Expenditures

Presentations from the 2016 National Home and Community Based Services (HCBS) Conference.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2017 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

The Community Living Policy Center reviewed the effects of the Better care Reconciliation Act (BCRA) should it pass. Upon review, they conclude that had it been implemented in the mid-2000s then it would have reduced Federal reimbursments becuase of the proposed caps.

Value-Based Payment (VBP) are alternative payment models that reward high-quality, cost-effective care. While many Medicaid state programs are developing VBP systems for physical health services, they have not made such advances in Medicaid behavioral health care services. The Center for Health Care Strategies’ (CHCS) brief, produced with the California Health Care Foundation, details how five states are innovating their Medicaid managed care organizations through VBP models.

This report from Truven Health Analytics describes Medicaid long-term services and supports (LTSS) expenditures. The report shows federal fiscal year 2015 data, along with updates for FY 2012 through 2014 spending. Along with discussing trends in Medicaid LTSS expenditures, the report includes numerous data tables that summarize national and state-level expenditures by service category and state.

The Office of the Actuary in the Centers for Medicare & Medicaid Services (CMS) annually produces projections of health care spending for categories within the National Health Expenditure Accounts, which track health spending by source of funds (e.g. private health insurance, Medicare, Medicaid), by type of service (hospital, physician, prescription drugs, etc.), and by sponsor (businesses, households, governments). The latest projections begin after 2014 and go through 2025.

This primer describes long-term services and supports (LTSS) delivery and financing in the U.S. and highlights covered services and supports, types of care providers and care settings, beneficiary subpopulations, costs and financing models, quality improvement efforts, and recent LTSS reform initiatives.

This report addresses: 1) federal programs that fund HCBS and supports for older adults, in particular in-home and nutrition services, affordable housing, and transportation; 2) how HCBS and supports are planned and delivered in selected localities; and 3) agencies’ efforts to promote a coordinated federal system of HCBS for older adults.

This report reflects on Medicaid’s accomplishments and challenges and considers the issues on the horizon that will influence the course of this major health coverage and financing program moving forward. The report follows Medicaid’s evolution, including major legislative changes and other inflection points in the program’s history and analyzes how Medicaid threads through our health care system today and the measure of its impact.

This report developed new estimates of the program's effects for Program of All-Inclusive Care for the Elderly (PACE) enrollees in eight states based on more recent data. PACE plans provide coordinated acute and long-term care services to nursing home eligible seniors residing in the community.