Expenditures

The 2008 national Aging and Disability Resource Center meeting took place in October in Boston. Find here the presentations and handouts from the workshops and plenary sessions. Topics ranged from nursing home diversion to quality to information flow and technology.

Answering the question posed in the title is one key to evaluating Medicaid Buy-In (MBI) programs. This issue brief, the fifth in a series on workers with disabilities, compares demographics, health status, and expenditures between these groups. Significant areas of difference that were identified are race, gender, diagnoses, and expenditures.

Should a state use the cost reimbursement or milestone-outcome payment options in their Ticket to Work (TTW) programs? Vermont commissioned this study to answer this question and to predict future TTW income for the state and for employment network partners.

This paper examines the extent to which states have balanced the delivery of Medicaid-funded LTC services and supports to people in their homes and in institutions. What is unique about this report is its primary focus on older people and adults with physical disabilities separate from other LTC populations, such as people with developmental disabilities. Explore what has been accomplished under current Medicaid law and review how federal policies impact the ability to balance service delivery.

This paper models the effect of occupancy rates on nursing home reimbursement. It surveys nursing home methodologies generally and specifically models the rate setting systems of California, Indiana and Pennsylvania. The modeling indicates that much of “the fixed costs” would not get calculated back into the rates. The costs that do would be allocated across all resident days used in rate setting regardless of payer source, including Medicare and private pay, limiting the Medicaid impact.

This issue brief and background paper outline the ongoing history, services, and expenditures associated with the Older Americans Act (OAA). The report also summarizes services that are funded through the OAA and other federal and state funds and are provided by the state and local agencies that comprise the Aging Services Network. Finally, key challenges to meeting the needs of the changing population are identified, especially with regards to service improvement and funding.

Whether by establishing strong referral protocols with local or state veterans agencies or by serving veterans directly, ADRC staff should be trained to assist veterans who come to ADRCs for information, assistance, or referral. This Issue Brief includes an overview of veterans, the services and benefits offered by the VA, examples of productive collaborations between veterans agencies and ADRCs, and resources for ADRCs.

A new AAHSA report proposes that individuals and government share the burden of paying for long-term care costs. The final report recommends that the nation move away from Medicaid's welfare model of long-term care financing and adopt an insurance system that is funded by premiums, provides cash benefits so consumers have optimal flexibility in choosing care options, and offers as close to universal coverage as possible. Review the AAHSA Cabinet LTC Financing Strategy.

The December Gerontologist highlights a study which reviewed the state-level Medicaid 1915c data from 1992-2001 and compared state predictors of waiver utilization and expenditures for waivers serving both older and working age individuals relative to waivers serving individuals with intellectual and developmental disabilities. The results found that increased community-based-care capacity appears to be an important factor in efforts to expand the availability of Medicaid community-based-care.

This report provides a framework and some of the basic data necessary to understand why the future of the United States will not be determined solely by anticipated changes in the size and age distribution of the population. The paper also examines public policies that encourage and facilitate education, basic research, and the application of promising technologies to enhance the well-being of current and future generations of older people.