Frank Spinelli is a Senior Consultant at The Stephen Group, LLC. Frank is a former Medicaid director with a proven record of innovative and successful leadership of long term services and support programs in the public and private sector. Prior to joining The Stephen Group, Frank worked for Xerox, Government Healthcare Solutions as the Vice President of Long-Term Care and Care and Quality solutions. In that role he was responsible for the development and implementation of Xerox’s long-term services and supports strategy and care management programs. Frank has almost four decades of experience working with long-term care and chronic care populations and in providing long-term services and supports across the life cycle; including the Rhode Island’s PASRR program, Pharmacy programs, LTSS and IDDD programs. Under his leadership, Rhode Island designed and implemented its first PACE program, three new home and community based waivers, a Traumatic Brain Injury Resource Center, an Aged and Disability Resource Center, a nursing home transition/diversion program as well as the Connect Care Program – Rhode Island’s first person-centered medical home program.

While Medicaid Director, Frank led the efforts to create the RI Global Waiver which rolled all of Medicaid including its HCBS programs and a number of state operated programs into a single waiver which focused on rebalancing the long-term care system, care management, providing a medical home and value purchasing. Under the Global Wavier, Rhode Island added a preventative level of care that enable providing LTSS services to non-nursing level of care participants and introduced a new shared living service that enable individuals to live in their own or caregiver homes. A 2011 Lewin Report on the Global Waiver identified: ‘The actions taken to re-balance the LTC system appear to have generated significant savings according to our estimates.’

Frank also has experience in developing long-term services value based purchasing programs. While at Xerox he worked with the Payment Methodology Group to implement nursing home reimbursement changes in DC, New Hampshire and California. While with Rhode Island Medicaid in 2006, he developed one of the few home care value purchasing programs that reimburse home care agencies enhance rates for certain items such as shift differential, staff education and continuity of care. A report from the AARP Public Policy Institute entitled: Paying for Quality Care: State and Local Strategies for Improving Wages and Benefits for Personal Care Assistants highlighted the rate enhancements as an example for other states.

Over the years Frank has been involved with the implementation and design of Medicaid Management Information Systems that not only focused on payments but data analytics as well. In Wyoming, he helped designed a program that used Medicare MDS data to identify Medicare beneficiaries that still clinically qualified for Medicare nursing home care. He also led an effort to determine the unmet needs of nursing home residents and lead a dental initiative to evaluate dental care of nursing home residents. While at Xerox he evaluated case management systems, caregiver Aps, predictive analytics, visit verification and home monitoring systems and companies in support of developing partnerships and acquisitions.

Frank is an alumnus member of the National Association of Medicaid Directors (NAMD); a former member of the Governor’s Council on Behavioral Health, the Governor’s Brain InjuryCommission, CMS’s System Technical Assistance Group (STAG, the New England States Consortium System Organization (NESCSO) and a current member of National Association of PASRR Professionals and CMS’s PASRR Technical Assistance Center.