The Wisconsin Department of Health Services has contracted with The Liberty Health Care Corporation for 16 million dollars to perform assessments for a 3 year period of time. Liberty is located 401 E. City Avenue, Bala Cynwyd, PA 19004.
Liberty conducts an assessment and eligibility program designed to match time with task with medically necessary activities required to maintain health and safety. Medically necessary typically means hands on help of another for eating, bathing, toileting, dressing, and transfers. Each of these tasks will have a range of minutes it would take to help complete the activity.
Eating range in minutes 20- 30 frequency 3-4 per day
Bathing range in minutes 25-35 frequency 1-2 per week
Toileting range in minutes 15-25 frequency 6-12 per day
Dressing range in minutes 15-25 frequency 2-3 per day
Transfers range in minutes 10-20 frequency 4-6 per day
In this example the beneficiary needs help eating 4 x per day - 20x4= 80 minutes.
The beneficiary takes one bath a week - 35 minutes
The beneficiary is toileted 7 x per day - 15x7= 105 minutes
The beneficiary is dressed 2 x per day - 20x2= 40 minutes
The beneficiary is transferred 7 x per day - 15x7= 105 minutes
80 + 105 + 40 + 105 = 330 minutes - divided by 60 = 5.5 hours per day
Bath day would be 6 hours and 5 minutes.
The Medicaid fund reimburses the provider 16.00 per hour for helping the beneficiary complete the activities of daily living. These activities are defined as preventive interventions to help maintain health and safety and reduce the need for higher cost treatments.
If we take the 16.00 per hour x the 5.5 hours per day the estimated daily cost is about 88.00 dollars per day. This would be higher on bath day about another 8.00 dollars.
Liberty Healthcare Corporation will send a clinical professional in to each Medicaid beneficiaries dwelling at least once per year to perform an assessment like we see outlined above. The beneficiaries needs are expected to be static - unchanging for the period of one year.
The cost of performing these assessments can be calculated by dividing the 16 million dollars by the 3 years to find an annual cost of about 5.3 million dollars. Department of Health Service analysis will be looking to see if this intervention reduces the outflow of Medicaid fund money by more than the 5.3 million dollars per year.
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