CNA to Examine Home and Community Based Health Services Research to Focus on Access, Finances, Services and Quality

ALEXANDRIA, VIRGINIA — CNA (CNA), a non-profit research and analysis institution, today announced that it is undertaking a major study of program management techniques used by states to balance their long term health care systems with home and community based services (HCBS). CNA has received $2M from the Centers for Medicare and Medicaid Services for the project.

"The balance of long-term care provided through HCBS, as opposed to that provided by other institutions is a complex question with political, philosophical and logistical barriers," said Lee Gunn, President of CNA's Institute for Public Research. "This study will help sort through the questions and problems involved in the issue, and provide a framework for finding answers and solutions."

CNA's work, to be carried out in partnership with the University of Minnesota, the National Academy for State Health Policy, and UC San Francisco, will explore best practices that will allow states to overcome barriers to reorienting long-term care toward increased HCBS. The study will also analyze ways that states can gain the programmatic and financial accountability needed to control costs and assure quality.

CNA's analysts will select and work with eight states that provide a range of HCBS and will assess their approaches and management techniques as they relate to access, financing, services, and quality—all toward better understanding the problems and finding effective solutions that will work for all states. Research efforts will provide states with information about their systems' performance, both internally and relative to others, and allow different states to build on each other's experiences. The research findings will also give federal authorities a picture of how well state HCBS programs are performing, whom they serve, at what cost and quality, and what management practices federal authorities should encourage.

"Health officials in all states recognize people's aversion to institutional care, and have consistently worked to make available a greater array of long-term and supportive-care solutions through HCBS, which is what people prefer," explained CNA's Director of Health Care Programs Laurie May. "But it's been difficult for states to expand the long-term care provided through HCBS while still maintaining needed institutional services. It's also been difficult to ensure that HCBS are targeting the right people and are of a quality equal to that found in institutions. This study will provide guidance on how states can resolve those problems."