2024 Health Meeting - Session 8B: Dan and Me - Our Journey Through the Medicaid LTSS System 6.25.24 Recording

I’ve been an actuarial consultant for 30 years, serving Medicaid agencies in multiple states to help my clients run cost-effective Medicaid programs that provide high-quality care to our most vulnerable populations. I am retiring on June 30, 2024. My older brother Dan is an adult with autism. We grew up together in the 1970s and 80s. He was diagnosed with autism in the early 70s when there was little to no support for people with disabilities living in the community. I’ve had a front row seat to witness his struggles, triumphs, limitations, and opportunities over the last 50 years. Today, I am his guardian, manage all of his care, and regularly interact with the Medicaid LTSS system in a very different capacity than my job as an actuary. Knowing Dan and seeing him live his life in the community makes me a better Medicaid actuary. My experience as a Medicaid actuary makes me a better brother and guardian to Dan. I want to share our story and offer you our unique perspective on the Medicaid LTSS system through real-life examples. In this session, attendees can expect to learn about the following questions: How does the data we use as actuaries impact the quality of care people like Dan receive? Functional screening tools – what does an actuary think they measure vs. what a guardian knows about the screening process? What workforce constraints exist for direct care workers and other professionals that care for adults with autism? How has my experience as a Medicaid actuary helped me care for Dan? How has my experience with Dan influenced how I think about the Medicaid LTSS system? How has my experience with Dan influenced how I think about setting Medicaid managed care capitation rates? What does Dan want you to know?