across physical health, behavioral health, and LTSS by giving MCOs full responsibility for all services Ensure quality of services delivered under Centennial Care to Medicaid recipients and their providers through monitoring and incentive systems Improve infrastructure to streamline health service delivery Care coordinators have responsibility and knowledge of individual participants Participants have improved access even when their health needs are complex, requiring physical health, behavioral health, and LTSS services Providers have responsible point of contact for clients’ needs and can obtain necessary supports Providers receive better compensation for delivering quality services Citizens and advocates receive better value for Medicaid expenditures Participants access to appropriate physical health, behavioral health, and LTSS Continuity of care for participants across the spectrum of services and the duration of their needs Efficient provider credentialing Improved claims adjudication Improved grievance and appeals processing Appropriate utilization of outpatient, inpatient, institutional, and HCBS services Effective and use of electronic health records and telemedicine Provider network adequacy across all domains of service (physical health, behavioral health, and LTSS) Satisfaction among all providers of care (physical health, behavioral health, and LTSS) Participant satisfaction Improved overall health status for Centennial Care participants Decline in growth rate of Medicaid expenditures Health service provider payment reform Delivery system reform
Evaluation%20of%20the%20Centennial%20Care%201115%20Demonstration%20Waiver%20-%201463080000006%20.docx