In 2011, The Stephen Group completed a comprehensive analysis of the South Carolina Department of Health and Human Services Long Term Care program. The State had asked the The Stephen Group team to analyze the data, program and practices of the long term care program and system and come up with a recommendation on strategies the state can develop to rebalance its long term care system.
Having reviewed the details of the state’s long term care system, as well as the approach that other states have taken, several of which were detailed in this report, The StephenGroup recommended that South Carolina implement a Community First Choice model that would for coordinating care for eligible seniors in an integrated manner across all Medicaid services.
Implementing a Community First Choice approach, as well as other changes to improve the efficiency of the Medicaid long term care system in South Carolina would have substantial financial savings opportunities. A detailed model included in The Stephen Group report outlines how an aggressive approach of these steps can produce savings of over $1 billion through Fiscal Year 2021. Assuming that South Carolina maintains a federal medical assistance percentage (FMAP) of 70% during this period, this would represent a savings of approximately $300 million in state general funds over a 10-year period.
Alternately, SCDHHS could follow an incentive-driven strategy that rewards providers for following best practices and paying for performance. This approach, if implemented with a concerted effort to realize a Community First Choice model, could still produce savings of over $800 million in total funds and $240 million in state general funds over the same time period.