Virginia’s National Core Indicators Aging & Disability (NCI-AD) Project
This report includes data from a sample of Medicaid members who use long term services and supports (LTSS) that completed the National Core Indicators - Aging & Disability (NCI-AD) Adult Consumer Survey across Virginia in 2023-2024. Comparison results between overall state and each of the state’s five Managed Care Organizations are also included.
Virginia participates in the NCI-AD Project as part of the state’s effort to measure the quality of LTSS and systems performance.
Questions about this report should be referred to Kayla Diggs Brody at diggskg@vcu.edu.
For more information about NCI-AD in Virginia, visit our website at: https://nci.partnership.vcu.edu/.
The Partnership for People with Disabilities is a university center for excellence in developmental disabilities at Virginia Commonwealth University (VCU). VCU is an equal opportunity/affirmative action university providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran’s status, political affiliation, or disability. If alternative formats of this document are needed, please contact the Partnership at (804) 828-3876 or (800) 828-1120 (TTY Relay).
Prepared by: VCU Partnership for People with Disabilities
Prepared for: Virginia Medicaid Program DMAS
2023-2024 Virginia’s NCI-AD Statewide Results
Description of Sample
- The 2023-2024 project year was the first time Virginia participated in the National Core Indicators Aging and Disability (NCI-AD) survey.
- A total of 1,002 Cardinal Care Managed Care Medicaid members from across the state of Virginia receiving LTSS services from all five Managed Care Organizations participated in the NCI-AD survey.
- All surveys were completed by phone either with the Cardinal Care Managed Care Medicaid member or with a proxy who knew the person well.
- 1,002 total respondents
Residence Location
- 77% Metropolitan
- 9% Small town
- 8% Micropolitan
- 6% Rural
Residence Type
- 81% Family Home/Own Home
- 9% Other
- 3% Nursing Facility
- 3% Group/Adult Foster
- 2% Assisted Living
- 2% Senior Living Apartment
Gender & Age
- 59% Female
- 41% Male
- 55 years old (average)
Race & Ethnicity
- White 54%
- Black 38%
- Asian 5%
- Other 2%
- Hispanic/Latino 1%
Medical Background
- 11% ID/DD
- 2% Have a mental health diagnosis
- 7% TBI
- 5% Alzheimer’s/Dementia
- 2% Physical Disability
- 56% Receives Medicare
Health & Healthcare
- 86% Have access to mental health services if they want them
- 77% Can get an appointment to see or talk to their primary care doctor when needed
- 51% Talked to health professionals using video conference/telehealth
- 63% Liked using telehealth
- In the past 12 months:
- 42% Went to the emergency room
- 23% Had an overnight stay in a hospital or rehab/nursing facility and was discharged to go home
Falls
- 21% Have a history of falls
- 46% Have concerns about falling/being unstable
- 71% Have worked with someone to reduce their risk of falling
Support
- 76% of respondents say they have enough help with everyday activities
Food Access
- 15% have to skip meals due to financial worries
- 85% have access to healthy foods when they want them
Support Access to Community
- 93% of respondents say they can see/talk to family/friends they do not live with when they want
- 72% always have a way to get where they want to go
- 69% can take part in activities with others as much as they want
- 21% often feel lonely
Access to Preventative Health Care (In the past 12 months)
- 78% Had physical exam
- 52% Had a vision exam
- 47% Had a dental visit
Services & Unmet Needs
- 92% Services and supports are delivered in a way that is respectful of their culture
- 59% Services meet all their current goals
- 45% Case manager talked to them about services to help with unmet needs
Respect & Privacy
- 63% Have enough privacy where they live (if living in a group setting)
- 69% Others ask before coming in their home/room (if living in a group setting)
Employment
- Overall 23% of respondents want a job
- For respondents aged 18-59: 36% reported they wanted a job and someone has talked with them about job options
Choice & Control
- 74% of respondents say they feel in control of their life
- 87% Can choose/change their services and supports
- 81% Can choose/change the people who provide paid supports
- 82% Can choose/change when/how often they receive services
Staff Longevity & Turnover
- 19% Paid staff changes too often
- 24% Case manager changes too often
Service Coordination
- 73% Have a backup plan if their paid support staff does not show up
Comparison of Each Managed Care Organization Results to Statewide Results
Employment
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Respondents that want a job (Overall) |
20% |
26% |
39% |
22% |
10% |
23% |
| Respondents that want a job (Aged 18-59) |
31% |
44% |
53% |
31% |
19% |
36% |
| Report that someone has talked with them about job options (Aged 18-59) |
37% |
50% |
24% |
44% |
19% |
36% |
Respect & Privacy
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Services and supports are delivered in a way that is respectful of their culture |
97% |
93% |
89% |
93% |
100% |
94% |
| Have enough privacy where they live (if in a group setting) |
63% |
92% |
50% |
29% |
57% |
63% |
| Others ask before coming in their home/room (if in a group setting) |
50% |
100% |
83% |
50% |
43% |
69% |
Choice & Control
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Can choose/change their services and supports |
92% |
83% |
85% |
87% |
91% |
87% |
| Can choose/change the people who provide paid supports |
85% |
88% |
64% |
77% |
88% |
81% |
| Can choose/change when/how often they receive services |
80% |
78% |
70% |
86% |
88% |
82% |
| Respondents say they feel in control of their life |
74% |
72% |
68% |
78% |
76% |
74% |
Services & Unmet Needs
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Services meet all their current goals |
46% |
68% |
58% |
60% |
59% |
59% |
| Case manager talked to them about services to help with unmet needs |
49% |
39% |
50% |
46% |
42% |
45% |
Staff Longevity & Turnover
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Paid staff changes too often |
26% |
26% |
17% |
19% |
9% |
19% |
| Case manager changes too often |
20% |
23% |
22% |
40% |
11% |
24% |
Service Coordination
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Have a backup plan if their paid support staff does not show up |
84% |
72% |
61% |
75% |
57% |
73% |
Health & Healthcare
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Have access to mental health services if they want them |
88% |
76% |
88% |
88% |
89% |
86% |
| Can get an appointment to see or talk to their primary care doctor when needed |
76% |
75% |
75% |
82% |
79% |
77% |
| Talked to health professionals using video conference/telehealth |
55% |
53% |
50% |
46% |
51% |
51% |
| Went to the emergency room (in past 12 months) |
47% |
37% |
49% |
34% |
45% |
42% |
| Had an overnight stay in a hospital or rehab/nursing facility in past 12 months and was discharged to go home |
23% |
18% |
31% |
20% |
26% |
23% |
Support & Food Access
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Respondents say they have enough help with everyday activities |
70% |
82% |
67% |
74% |
84% |
76% |
| Have to skip meals due to financial worries |
19% |
14% |
18% |
17% |
9% |
15% |
| Have access to healthy foods when they want them |
84% |
85% |
84% |
84% |
87% |
85% |
Falls
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Have a history of falls |
24% |
16% |
25% |
24% |
17% |
21% |
| Have concerns about falling/being unstable |
55% |
42% |
44% |
36% |
51% |
46% |
| Have worked with someone to reduce their risk of falling |
62% |
67% |
72% |
68% |
85% |
71% |
Support Access to Community
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Can see/talk to family/friends they do not live with when they want |
96% |
86% |
90% |
94% |
96% |
93% |
| Always have a way to get where they want to go |
74% |
69% |
65% |
80% |
73% |
72% |
| Can take part in activities with others as much as they want |
70% |
65% |
60% |
76% |
74% |
69% |
| Often feel lonely |
23% |
16% |
20% |
27% |
19% |
21% |
Access to Preventive Health Care
| Measure |
Aetna |
Anthem |
Molina |
Optima |
United |
Virginia |
| Had a physical exam in past 12 months |
77% |
77% |
73% |
77% |
85% |
78% |
| Had a vision exam in past 12 months |
59% |
46% |
44% |
50% |
60% |
52% |
| Had a dental visit in past 12 months |
46% |
45% |
40% |
47% |
57% |
47% |