Medicaid Research Center at the University of Pittsburgh Health Policy Institute

The Department of Human Services developed an independent 7-year evaluation of the Community HealthChoices program. Early development included stakeholder input from consumers, the aging and disability network, advocates, providers and managed care organizations. Over 200 public comments were received from stakeholders. Areas of interests included the importance of using a clear methodological way that reflects regional differences, adding additional key stakeholders to participate, reflect the various age groups, expand survey approaches to include LTSS providers, eligibility and enrollment process, feasibility of translation services for diverse population, demonstrate data by individual plans and aggregate, and frequent updates on evaluation activities and analysis of the program.

The revised Evaluation Plan is available and will be updated as needed during the course of the project. The complete Evaluation Plan provides a narrative overview of how the University of Pittsburgh proposes to structure and implement the CHC program evaluation. The narrative describes the timeline of the evaluation, primary research questions, data collection methods and analytic strategies.

The University is conducting a comprehensive multi-year evaluation of Pennsylvania's new Medicaid Long-Term Services and Supports (MLTSS) program, Community HealthChoices (CHC). The evaluation is providing an independent assessment of the implementation and outcomes of the program to complement other oversight and quality assurance activities conducted by the Department of Human Services (DHS), Office of Long-Term Living. The evaluation will address the following broad research questions:

  1. Does CHC result in greater access to home and community-based LTSS and shift the balance of care away from institutionalized settings for people who prefer to live in the community?
  2. Does CHC improve coordination of LTSS, physical health care, and behavioral health care?
  3. Does CHC improve the quality of care and quality of life of participants and family caregivers?
  4. Does CHC lead to innovation in the delivery of physical health care and LTSS?
  5. Does CHC reduce unnecessary utilization of services and reduce the growth in aggregate costs?

The evaluation is also analyzing administrative data, enrollment, utilization and cost data from Pennsylvania Medicaid and from Medicare services. The evaluation has also incorporated data from a variety of sources, including the CHC-MCOs, nursing facilities, person-centered service plans, and level of care assessments.

A 3-year Public Report is available, and will be updated as needed during the course of the project.