Medicaid

This issue brief discusses the pressing legal needs of older adults and the ways that coordinating health care, legal, and social services can improve their well-being. The brief examines three medical-legal partnership programs serving older adults and explores their impact, including the prevention of homelessness and the improvement of financial stability.

This paper focuses on how state-funded home and community-based services programs can support low-income older adults. It highlights promising practices that support maximum independence for low-income older adults and/or people with physical disabilities and their family caregivers. The paper explores programs across nine states, including Washington state’s emerging innovation: the Medicaid Transformation demonstration.

The Centers for Medicare & Medicaid Services released their monthly report for November 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

This study analyzes the financial burden experienced by people who require long-term services and supports. The study analyzes medical and LTSS spending among older Medicare beneficiaries, particularly the costs of assistive devices and personal care. The results show that for medical services covered by Medicare, beneficiaries with a high need for long-term services spend more than $2,700 a year out of pocket on average, twice as high as those without such need.

While healthcare payment systems are moving toward paying for value, the unique needs of individuals with I/DD and their families means that the transition toward alternative payment models (APMs) for Medicaid-funded services must be undertaken carefully. This white paper includes 14 payment reform principles to guide the development and assessment of new and emerging APMs for Medicaid I/DD services. The paper also includes 13 recommendations for current and future APMs for I/DD services.

The Centers for Medicare & Medicaid Services released their monthly report for October 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

This semi-annual report analyzes the fiscal condition of the states and includes data summaries of state general fund revenues, expenditures, and balances. State fiscal conditions continue to show signs of improvement and greater stability. Fiscal 2019 is projected to be the ninth year in a row with moderate state spending and revenue growth. State general fund spending is expected to grow 4.3 percent in fiscal 2019 compared to fiscal 2018 levels.

The Centers for Medicare & Medicaid Services released their monthly report for September 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

This recently released report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019. The report focuses on changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

This study from Milliman highlights the success that MLTSS programs have had in reducing institutional care for older adults and people with disabilities compared to states operating a fee for service system, both in absolute numbers as well as the acuity level of consumers receiving services in nursing facilities.