Perspectives of adults with disabilities and opioid misuse: Qualitative findings illuminating experiences with stigma and substance use treatment.

Background: Opioid misuse is a significant public health problem in the United States; however, there is a gap in knowledge regarding the experiences of individuals who have experienced both opioid misuse/opioid use disorder (OUD) and another disability. This gap in knowledge is particularly problematic because people with disabilities are more likely to have co-occurring serious mental illness, experience chronic pain, and be socially isolated, which are all independent risk factors for any substance use disorder (SUD).

Objective: The purpose of this study was to illuminate the perspectives of individuals who have both opioid misuse/OUD and another disability, focusing on their experiences accessing and engaging in SUD treatment.

Care Plans, Care Teams, and Quality of Life for People with Disabilities.

Background: Massachusetts One Care was the first program approved among the Centers for Medicare & Medicaid Financial Alignment Demonstrations for dually eligible beneficiaries. The only program focusing on dually eligible beneficiaries ages 21-64, One Care espouses an independent living philosophy for persons with disabilities. Researchers engaged with enrollees to develop new measures of enrollee quality of life and health to understand changes experienced in this new model of care.

Health plan enrollees with disability informing primary care practices and providers about their quality of care: A randomized trial.

Background: In October 2013, Massachusetts initiated the One Care demonstration, which enrolls beneficiaries ages 21 to 64 dually-eligible for Medicare and Medicaid. Local disability advocates argued that persons with disability should assess their own One Care quality.

Objectives: To test the comparative effectiveness for improving patient-reported health care experiences of two informational interventions in a 12-month period: (1) "YESHealth: Your Experience, Speak up for better health care," in which disability advocates developed brief topical surveys and gathered information from One Care enrollees with significant physical disability or serious mental illness; and (2) the Persons with Disability Quality Survey (PDQ-S), developed collaboratively with persons with disability.

Description of YESHealth: A consumer-directed intervention in a randomized trial of methods to improve quality of care for persons with disability.

Background: Persons leading their own evaluations of care quality offers the promise of generating maximally meaningful information to ensure person-centered care.

Objectives: To describe an intervention where persons with disability engage other persons with disability, develop their own metrics to assess their care, and provide these care evaluations directly to primary care practitioners, with the goal of improving care. The context was a research study involving One Care, a Massachusetts demonstration program with capitated reimbursement for individuals ages 18-64 dually eligible for Medicare and Medicaid.

Do prominent quality measurement surveys capture the concerns of persons with disability?

Background: Demonstration programs nationwide aim to control costs and improve care for people dually-eligible for Medicare and Medicaid, including many persons with disability. Ensuring these initiatives maintain or improve care quality requires comprehensive evaluation of quality of care.

Objectives: To examine whether the common quality measures being used to evaluate the Massachusetts One Care duals demonstration program comprehensively address the concerns of persons with disability.

Collaborative design of a health care experience survey for persons with disability.

Background: When assessing results of health care delivery system reforms targeting persons with disability, quality metrics must reflect the experiences and perspectives of this population.

Objective: For persons with disability and researchers to develop collaboratively a survey that addresses critical quality questions about a new Massachusetts health care program for persons with disability dually-eligible for Medicare and Medicaid.

Methods: Persons with significant physical disability or serious mental health diagnoses participated fully in all research activities, including co-directing the study, co-moderating focus groups, performing qualitative analyses, specifying survey topics, cognitive interviewing, and refining survey language.

Unmet needs for home and community-based services among persons with disabilities in Massachusetts.

Background: Home and community-based services (HCBS) are vital to the health and well-being of persons with disabilities. However, no previous population-based studies have examined the prevalence of unmet needs for HCBS among working-age persons with disabilities. The purpose of this report is to document the prevalence of unmet need for HCBS among a representative sample of working-age persons with disabilities in Massachusetts.